Pigmentation & Dark Spots Treatments

Pigmentation can be caused by a number of factors including hormones, medications, genetics and sun exposure. The melanocyte cells over react by producing excess melanin, causing the increase in the pigmentation. Targeting hormones and maintaining sun protection is the best way of preventing pigmentation.

The best treatment for pigmentation involves multiple steps. Skin assessment from a dermatologist and getting the correct advice is essential. Most patients respond best with a combination of prescription products and a revised skincare regime.

A short course of dermatologist recommended anti melanocyte preparations, which inhibit the main tyrosinase enzyme, go a long way in quick and lasting results. A revision of one's skin care is necessary. Your dermatologist may decide to revise the use of the oral contraceptive in patients using the pill. Topical applications may sometimes be as effective as a laser treatment. A dermatologist can advise you on an appropriate treatment. Generally it will take at least 6-8 weeks to see any significant improvement.

Isn't laser the best treatment for my pigmentation?

Many of us feel that lasers are the best and likely permanent treatment for pigmentation. This is because of the heavy spends on marketing campaigns and the availability of so much information shapes our perceptions about lasers.
Also, while thinking of lasers for pigmentation generally we forget that not all lasers are created equal this applies more so to lasers for pigmentation. There are many types of lasers, which can cause significant aggravation in certain types of pigmentation. The choice of laser and the type of pigmentation, the patient's lifestyle- all of these need to be factored in before making a sound choice of which laser to undertake.
It is best to see a dermatologist before undergoing laser for pigmentation. We should also remember that when chosen correctly, lasers could provide great results in the management of pigmentation. It is also important to note that lasers may not offer a permanent solution to all types of pigmentation.

The following points enlist important skin care products used to help lighten the skin and for patients who have mild pigmentation. Some of these products are used in conjunction with each other and some can be used alone. Different treatment regimens will differ from patient to patient depending on the severity of the uneven skin tone. Please note sunscreen is essential when being treated with pigmentation treatment products.

While choosing a product for pigmentation it is important to see what type of pigmentation is visible on the skin. The pigmentation might be due to skin damage, collagen damage and vascular change. It is important to not only use a skin lightening cream but also compliment it with products that will help the skin regenerate and rejuvenate reduce inflammation and reverse collagen damage.

So one can choose to start with products that contain Vitamin C, low doses of stable retinols or retinaldehyde, low doses of fruit acids, tranexamic acid and botanicals like soya isoflavones etc.

CLEANSER

Use of a cleanser in pigment management is generally of adjuvant and supportive use only, as all the actives that are present need a certain contact time with the skin, and when we use a face wash or cleanser the contact time is very limited. This reduces the efficiency of active ingredients. Appropriate cleansing helps better the efficiency of the main active ingredient based products, at the same time it protects the skin barrier.

Using a cleansing system from our experts provides an innovative method of cleansing. It makes the process extremely effective. This aids in the natural turnover of the skin to reveal fresher, vibrant, even toned plump skin. It is essential for some skin types that you use an exfoliating cleanser. Please be aware that some prescription creams will have exfoliating agents or exfoliating effects. In these cases, make sure to speak to a consultant to decide which one is the best for you.

Also it is important to remember here, that certain skin types cannot tolerate or should not be doing exfoliative cleansing as it can make the skin more sensitive.

VITAMIN C SERUM

Vitamin C is commonly used in conjunction with other ingredients to effectively lighten and even the skin tone. It is generally applied in the morning and nights after cleansing, it lightens and brightens the skin whilst also hydrating the skin. Vitamin C helps stimulate collagen to give you plumper looking skin.

One can choose from a range of options of Vitamin C serum containing different active ingredients. Some are designed for specific anti-aging purposes, some contain vitamin C with hydrating ingredients, some contain vitamin C with sunscreen and yet others will have vitamin C with skin brightening agents.

It is important to also understand that Vitamin C is a highly unstable molecule. Many products are available online you may find that a few don't work at all because the form of Vitamin C that is chosen is not a stable form or Vitamin C does not combine well with certain ingredients, hence we find some products work better than others in such cases for a better understanding you can talk to our consultants or go with our recommendation.

HYDROQUINONE 2.0%

This is a widely used ingredient mostly in 2% to 5% strengths. It is a pharmacological gold standard for skin lightening and anti-pigmentation effects. But judicious use is extremely important, as most of the trouble starts when we overdo it or use higher strengths. If the nature and reason for your pigmentation is underlying inflammation, then hydroquinone is not for you. Hydroquinone should preferably be used under supervision.

