01 Jun Melasma vs Pigmentation
What is Melasma
There are essentially three different types of Pigmentation issues that can arise in the skin. Hyper Pigmentation is found in the skins outer most layers called the “Epidermis.” This can arise following sun exposure where the skin has tanned but doesn’t do so evenly. Often older people develop Hyper Pigmentation because the skin cells found in the deeper layer (Stratum Basal) called Melanosomes are responsible for making pigment granules called Melanin. Melanosomes become damaged by UV radiation and other environmental factors that result in DNA damage. This is the software that controls how the cell behaves and when there is a mutation the cell no longer functions normally, often over producing melanin granules. We like to describe this breakdown, as being just like when a fireman hoses down a burning house but unfortunately, floods the soil around him as the hose doesn’t get switched off! Combined with a decrease in skin cell renewal rate, it is no surprise that patches of brown spots appear on the skin’s surface.
Having determined when skin damage first sets in we know it is often before the age of twenty-four. This is important to register because even if sun exposure has been limited or stopped later in the life, the healthy processes that helps the skin to repair following exposure to UV radiation and remain even in colour have already started to decline many years beforehand. The rot has effectively already set in!
All skin types are prone to developing Hyper Pigmentation but the large, brown patches are found in darker skins because by design they are more likely to product browner pigment. Fairer skin types are programmed to produce more red that is why when exposed to sunlight their skin burns. Interestingly what have lead to an increase in seeing issues with pigmentation aren’t sun exposure but the different skin types that have emerged due to inheriting a combination of genetic heritage. If one parent is fairer skinned than the other. Having a combination of different skin types, even when a person appears fair skin in the winter months, if they tan when exposure to sunlight (rather than burn) their skin behaves in a similar fashion to a dark skin.
This “deviated” skin type is far more likely to see issues with Hyper Pigmentation and must be particularly vigilant of how they long they exposure their skin to sun and take other measures to protect the skin including wearing a hat when in direct sunlight.
In addition a number of women are unaware that taking the contraceptive pill can increase the likelihood of developing Hyper Pigmentation because the effect of the medication increases photosensitivity (which is the likelihood of burning). The risk of Post Inflammatory Hyperpigmentation (PIH) is also greater in darker skin types that are burnt or irritated by contact with a product that is made with irritants such as perfumes.
In all cases of Hyper Pigmentation where the damage lies isn’t as “deep” in the skin as Melasma. The skin darkens more than the surrounding skin with exposure to sunlight. For this reason it’s much more challenging to treat and requires a blend of many different active ingredients to tackle the root causes that do include sun but the over production of pigmentation is related to hormonal shifts that happen in pregnancy or other auto immune conditions such as Hyperthyroid. The effect of medications including Statins taken to reduce Cholesterol also raise the skin’s photosensitive. In many cases it’s normal to see a mixture of two different types of pigmentation Hyper Pigmentation and Melasma. The Melasma looks like a patch, around the face and often looks like a mask. Causing dark patches to appear above the lip, forehead on the cheeks and under the eyes. The condition has been found to run in a family that also suggests it could be hereditary.
Some factors to consider include:
- Hormone treatments – oral contraceptive pills that contain oestrogen and/or progesterone, hormone replacement and intrauterine devices are causing factors in about a quarter of affected women.
- Pregnancy – however, the pigmentation usually fades a few months after the birth.
- Hypothyroidism – low levels of circulating thyroid hormone
- Sun Damage – the most common cause and the fortunately the most avoidable.
- Other medications – some therapies for cancer and even general toiletry products can lead to the onset of Melasma.
Excessive skin pigmentation is a result of abnormal production and deposition of melanin by the melanocytes. Melanocytes are pigment-producing cells. The number of melanocytes present in our skin will determine our skin colour. Production of melanin is dependent on UV or sun exposure, and is a natural protective mechanism of the skin.
Hyperpigmentation, areas that are darker than the rest of the skin, result from excess melanin production and deposition.
SKIN PIGMENTATION TREATMENT WITH TOPICAL LIGHTENING CREAMS
The first method of treating skin pigmentation is to prevent its appearance or worsening by daily application of sunscreen. UV exposure from sunlight or sun beds will invariably worsen any existing pigmentation and promote further pigmentation to arise. The risk of skin cancers also rises with increasing exposure to UV.
At Skin Envy, we recommend physical sunscreens as opposed to chemical sunscreens. Physical sunscreens contain titanium dioxide and zinc oxide. These are not absorbed by the skin and provide long lasting protection through the day. Chemical sunscreens such as Para-aminobenzoic acid, are absorbed into the skin and need reapplication after two hours. Studies have found that these chemicals are absorbed by the skin and found in the liver soon after application. All sunscreens should be applied with two coats. Like painting a wall spots are often missed with only one coat. Furthermore, sunscreen should be applied everyday, even if it is cloudy, or overcast, as UV light is still present. It is also important to avoid direct sunlight, especially during the middle hours of the day, seek shade when possible, and wear a hat and protective clothing.
Topical lightening agents can be used in conjunction to help reduce skin pigmentation. Topical lightening agents help to reduce pigmentation by inhibiting enzymes that produce melanin (skin pigment) and by increasing the turnover of the skin to flush out existing pigmentation. Common lightening agents include; hydroquinone, kojic acid, paper mulberry bark extract, retinoids, and glycolic acid.