Recent advances in the field of cosmetic dermatology have developed lasers as another modality for the treatment of skin hyperpigmentation removal.
A basic understanding of the skin hyperpigmentation pathway is helpful prior to a discussion of various skin lightener agents and their known mechanisms of action. The type and amount of melanin synthesized by the melanocyte and its distribution pattern in the epidermis determines the actual color of the skin. Skin Hyperpigmentation forms through a series of oxidative reactions involving the amino acid tyrosine and the enzyme tyrosinase.
The first step is the most critical because the remainder of the reaction sequence can proceed spontaneously at physiological pH. Here, tyrosinase converts tyrosine to dihydroxyphenylalanine (DOPA) and then to dopaquinone. Subsequently, dopaquinone is converted to dopachrome through auto-oxidation, and finally to dihydroxyindole or dihydroxyindole-2-carboxylic acid (DHICA) to form eumelanin (black-brown pigment). The latter reaction occurs in the presence of dopachrome tautomerase and DHICA oxidase. In the presence of cysteine or glutathione, dopaquinone is converted to cysteinyl DOPA or glutathione DOPA. Subsequently, pheomelanin, a yellow-red pigment, is formed called Skin Hyperpigmentation.
Determining the cause of the skin hyperpigmentation is important in selecting the best approach for treatment. Based on the history and clinical findings of the patient, the etiology of the skin hyperpigmentation may include postinflammatory hyperpigmentation, drugs, photosensitizing agents, ultraviolet light, or systemic disease (eg, Addison disease, liver disease, pregnancy, pituitary tumors). In order to adequately treat the pigmentary disorder, the causative agent should be determined and managed.
Skin Hyperpigmentation is treated with the application of topical agents and/or with laser treatments. Therapy with topical skin lightener products and laser treatments may take weeks to several months before any significant difference is noted. During the treatment phase, patients should avoid the sun by using sun-protective clothing and sunscreen to decrease the likelihood of pigmentary changes induced by UV light.
Skin Hyperpigmentation is a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin. Skin Hyperpigmentation can affect the skin color of people of any race.
Hyperpigmenation is more frequently found in people of Asian, East Indian, Mediterranean or African descent especially when exposed to excessive sun however, those with lighter skin can also suffer.
Fortunately skin hyperpigmentation removal can be treated successfully with the use of skin brighteners and lighteners. We strongly suggest using a all natural brightener rather than some that contain hydroqinone as they have been found to be gentler and safer for regular use.
Skin Hyperpigmentation has been associated with a number of different skin afflictions including, but not limited to, Addisons and Cushings disease, Melasma, Linea Nigra, Tinea, Celiac Disease and more. If you have not consulted a physician about your skin hyperpigmentation we strongly suggest you do before starting any skin care regimen.
Melanin is the substance that gives color to your skin. Ideally, melanin concentration should be even across the entire expanse of your skin but this is seldom the case. Various environmental, dietary, hereditary and age factors contribute towards the formation of these spots and blemishes. These lesions or spots have different names depending on the cause. Melasma, skin hyperpigmentation, freckles are some of the various names that refer to these blemishes.
How do I rid myself of these spots?
Any dermatologist will tell you that pigment problems are extremely difficult to get rid of. But there is hope. There have been various advances in the field of pigment research and there are a number of remedies that can effectively remove the excess pigment and prevent the re-accumulation of melanin on the skin or hyperpigmentation.
Are all pigment problems basically the same? Can I use the same treatment for various pigment problems?
There are several ways to get rid of spots or patches of skin hyperpigmentation. Skin hyperpigmentation could be hormonal in nature like melasma, dark underarms, dark skin patches on the neck or inner thigh area and age spots. Once these spots or patches of dark skin have lightened, you will need to continue some sort of maintenance regimen due to the hormonal nature of the problem. Stopping treatment as soon as these spots have disappeared will cause them to reoccur in a few months. There are certain other kinds of spots or patchy skin caused by trauma to the skin by insect bites, shaving, acne or repeated pressure to certain areas of skin. These patches, spots or skin hyperpigmentation once lightened usually don’t return.
