Hyperpigmentation (increased pigmentation) is the bane of so many people’s lives – if you’ve got it, you’ve probably tried numerous products with limited success, and you have no idea where to turn for further advice.  Only those who have it, know just how distressing it can be, and we all know someone who will try anything to improve it!

Depending on the cause, pigmentation can either lie superficially in the top layers of the skin (epidermis), or much deeper, at the epidermal- dermal junction (the junction between the top and middle layers of your skin) or anywhere in between.

Sun spots (solar lentigines) tend to lie nearer the surface of your skin and are caused by previous sun damage, most likely from time spent in the sun as a child.  It has been estimated that 90% of long term sun damage occurs before the age of 7!  With the passing years, this sun damage rises to the surface as presents as sun spots which certainly age us.  In darker skins, it appears as irregular dark patches.

Hormonal pigmentation lies much deeper and is caused by a darkening of your melanin-producing cells called melanocytes, under the influence of hormones.  Estrogen is the main culprit, and for this reason we usually find hormonal pigmentation in women, although men are not completely immune. Hormonal pigmentation tends to worsen with the contraceptive pill and pregnancy and is exacerbated by sun and heat exposure.  This pigmentation is typically what causes the “mask of pregnancy”, or melasma.  The usual distribution is symmetrically over the cheeks, upper lip, and forehead.

Post-inflammatory hyperpigmentation is a darkening of areas of the skin where inflammation has occurred.  Typically this occurs in darker skins and may occur after a pimple, an ingrown hair, trauma to the skin, a reaction to a skin product, or a deep chemical peel, or due to repetitive friction on an area (such as elbows), knuckles of the fingers, and heels of the feet.

Exposure to the sun causes melanocytes to produce more melanin (dark pigment) as a protective measure.  Regular sun exposure without the use of sun block and a hat, will lead to a gradual darkening of the skin, which results in a tan in light skins, and often a patchy, uneven appearance in darker skins. Over the long term, sun exposure also causes a breakdown of collagen, causing more fine lines and wrinkles to appear.

Treatment of hyperpigmentation involves a multi- level approach and differs according to the level where the pigmentation lies.  For best results, a patient needs to do a combination of home and in-salon treatments, and should expect results over the course of a few weeks to months, rather than an instant fix.

At Laserderm Aesthetic Centres, patients are offered a consultation with an aesthetic doctor or therapist, who will assess their skin and cause of pigmentation, and work out a treatment plan that is best suited to that patient.

“There are so many good products now available that help to combat pigmentation, from supplements that prevent further pigmentation from forming, to creams and serums containing agents such as anti-oxidants, retinol, and lightening agents.  A combination of agents will help to give the best results, “ says Dr. Natasha Chapman (nee Begg-Spiro) of Laserderm Sandton.

“Although hyperpigmentation is notoriously difficult to treat, there have been many advances in the aesthetic industry with regard to pigmentation treatments. We now have a whole array of different options to help reduce and remove pigmentation.” “Combine home products with medical treatments such as chemical peels, infusion facials with brightening serums (such as Dermafrac), and FRAXEL laser treatments, and there are very few patients with hyperpigmentation that we will not be able to improve.”

FRAXEL laser is considered one of the best treatments in the world for removing pigmentation, whatever the cause.   Minute laser beams penetrate the skin, removing pigmentation and resulting in a fresher, tighter appearance to the skin.  Multiple treatments over time usually give a fantastic result in reducing the appearance of dark areas, and this laser can be used on any skin type.  Often this is combined with other treatments such as chemical peels or Dermafrac facials which infuse lightening agents into the skin.

The first step in treating your pigmentation problems is to have an assessment to find the cause, as prevention is your first line of treatment.  A doctor or therapist needs to look at your skin, take a medical history, and ask about your personal routine, before advice can be given.  Skincare products will be recommended, as well as medical treatments that are best suited to you.  Every patient is looked at individually as there is not one treatment that suits all.