Dermatology series: Hyperpigmentation
This week we're starting to zone in on the exact kinds of treatment dermatologists can offer for various conditions. To kick things off, we'll be looking at how they can help with hyperpigmentation and sun damage, two things which are pretty common and can make people very insecure.
First up, it's important to understand what you're dealing with. Hyperpigmentation is caused by the body producing too much melanin, or pigment. They can take years to show up on the skin though, so you won't always know when it's happened to you.
Age spots (sometimes called sun spots) appear at random, in patches or scattered and aren't usually symmetrical. They are caused by sun exposure and can respond to retinoid cream and lasers which help fade the pigmentation.
Melasma is different and is characterised by dark patches on the forehead, cheeks, chin and upper lip. They are usually symmetrical, can be densely pigmented and tend to be linked to hormonal changes. Also sun can make them worse. It tends to come on in women aged between 20 and 40, with pregnancy, hormone treatments like the oral contraceptives and an underactive thyroid leading to it.
Another difference between age spots and melasma is how they are treated.
"Melasma can be recurrent and refractory which makes it difficult to treat," Dr Anjali Mahto of Cedars Dermatology told Cover Media.
"General measures should include rigorous, high factor, broad-spectrum sun protection throughout the year (SPF50+) and avoidance of hormonal contraception, if possible. There are a large number of topical treatments available which aim to prevent new pigment formation e.g. hydroquinone, azelaic acid, kojic acid. Regular chemical peels can also be used to remove pigment in the upper layers of the skin."
While sun spots may be treated with lasers, it is not recommended with melasma. Many lasers have been tested on the condition, but it's viewed as controversial because it can actually make things worse.
"In an ideal world, a laser would only destroy melasma pigment in the skin but leave the other normal skin cells alone," Dr Mahto explained. "In actual practice, this is almost impossible to achieve, and the resultant normal skin cells that are damaged in the process of laser treatment may also cause pigmentation change. So, essentially, many lasers can actually cause further pigmentation problems if patients are not selected carefully."
If your issue is more with freckles, there is little point in visiting a dermatologist because once you have them, you can't get rid of them. However, keep an eye out for any which seem rougher than usual.
"Using laser treatment for pigmentation like this can be dangerous as in rare cases there may be an underlying skin cancer that is masked by the laser," Dr Anand Patel, Consultant Dermatologist and Dermatological Surgeon at BMI The Park Hospital in Nottingham, explained.
"Sun damage can also cause pre-cancerous change which usually presents as scaly rough areas on sun exposed skin. These are called actinic keratosis and are not dangerous but do need treatment most of the time, as few can turn into skin cancer over many years."
Dr Gabriela of Aesthetics Lab has developed a two step process to treating hyper pigmentation, involving Nano-peptide Rejuvenation and then her Dr Gabriela Beauty Face Lift Serum and Advanced Molecular Mask. The first sees the patient have injections of growth factors and vitamins which promote cell renewal, with the mask promoting blood flow. When combined, the process of cell renewal and collagen production is sped up, cells turnover quicker and hyperpigmentation should lessen.