Expert Advice | Pigmentation

Pigmentation is the colouring of the skin, hair, mucous membranes, and retina of the eye. Pigmentation is due to the deposition of the pigment melanin, which is produced by specialised cells called melanocytes.

Pigmentation is one of the hardest things to treat, as it relies a lot on clients being compliant and following what is recommended on a daily basis. It is complicated more by the fact often it is hard to understand what has caused it in the first place.

Causes

• Hormones
• Medication
• UV
• Stress

Pigmentation is an inflammatory response. As there are so many triggers, pigmentation is a complex process.

During the consultation process I will look at skin history and when it came about. We are all pre-dispositioned to a certain amount of pigment in the skin.

These identical twins have the same genetic disposition, the difference in how their skin has pigmented is due to differences in extrinsic exposures. 90 percent of skin damage is done before the age of 18. Not everyone’s skin tans in the same way. It is important to remember that there is no safe way to tan.

People's skins are conveniently classified into a number of different types. The interesting thing is that all the different skin colours are determined by only two different types of melanin:

• eumelanin which is dark (black) or lighter brown
• pheomelanin which is reddish brown in colour which is in fair clients.

Other influences on the colour of skin are:
- The concentration of carotenoids (e.g betacarotene) and flavonoids
- The amount of blood vessels in the skin the thickness of the skin
- Dark circles around the eye and thin skin in this area
- The thickness of the horny layer
- The density of the collagen in the dermis

Types & Trggers of Pigmentation
Damage to the skin caused by damage can take years to show up. 

Hyper Pigmentation
Darker patches in the skin. In a skin with hyper - pigmentation is increased in the epidermis, the dermis (or both). Melanin is increased primarily due to UV exposure epidermal melanin is found in the keratinocytes in the basal layer in most cases the number of melanocytes is not increased yet the melanocytes that are present are larger, more dendritic and more active. The production of melanin is increased and the transfer of melanin into the keratinocytes takes pace creating hyper - pigmentation.

Hypo Pigmentation
White patches in the cell- can’t reverse this as damaged and no pigment and can’t get this back . This can be cause from trauma or chemical peels . Often found a lot in older clients, skin is lighter than genetic colouring.

Chloasma
Pregnancy pigmentation - hormones cause this. Tends to be on the face. Hard to treat as don’t know if hormones are still there. Sometimes pigment stagnant in dermis or epidermis. Genetic disposition to pigmentation, more common in women
than men and often because women’s hormones fluctuate more than men.

Solar Lentigines
Skin is very damaged. Ephelides (Freckles) - appear at the age of 2. These are your genetic freckles. Freckles around age of 10 is the sun damage from too much exposure. We must protect children's skin at a young age and so to protect them
from when they are older.

Poikiloderma
Normally found on the side of neck. Seen in areas where there has been a lot of exposure to the sun.

Post Inflammatory Inflammation
In dermis of epidermis - hard to treat as don’t know where it is. Allergic reaction to the skin, mechanical, picking skin, burns. The worse the injury the deeper the pigment.

Dermal pigmentation
Caused by trauma this is when post inflammation combined with UV rays.

Treatment of Pigmentation
Time and dedication is essential when treating pigmentation. Regardless of the treatments used, all will fail if sunlight is not strictly avoided UVBM UVA and visible light are all capable of stimulating melanogenesis. Therefore sunscreens containing
physical blockers, such as titanium dioxide should be used 365 days a year. Resolution is gradual and may take months and results based on individual specific skin physiology - there is no permanent removal of pigmented marks unless the
melanocyte cells are totally killed; we can only control pigment, but can't remove it. But if you don't maintain good skin health it will come back. Control activity of pigmentation by Vitamin C Normalise DNA in cells by Vitamin A.