What are the various ways I can use to get rid of these blemishes?
There are three ways to get rid of skin hyperpigmentation.
Mechanical: Mechanical methods work best when the skin hyperpigmentation is recent and superficial. Those who don’t exfoliate their skin on a regular basis will also see good results. There are various derma-abrasion kits available in your local pharmacy that could help gently exfoliate the area. Micro-derma abrasion cloths are also a good option as they remove dead skin cells very gently. Exfoliating encourages skin cell turnover ensuring that fresher and more even toned skin surfaces. However, one needs to be careful when exfoliating because over exfoliation or over zealous use of mechanical methods can actually increase the darkness of blemishes.
Skin peels: Peels work to invisibly remove the “glue” that holds the surface skin together and encourages exfoliation without any need for mechanical interference. Peels used to be administered at a doctor’s office and some strong peels are still only available to medical or aesthetic specialists. Nowadays there are various kinds of peels available online and even at low concentrations over the counter. The right choice of peel depend on the nature of the problem, the depth of skin hyperpigmentation and the general health of the skin. Certain peels can go as deep as the dermis (deepest layer of the skin) to lighten skin from the inside out. Certain peels along with their exfoliating capabilities also target abnormal pigment cells and work to uniform skin tone.
Skin Lightening Agents: Skin lightening Creams penetrate the skin to destroy the skin hyperpigmentation and give skin an appearance of being even toned. There are various skin lightening agents identified by scientists and herbalists and many of them work very well on skin blemishes. Different skin whitening agents have different modes of action. Some work to destroy skin hyperpigmentation, some work to prevent the transfer of melanin from the deepest layer of the skin to the surface, still others interfere with the actual production of melanin. There are a few chemical agents actually destroy the skin hyperpigmentation creating cells called melanocytes. These should never be used for skin blemishes unless one has depigmentation problems. The best methods entail the use of herbal or natural skin lighteners on the skin hyperpigmentation that are used in a combination so as to affect the whole production cycle of melanin.
Are You a Candidate for Hyperpigmentation Removal?
This entirely depends upon the cause of hyperpigmentation and the treatment which is suited to your needs and skin type. Some you very well may be able to handle, some you may not be a candidate for. The first step is consulting with a qualified surgeon or dermatologist to determine the cause and then go over your options for a solution. For instance, you may be a candidate for hydroquinone use in hyperpigmentations but not laser resurfacing. Some may only need medication cessation or substitution.
This is really important as not all skin types and individuals will be a candidate for every technique or treatment. This largely depends upon your skin type, wound type response and the presence of ethnicity in your family history (keloids and hypo- or hyperpigmentations can form in darker skinned individuals).
Regardless, and especially for surgical applications -- an individual must be in good health, not have any active diseases or pre-existing medical conditions and must have realistic expectations of the outcome of your treatment. Communication is crucial in reaching one's goals. You must be able to voice your desires to your physician if he/she is to understand what your desired results are. Discuss you goals with your physician so that you may reach an understanding with what can realistically be achieved.
You must be mentally and emotionally stable to undergo an cosmetic procedure or treatment. Some of these treatments will require patience and stability in dealing with the healing period. There is sometimes a lull or depression after surgery or during prolonged treatments and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue. Please consider this before committing to a procedure. If the above describes you and you have the desire to rid yourself of hyperpigmentations, you may be a good candidate for these treatments.
Focal hyperpigmentation is most often postinflammatory in nature, occurring after injury (eg, cuts and burns) or other causes of inflammation (eg, acne, lupus). Focal linear hyperpigmentation is commonly due to phytophotodermatitis, which results from ultraviolet light combined with furocoumarins in limes, celery, and other plants.