EXFOLIATING MOISTURISER

A good exfoliating moisturizer will encourage the renewal of the skin and give added benefits to the serums and active medications. Commonly they will contain AHA’s such as glycolic acid and or lactic acid, sometimes retinol in varying strengths. They will continually encourage the turnover of the skin cells to help lighten the skin. These include products such as Neostrata or Obagi Exfoderm Forte, Filorga sleep and peel, various Sebium range and Uriage hyseac 3 regul range of products. Aveil Exfol-A is one cream based comprehensive exfoliator for tough to treat skin conditions, but it is best to get complete clarity before commencing the use of any of these. Dry Skin Type patients must take special precautions.

SUNSCREEN

Sun can also damage skin cells, which causes premature photo ageing and early signs of fine lines. Make sure to use a sunscreen with a very high UVA protection, and as not all sunscreens are made the same.

As we have always maintained, use of sunscreen with added anti redness and anti-inflammatory properties is of additional use in protecting the skin.

Also if you sweat a lot or are going out for water sports and water-based activities, then you must choose a water resistant or waterproof sunscreen. These water resistant sunscreens are generally oily barring a few like Isdin 50 fusion water. Most sunscreens clearly mention how long they are water resistant. Generally 40-80 minutes of water resistance is offered on most water resistant brands.

There are some oral sunscreens also!! Many antioxidants serve to protect us from sun induced skin and free radical damage.

Most common is beta-carotene. One must keep in mind that beta carotene and some other oral sunscreens may contain high concentrations of vitamin A like compounds and may not be suited for someone planning a pregnancy soon or currently pregnant.

There are many natural supplements known to protect from sun damage and also reduce pigmentation, like rubia cordifolia. Tablets and concoctions have traditionally been used in Ayurveda.

TRETINOIN CREAM

Tretinoin cream is known to reduce fine lines, wrinkles and pigmentation. Dermatologists around the world commonly prescribe tretinoin; it is a Vitamin A derivative that is used to treat multiple skin issues. It can cause severe irritation to the skin if it is not used correctly. This cream should be introduced very slowly in one’s regime as immediate regular use can cause severe irritation.

Side effects of tretinoin cream include: The skin being light and heat sensitive, dryness and stinging

Depiderm Fluide is one example of a hydroquinone free skin-brightening product to fight pigmentation. This light fluid corrects brown spots and makes the complexion look even-toned, while ensuring the skin is moisturized and protected. Its light and melt-in texture leaves the skin supple and comfortable.

Corrects brown spots and unifies the complexion. It contains a patented Cx complex, which is a concentrated solution with 20% anti-brown spot, soothing and antioxidant active ingredients, Pea and sucrose extracts, Vitamin C, Thermal spring Water, Enoxolone, it corrects brown spots and evens out pigmentation.

The AHAs help to boost the exfoliation of pigmented epidermal cells. It also prevents brown spots.
With its SPF 15 UV filter system, this cream prevents the appearance of brown spots every day.

Results 30% reduction proven in studies on the intensity of the brown spot and +90% increase on skin evenness. It is also hypoallergenic and noncomedigenic.

Active ingredients

• Cx complex (Pea and sucrose extracts, Vitamin C, Uriage Thermal Water, Enoxolone)
• AHAs
• SPF 15 UV filter system

Can be purchased without a prescription but please speak to one of our consultants before starting the treatment.

Side effects: Irritation and light sensitive. Always use it at night time.

Exfoliation is important to get rid of dead skin cells and to allow the healthy turnover of new skin cells. Chemical exfoliants are preferred, as this is a much more effective way of exfoliating the skin. These are most commonly AHA’s which can also aid in lightening the skin. Exfoliation removes the dead skin cells leaving your skin looking rejuvenated, even toned and plumper. Some of these skincare products will be used on a daily basis to encourage routine exfoliation and lightening of the skin.

We commonly suggest a chemical face peel. This is much stronger and generally provides excellent results. Face peels should only be conducted by trained practitioners as it contains very high percentages of actives and follow up care is essential.

The choice of makeup is still an important step in pigmentation management. Using the correct type of makeup and skincare regime can aid in slowing down premature photo-ageing and give you healthier looking skin. As previously mentioned some makeup containing spot lighteners will help in making the treatment more effective and easier.

• Sun avoidance
• Review the use of oral contraceptives if they are being used
• Pigmentation of the folds can be caused by hormones and high Glycemic index foods and high carbohydrate foods. Please refer to DARK UNDERARMS & NECK TREATMENTS.
• Gentle exfoliators and lightening products.
• Cosmetics and products containing kojic and azelaic acid if you have acne.