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Pigmentation Why & How it forms

The colour of the skin is influenced by a number of pigments, including melanin, carotene, and haemoglobin. melanin is produced by cells called melanocytes which are found scattered throughout the bottom layers of the epidermis. The melanin is then transferred into keratinocytes via a cellular organelle called a melanosome. Dark-skinned individuals produce more melanin than those with pale skin.

Exposure to the sun causes melanin to be manufactured to make keratinocytes, as sun exposure stimulates keratinocytes to secrete chemicals that stimulate melanocytes.

The build-up of melanin in keratinocytes results in the darkening of the skin. Increased melanin can protect the epidermal cells from UV ray damage and the breakdown of folic acid, a nutrient necessary for our health and well-being. However, too much melanin can interfere with the production of vitamin D, an important nutrient involved in calcium absorption, also resulting in the darkening of the skin. 

The amount of melanin present in our skin is dependent on a balance between sunlight, folic acid destruction, protection from UV radiation and the production of vitamin D.

10 days after initial sun exposure melanin synthesis is at its peak (Keratinocytes), which is why pale-skinned individuals tend to suffer sunburns of the epidermis initially. Dark-skinned individuals can also get sunburn but are more protected than are pale-skinned individuals. Melanosomes are temporary structures that are eventually destroyed by fusion with lysosomes; this fact, along with melanin-filled keratinocytes in the stratum corneum sloughing off, makes tanning impermanent.

Too much sun exposure can eventually lead to wrinkling due to the destruction of cellular structures of the skin, and in severe cases, can cause sufficient DNA damage to result in skin cancer. When there is an irregular accumulation of melanocytes in the skin, freckles appear. Moles are larger masses of melanocytes, and although most are benign, they should be monitored for changes that might indicate the presence of cancer. Moles range from benign accumulations of melanocytes to melanomas.

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TYPES OF PIGMENTATION

POST-INFLAMMATORY
HYPER-PIGMENTATION 

Post-inflammatory hyperpigmentation occurs when a skin injury or trauma heals and leaves a flat area of discolouration behind. It’s commonly found among acne sufferers and can also be caused by cosmetic procedures such as dermabrasion, laser treatment and chemical peels.

Men and women are equally susceptible, and all skin types can get post-inflammatory hyperpigmentation although it is more prevalent in darker tones of skin.

MELASMA

One specific type of hyperpigmentation is melasma, a condition in which brown patches appear on the face. It can be due to hormonal changes during pregnancy or from sun exposure. Women are much more likely than men to develop this condition. The brown or grey-brown patches of melasma appear most often on the cheeks, forehead, nose and chin.

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In women melasma often fades on its own after pregnancy or after a woman stops taking contraceptive pills.

ACANTHOSIS NIGRICANS

AGE SPOTS

Age spots are also known as Liver Spots.  Flat tan, brown or black spots on the skin are common with age. Older adults, people with fair skin and people who've spent lots of time in the sun are most prone to age spots.

The main symptom is a dark spot on the skin. They appear most often on sun-exposed areas, such as the face, hands, shoulders and arms and are harmless and don't need treatment.

ALBINISM

This is a genetic disorder that affects the colouring of skin, hair, and eyes. The effect on the body can be complete or partial. The defect is primarily due to the inability of melanocytes to produce melanin. Individuals with albinism tend to appear white or very pale due to the lack of melanin in their skin and hair.

As melanin helps protect the skin from the harmful effects of UV radiation. Individuals with albinism tend to need more protection from UV radiation, as they are more prone to sunburns and skin cancer.

They also tend to be more sensitive to light and have vision problems due to the lack of pigmentation on the retinal wall.

Acanthosis nigricans is a skin disorder characterised by darkening (hyperpigmentation) and thickening (hyperkeratosis) of the skin, occurring mainly in the folds of the skin in the armpit (axilla), groin and back of the neck.

Acanthosis nigricans is not a skin disease but a sign of an underlying condition or disease. The cause is still not clearly defined but it appears to be related to insulin resistance.

There are two important types of acanthosis: benign and malignant.

VITILIGO

A disease that causes the loss of skin colour in blotches. Vitiligo occurs when pigment-producing cells die or stop functioning.

Loss of skin colour can affect any part of the body, including the mouth, hair and eyes. It may be more noticeable in people with darker skin.

This leads to a loss of colour in patches. Neither albinism nor vitiligo directly affects the lifespan of an individual.

WHAT TREATMENTS ARE AVAILABLE

CHEMICAL PEELS

There are three varieties of chemical peels, the differences between them depend on the depth it penetrates and the percentage of ingredients within the peel.

Light peels are known as superficial peels and penetrate up to 2 layers of the epidermis, light peels can have good results treating pigmentation as well as wrinkles, acne, uneven skin tone and dryness. Treatment can be as little as one to two weeks apart due to being gentle causing very little to no downtime.

Medium peels can remove up to 6 layers of the epidermis. This has good results for the removal of pigmentation, however, they can be uncomfortable to receive than lighter peels because of the concentration of ingredients. Downtime can be up to 8 days depending on the peel used.

Deep peels are medical grade peels that can remove several layers of the epidermis depending on what peel you choose. These are only recommended to be performed by a cosmetic doctor. Downtime will be much longer than with a medium peel.

INTENSE PULSE LIGHT ( IPL)

Known as a Non-ablative laser. IPL is also known as a photo facial. IPL therapy can treat most mild pigmentation and requires multiple sessions.

IPL treatments won't suit everyone as it's not recommended for the treatment of melasma or people with darker skin types.

ABLATIVE LASERS

Laser treatments are legally only available by a cosmetic doctor, These are ideal for severe pigmented areas.

As with any medical procedure, laser therapy isn’t for everyone. It can also cause side effects like discolouration, scarring, and infection.

MICRODERMABRASION

Microdermabrasion is typically used to treat sun-induced pigmentation, wrinkles and enlarged pores. It can be combined with light peels to treat acne. 

There is no skin treatment that will help improve Acanthosis Nigricans.

I recommend you seek advice from a cosmetic doctor to see what options they may be able to offer you. The primary aim when suffering from this condition is to correct the underlying disease process.

When it comes to Vitiligo there is no cure, however, treatments with a cosmetic doctor can create a uniform skin tone by either restoring colour (repigmentation) or eliminating the remaining colour (depigmentation).

Common medical treatments include camouflage therapy (cosmetic tattooing), repigmentation therapy, light therapy and surgery.

WHAT PRODUCTS ARE BEST TO TREAT PIGMENT

ULTRA BRIGHTENING RANGE

This range has been manufactured to help control and remove unwanted pigmentation.

Key ingredients of Niacinamide, Squalane and Linoleic Acid.

ULTRA C FIRMING RANGE

Ultra C Firming Eye cream has l-ascorbic acid, another great ingredient​.

OVER THE COUNTER

Skin lightening products are available by prescription or over-the-counter. Typically, a product will have one of the following ingredients:​

• Hydroquinone

• Kojic acid

• Vitamin C

• Glycolic acid

• Azelaic acid

• Retinoid

Remember, using the wrong product can make the pigment worse. It is best to seek advice before treating pigmentation yourself at home