There is Light after dark

The summer sun has been gone for a while, but it can leave behind some telltale signs. You look in the mirror and notice darkened areas or spots on your face, neck, or décolletage. Our skin is a reactive organ, affected by everything from hormones to UV light, or injuries to the skin. Even an inflamed pimple can trigger the skin’s defense mechanism; melanin. These insults to the skin add up, resulting in patches of excess pigmentation and uneven tone. This can be quite distressing to deal with, but good news, there are effective products and treatments that can restore a more even skin tone and texture. 

What is Hyperpigmentation

Pigment production begins in the deeper layers of the skin and naturally rises to the surface where it concentrates and forms dark spots. Hyperpigmentation occurs when melanocytes, the pigment producing cells of the skin, produce too much pigment. When melanocytes are injured or unhealthy, excess melanin can clump together causing that area to appear darker. Pigment tends to form faster than it’s shed away and the longer it’s left untreated, the more deeply rooted it becomes. This leads to the development of light to dark brown, black, gray, red or even pink spots or patches on the skin's surface.

Why Do We Get Hyperpigmentation

Many things can lead to hyperpigmentation, but the most common causes include UV exposure, inflammation and/or trauma on the skin, and acne. Certain medications like oral contraceptives or photosensitive drugs, medical conditions such as thyroid disorders, hormonal changes like puberty or pregnancy, and age can also contribute to hyperpigmentation. 

UV exposure is the main cause for discoloration. The sun’s radiation stimulates melanin production. While a tan is beautiful, it’s actually your skin's defense mechanism, absorbing and redistributing the damaging UV rays. 

Pigmentation that follows trauma to the skin, such as a cut, burn, abrasion, incision, or as inflammation after acne, is known as post-inflammatory hyperpigmentation. Injury to the skin causes inflammation. This elicits the skin’s natural protective melanin response, resulting in darkening at the damaged site. Pimples, which are the result of inflammation inside the pore, can leave dark spots behind after they heal. Picking at pimples amplifies the inflammatory response, making it even more likely a dark spot will develop.

Pregnancy mask, or melasma, is a condition affecting an estimated 50 to 75 percent of expectant mothers. This discoloration may appear as dark, blotchy, brown, confetti-like patches of skin. It’s most commonly on the cheeks and nose, but also found on the forehead and upper lip. It happens due to a surge in the melanocyte stimulating hormones estrogen and progesterone, and is amplified by sun exposure.

As we get older, noticeable “age spots” appear. These are the evidence of an accumulation of UV damage over the years. The older you get, typically after 40, the more accumulation occurs, hence the name “age spots'', or solar lentigines.

Effective Procedures for Hyperpigmentation

A treatment regimen is tailored to each individual case of hyperpigmentation. It is not a one size fits all. Your practitioner will determine the best treatment for your hyperpigmentation. 

Two of the most common procedures to help correct hyperpigmentation are chemical peels and IPL laser treatments. Medium depth chemical peels, performed by a trained professional, rely on acids to remove the top layers of skin. The exfoliative effects spur cell regeneration and collagen production, fade discoloration, and peel away impactions to rapidly improve skin's appearance. 

IPL laser treatments, or photo facials, use powerful flashes of light to create energy that penetrates the dermal layers below the skin’s surface. It also utilizes heat to penetrate and attack the pigment particles, breaking and destroying their bonds. These broken particles rise to the surface as dark “peppering” of pigment to slough off with our skin’s natural cellular turnover. 

Products for Hyperpigmentation

Products and procedures are often used synergistically to even out skin’s tone and texture. The correct product regimen will do wonders for correcting existing photodamage and preventing new, largely based on ingredients. An optimal treatment regimen includes ingredients to accelerate melanin dispersal and inhibit its production and transfer, as well as exfoliate. A complete skin cell cycle takes approximately thirty days. Exfoliation speeds up the process to about 14 days, revealing brighter, smoother skin much sooner. It also clears dead skin cells and oil from pores, reducing the chances of breakouts and inflammation. The good news is many of our melanin inhibiting products are also great chemical exfoliators.

At Giddie Skin we love products with Mandelic Acid. This is a large molecule Alpha Hydroxy Acid proven to gradually fade dark spots. It renews cells and acts as an inhibitor of tyrosinase, the enzyme responsible for melanin production (and for your fruit to turn brown). It’s also anti-inflammatory and anti-bacterial, making it great for acne prone skin. It is also pregnancy safe. 

Kojic acid removes the upper layers of dead skin cells, leaving skin renewed, brightened, and free of cellular debris. It also inhibits the enzyme tyrosinase from forming, preventing melanin production. 

Niacinamide blocks melanin from reaching the surface of the skin and prevents additional UV damage. Its cell renewing properties can also accelerate the reduction of existing pigmentation. It boosts ceramide production, contributing to healthy cell function, and reducing inflammation.

Vitamin A is a potent antioxidant and cell regenerator that interrupts melanin triggers, pulls excess pigment up from the deeper level of the epidermis, and speeds up the cell turnover cycle from 30 to about 14 days. This disrupts the transfer of pigment to skin cells and breaks up surface pigment, promoting a more even skin tone. 

Vitamin C is known for its ability to prevent and repair UV damage. It’s an antioxidant powerhouse that interacts with copper, inhibiting the melanin-stimulating enzyme tyrosinase, reducing pigment formation and encouraging a brighter, more even tone. It also has potent photoprotective effects that block melanin triggers. 

The undisputed champion of the war on pigment is hydroquinone. It breaks up melanin cells to disperse existing pigment and prevent new pigment formation.

However, you can no longer find hydroquinone in any OTC product. Due to the 2020 CARES Act, it's only available by prescription from your provider.

Daily sunscreen is a must to protect against the melanin-triggering effects of UV exposure. This prevents the formation of new melanin, and darkening of existing pigment. Use broad-spectrum sunscreens and reapply as indicated. 

Don’t Give Up, It is Worth the Wait

If summer is lingering in all the wrong places, be patient. The good news is, most cases of hyperpigmentation can improve over time, but will often get worse before it gets better. This excess pigment is a deep rooted problem, and layer by layer it must be treated. Active treatment accelerates cell turnover, pulling pigmented cells to the surface at a faster rate, causing an increase in the concentration of melanin in the skin. It can create a temporary darkening of spots as they are ready to be shed away. 

Slow and steady wins the race with hyperpigmentation. With the appropriate approach, products, time, and maintenance, you can start to see a difference in four to six weeks. Follow the basic rules for protecting your skin from damage: Limit sun exposure. Don't pick at blemishes. Avoid irritating or damaging your skin. Wear sunscreen! Yes, even in the winter. UV exposure and damage doesn’t take a season off. Keep up with your treatment plan and stay diligent in your everyday routine. Restoring a glowing, even skin tone is achievable!

Emily Giddings, RN