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Pigmentation….the biggest puzzle of all

Cape Dermatology - Skin Concerns
Cape Dermatology - Mini Fraxel

Numerous women have a daily struggle with hiding uneven skin tone or brown patches on the skin.  Only an individual with hyperpigmentation will understand the frustration of trying to cover dark spots with concealer, foundation and powder and then feeling disheartened and even embarrassed when one can still notice the patches!  A skin condition as such can deprive a person of their social life and negatively affect their work performance and confidence levels.

The first step to treat hyperpigmentation is to recognize the type of skin discolouration.

Freckles can be found on the face or body in the form of flat, circular spots which are brown in colour.  They are genetic, appear when one is young and may increase with age. Overexposure to sun will make the appearance worse and while some people spend thousands of rands on trying to remove them, they will re-occur.

Any inflammation or bruising can result in post inflammatory hyperpigmentation due to sun exposure.

If you had acne for several years you might have post inflammatory hyperpigmentation which can present itself as dark marks as a result of overproduction of melanin in the area as a protective reaction to inflammation in the skin.  This type of pigmentation is very common amongst patients, especially people with olive and darker skin tone.  This can often be very difficult to treat and might require a combination of treatments under the supervision of a dermatologist.

Sun spots or solar lentigines are often seen as an irregular, brown, flat spot in younger or older patients as a result of extreme sun exposure for a prolonged period of time.  These are often easy to treat with laser, which is a more cosmetically elegant treatment when compared to traditional freezing methods.

Melasma or Chloasma is probably the most difficult form of hyperpigmentation to treat.  It can occur during or after pregnancy and presents itself as either a butterfly shaped mark or solid patches of brown pigmentation especially forehead, upper lip and the cheeks.  Hormonal changes within the body, pregnancy, birth control pills and the combination of UVA radiation can result in melasma.  Genes can also play a role if you have a family history.  Melasma can be aggravated by many other contributing factors and that is why it is very difficult to treat.  No permanent cure is available.

There are many ways to treat hyperpigmentation, but the importance lies in the analysis of the type of hyperpigmentation present.  Once that is established, an option can be determined by a Dermatologist or skin specialist.  

The options are:  

  • Chemical Retinol peel – preferably in winter time
  • A topical concentration of a bleaching cream paired with a treatment such as microdermabrasion on a regular basis – preferably in winter time
  • Pigment laser – non-ablative laser treatment for individual sun spots.
  • Photofacial / Lumecca – a gentle skin improvement pulsed light treatment specifically indicated for scattered sun damage.
  • Fractional Thulium – a non-ablative laser treatment that is used for complexion blending.

Should you be one of those people whom have tried every remedy in the book to treat your pigmentation…perhaps it’s time to visit Cosmetic Dermatology Centre for a world class, professional opinion on  how to treat your skin.

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By Maryke Myburgh