Lucija Kračun, MD
Specialist of family practise
AAAMED diploma for aesthetic medicine
Do pigment spots justifiably get on our nerves or are we special because of them?
The once lovely freckles on our foreheads, noses and cheeks are slowly spreading over our faces over the years. Cemetery flowers, as pigmented spots (or hyperpigmentation) were once jokingly said by one of the greatest Italian icons of the 1950s, Gino Lollobrigida, are terribly annoying. If you have them, then you certainly know how hard it is to get rid of them. But even if at 94 you look as incredibly good as Lollobrigida, you can of course really whistle at these chronological traitors. But most don’t have that luck.
And so they surprise us all of a sudden, on vacation, during pregnancy, after acne or skin inflammation, in old age or while taking a certain medication… And they remain – these dark spots on the skin, irregular shapes that appear mainly on the face, décolleté and arms. Unlike maternal, pigment spots are not bulging, which means that you will not feel them if you rub them with your hand, and in most cases they are not dangerous. However, unlike naughty freckles, they are aesthetically disturbing and unattractive for most. That is why we are in a very bad mood when we look at them and we keep asking ourselves the question: will they disappear or will they stay forever?
Let’s meet annoying intruders
If we want to get rid of uninvited guests effectively, we must of course know them as well as possible. So when does hyperpigmentation “visit” us? The moment melanocytes, our small pigment factories, decide it’s time for overtime, for more melanin then. And this happens when they feel threatened, or when they are motivated to do so by various factors. That is why it is so important to take proper care of and protect your skin every day.
Among the most common causes of hyperpigmentation are:
• excessive sun exposure,
• acne,
• hormonal changes during pregnancy or menopause
• autoimmune diseases and certain medicines,
• inadequate diet – too much sugar and processed foods,
• age and
• genetics.
How do we recognize them? Pigment spots often differ from the natural color of the skin in beige to dark brown, sometimes they also have an ocher or slightly reddish tinge. Their shape is well visible, while the size and intensity of the coloration can vary from season to season. Because both depend on skin exposure to the sun, blemishes usually fade slightly in the winter months, while dark spots reappear in the summer season.
Of course, choosing a qualified professional who will openly advise you on the best procedure for your problem and skin is even more crucial in this case.
Lack of sleep, fever and stress
Despite the general belief that hyperpigmentation is (solely) the result of exposure to UV rays, research by Japanese scientists reveals that allergies, fever and stress are also common culprits. As a result of which inflammatory processes occur under the skin and thus again to the accelerated production of melanocytes. With a lack of sleep due to congestion, pigment spots also appear. The reason for them is therefore inflammatory reactions, so you can also fight melanin herring around your neck due to an allergy to your favourite necklace. And even the dark circles of dark under-eye circles, which we have so far believed to be (merely) the result of poor blood circulation, sensitive skin, and less collagen production, are supposed to be the result of inflammatory processes. Therefore, the next time you choose facial care, be sure to choose 100% organic natural products and thus avoid allergies, and most likely annoying dark spots.
There are many options that are worth considering well when looking for the right solution.
The best ingredients and products
How effective dermocosmetic products are in combating hyperpigmentation depends on their correct choice, regular use and length of use. The process of reducing or eliminating pigmentation is time-consuming and can sometimes take a long time. But it is important that we persevere and not give up too quickly.
There are so many products on the market, but the gold standard for lightening solutions remains hydroquinone. With regular use, blemishes fade in about three months, and in combination with a retinoid, we can be successful in as little as four to six weeks or even sooner.
However, there is some controversy surrounding hydroquinone. There are many studies about hydroquinone as well about the serious side effects. Always consult with an expert before using hydroquinone. Although it is often referred to as a “whitening” agent, it does not really whiten the skin. The secret of its success lies in inhibiting the action of the enzyme tyrosinase, which forms a pigment, and thus prevents the darkening of new cells. Nevertheless, we recommend that you use it only for a short time.
Retinoids – such as prescription tretinoin and over-the-counter retinols – are also great for fading blemishes, as they block the transport of melanin to epidermal cells and reduce melanocyte activity. The appearance of dark spots is also successfully reduced by alpha hydroxy acids such as glycolic, which accelerate the regeneration of skin cells and remove excess pigment on the surface. We also highly recommend the use of products with vitamin C in a high concentration. There are many forms of vitamin C. A powerful antioxidant helps to stop the production of melanin.
Best practices
Although the ease of use of cosmetics is appealing to many, medical-aesthetic treatments are certainly the fastest and most effective way to reduce dark spots. But – before choosing a procedure or method of treatment, be sure to tell the chosen specialist the entire family history and make sure that you do not risk side effects.
Chemical peels and lasers are certainly the best choice in eliminating hyperpigmentation. With the former, we improve the appearance of the skin and lighten the pigmentation by controlled removal of the upper layers of the epidermis with the help of hydroksy acids and TCA. With different types and different concentrations of the acid used, we also achieve different depths of peeling action and thus its effects. Only one, independent acid or cocktail or a combination of several can be used in therapies, as each has a specific action. Studies have shown, for example, that pyruvic acid stands out for its effectiveness in exfoliation, as this ingredient is particularly effective in reducing hyperpigmentation. But while a range of chemical peels can help, be careful because, if you make the wrong choice or use it, the condition can get significantly worse.
Revolutionary progress in the treatment of pigment disorders, as said, is also achieved with sublablative or other pigment-specific lasers and other light sources ( IPL) .Their principle of operation is the absorption of light in melanin, where it is converted into heat. The heat then breaks down the pigment into smaller particles that move to the surface of the skin and exfoliate or excrete through the lymphatic system.
Of course, choosing a qualified professional who will openly advise you on the best procedure for your problem and skin is even more crucial in this case.
During the procedures, it is definitely worth mentioning microdermabrasion, which also enables gradual and controlled mechanical peeling of the epidermis. By removing melanin-containing epidermal cells, the pigmentation fades and the skin becomes brighter. Dermabrasion is a more invasive procedure and is performed in dermatological and aesthetic clinics.
Combination is the key to success
Some pigment spots cannot be permanently removed, but, as we have seen, they can be lightened with the help of various cosmetic and dermatological procedures. With proper care and procedures, the condition is then maintained in such a way that the pigmentation is not disturbing, or that there is no deterioration or the appearance of new ones.
Because there are different types of pigment changes that differ in their cause and morphological characteristics, the approach to removing them also differs. Also, long-lasting and extensive hyperpigmentation cannot be removed with just one type or one implementation of the pigmentation removal procedure. The most effective is a combination of different procedures, the use of lightening creams and strict protection from the sun throughout the year. Always leave the choice of a suitable method for removing pigmentation to doctors or other professionals as dangerous malignant skin cancer malignant melanoma may be hiding behind the indefinite pigment change.
