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What is Pigmentation?

 

Pigmentation is the term most often used to describe dark marks or patches on the skin-In particular the facial skin. However, strictly speaking disorders of pigmentation can be divided into conditions resulting in hypopigmentation (lightening of the skin) and those resulting in hyperpigmentation (darkening of the skin).

The best known disorders of hypopigmentation are vitiligo and albinism. Disorders of hyperpigmentation(increased pigmentation) can be widespread or localised.

Causes include genetic disease, metabolic abnormalities (thyroid, liver, renal and endocrine diseases), vitamin and nutritional deficiencies. These patients could have other symptoms or signs of the underlying problem. Certain medication may cause hyperpigmentation as an adverse drug reaction.
Melasma and and post inflammatory hyperpigmentation (PIH) are by far the commonest and most distressing forms of hyperpigmentation seen by dermatologists.

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Sunspots- when to see a dermatologist?

“Sun spots” is a broad term which includes a range of cancerous and benign lesions. Common types of skin cancer include squamous cell carcinoma (SCC), basal cell carcinoma and melanoma.
Basal cell carcinoma presents as a pearly white, pink or pigmented nodule, a pink scaling patch, a non healing ulcer or an unexplained scar.

Squamous cell carcinoma commonly presents as a pink or brown scaling patch.

Melanoma is the most dangerous of all skin cancers and most often presents as a ‘new’ irregular pigmented spot. Early detection can save lives.

Solar keratoses (Actinic keratoses) are precancerous lesions and 10-25% of these may persist and progress to skin cancer.
It is important to regularly check your skin and be aware of new or changing lesions (spots).

Solar lentigenes are freckles which increase in number with age and cumulative sun exposure. These spots are benign, but should be checked so that a melanoma, which is a deadly skin cancer, is not missed.

Seborrhoeic keratoses (seborrhoeic warts) are warty, pigmented or skin coloured growths, which can occur because of a genetic predisposition and sun exposure.

Visit a dermatologist if you have:
1. Personal or family history of skin cancer
2. Frequent sun exposure with a history of sunburn
3. New or changing ‘spots’
4. Scaling / crusting lesions
5. New or rapidly growing nodules
6. Wound/ulcer that does not heal

While most sun induced spots are benign, it is important to make an early diagnosis of skin cancer
Your dermatologist will be able to make a clinical diagnosis, or perform a skin biopsy if necessary for a histological diagnosis.
It is possible to treat early or newly evolving lesions with non surgical treatment options like freezing with liquid nitrogen or topical creams.
If a skin cancer needs surgery, there is a greater chance of complete cure with an early lesion.
Checking your skin yourself and regular visits to a dermatologist will ensure that all sunspots are diagnosed early and dealt with effectively.

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Understanding Sensitive Skin

Thousands of ingredients are used by the cosmetics and skincare industry, including pure compounds, plant extracts, oils and waxes, preservatives, surfactants, detergents and polymers. While all ingredients used are tested for safety, some patients may still experience reactions to some of them.

There are 2 types of reactions that may be seen.

The most common is the primary irritant contact reaction. This tends to be of rapid onset following contact with the irritant ingredient, and causes mild discomfort, redness and possibly scaling of the skin.

An allergic contact reaction on the other hand, is often delayed, persistent, and sometimes severe.

More than 50% of the general population perceives their skin as sensitive, and this is often related to impaired barrier function. The human skin is constantly exposed to environmental stress, including changes in humidity, extreme temperatures, pollution, and daily topically-applied products, including soaps and household chemicals. These factors can lead to the removal of the epidermal barrier lipids, thus leading to impaired barrier function. Ingredients that have been used in the past can become irritating to the skin, because of the increased penetration into the skin.

A wide variety of procedures and ingredients can act as irritants.

Mechanical, chemical and environmental factors can act alone or in combination to produce skin irritation.

Mechanical factors: cosmetic procedures such as waxing, laser therapy, dermabrasion

Chemical factors:  solvents, some acids, alkaline substances such as soaps

Environmental elements: air-conditioning, food allergies, prolonged exposure to water.

These factors contribute to skin irritation, the disruption of the skin barrier and increased trans-epidermal water loss.

Other common irritants in cosmetic formulations are fragrances, preservatives and some botanical ingredients.

In order to manage cosmetic intolerance syndrome, we need to focus on maintaining and supporting the integrity of the skin barrier

If the skin barrier is working well, it will retain water effectively. If it is defective the skin will become dry and dull, and this means that irritants can penetrate more rapidly, causing sensitivity.

Much like a security guard for your skin, the barrier is there to stop potential irritants from passing through, and to protect what lies beneath!

So follow these simple steps to restore and maintain your skin barrier function:

  1. Avoid foaming cleansers containing sodium laureth sulphate. Avoid astringents, like alcohol on the skin
  2. Avoid physical granular scrubs or skin buffers, as these are too harsh on the skin
  3. Do not wash the skin with overly hot water
  4. Look for products containing active ingredients that are proven to be safe and effective.
  5. Keep the skin well hydrated. Use barrier repair creams containing cholesterol, ceramides, essential and non-essential fatty acids.

It is important to note that if you have a ‘sensitive’ skin, you could possibly have a skin condition like rosacea or eczema. It is best to consult with a dermatologist for a proper skin evaluation and diagnosis.