Tag: hyperpigmentation

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The Magic of Serums

Serums are often the ‘wonder product’ of most skincare brands, and the go-to product for most dermatology and specialist skincare clinics. With so many different options, it isn’t always easy to know which product to choose or even how these can fit into your skincare regimen.

So, let’s shed some light on the matter …

What are serums and why are they so special?
Serums are lightweight liquids or gels containing the highest quality, highest concentration of active ingredients specially formulated to enable the product to penetrate the epidermis to reach the deeper dermal layers of the skin. The sophisticated delivery systems ensure faster and efficient absorption of the product and consequently less wastage.

To be able to guarantee stability of these high quality ingredients while they are on the shelf, to ensure maximum benefit when the product is applied, is nothing short of scientific genius and the reason why serums are often more expensive.

In fact serums are generally the most expensive part of a skincare regimen and this is often the reason most patients are hesitant to use them.

It’s important to remember that very little product is required as the delivery systems are often superior to creams and lotions. With proper use and correct storage most serums actually end up lasting longer than creams or lotions and are ultimately more cost effective.

Where do serums fit in my skincare regimen?
Serums are best applied after cleansing and toning when the product can achieve maximum penetrance into the skin without being hindered by other products. There may be exceptions to this rule.

Serums may be used morning or night depending on the product.

Remember serums do not always give enough moisturise or hydration so you may still need to apply a moisturiser after the serum especially if your skin is dry.

Which serum should I choose?
Serums are often used to target specific skin types or skin concerns. A product range may have a variety of serums with different concentrations of active ingredients to suit different skin types . For example, an oily skin may benefit from a higher concentration of Vitamin C while a dry sensitive skin may only be able to tolerate a low concentration.

Serums may fall under the ‘prevent’ , ‘treat’ or ‘hydrate’ categories of a skincare brand.

Antioxidant serums containing combinations of Vitamin C, E and other ingredients will help prevent and reverse damage caused by sun exposure.

Various skin concerns like hyperpigmentation, acne, rosacea and dryness are targeted by appropriate ingredients found in different serums.

Since most serums contain superior active ingredients either alone or in power combinations, you may find a single serum effective for numerous skin concerns.

Can serums be combined?
Absolutely! Since most of us have more than one issue going on at once, it’s often necessary to treat more that one problem. So if you want an anti-ageing serum , and also a treatment for hyperpigmentation you may use more than one serum. In this case, you may apply one and wait a few minutes before applying the other or use them at different times of the day. Sometimes a single serum can fulfill all your needs.

Have a look at our Skinsmart product recommendations below where we try to help you find what you need, or complete our free online skin assessment here.

– Skinsmart Suggestions –

For hyper-pigmentation or uneven skintone:

*SkinCeuticals Discoloration Defense
*Neostrata Illuminating Serum

For skin redness and rosacea-prone skin:
*Neostrata Redness Neutralising Serum
*SkinCeuticals Phyto Corrective Serum

For hydration:
*SkinCeuticals Hydrating B5

For ageing and fine lines:
*Neostrata Tri-therapy Lifting Serum
*Neostrata Firming Collagen Booster
*SkinCeuticals HA Intensifier Serum

For prevention of free radical damage:

*Obagi C Clarifying Serum
*SkinCeuticals Phloretin CF
*SkinCeuticals C E Ferulic
*Neostrata Antioxidant Defense Serum

For skin barrier repair:
*SkinCeuticals Retexturing Activator
*Neostrata Bionic Face Serum

For mature skin prone to acne:
*SkinCeuticals Blemish + Age Defense Serum

If you are still unsure of what you need, email us at [email protected]. Our qualified medical therapist can give you the right advice for your skin concerns.

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The light side of pigmentation

Hyperpigmentation is the darkening of areas of skin compared to the surrounding skin colour leading to uneven skin tone or large darker patches. It occurs when melanocytes are stimulated to produce increased pigment called melanin. Melanocytes can be stimulated by sunlight, hormones, trauma, inflammation, medication and a constantly growing list of other factors. It was recently discovered that vascularisation (increase in blood vessels) also has a role to play in melanocyte stimulation and hyperpigmentation.

Hyperpigmentation is a common and intensely distressing condition. The commonest forms seen are melasma, solar lentigenes (sun spots) and post inflammatory hyperpigmentation (PIH).

What causes hyperpigmentation? – new evidence!

Melasma and sunspots mostly occur on sun exposed areas, particularly the face, while PIH can occur in any area of skin trauma or skin conditions like acne, eczema or insect bites.

All forms of hyperpigmentation worsen with sun exposure. It is well established as the greatest contributor, with the condition worsening during summer and improving in winter when ultraviolet exposure is less intense.

Melasma is also strongly influenced by genetic and hormonal factors and is often precipitated by pregnancy or the use of the contraceptive pill.

The influence of other environmental factors is only recently being examined, and other causative factors have now come to our attention as contributing to skin ageing and hyperpigmentation.

The solar energy spectrum is composed of ultraviolet radiation (A, B and C), visible light and infrared. The visible light spectrum is the light that we see. It has longer wavelengths than ultraviolet A and B and therefore actually have a deeper penetration into the skin, though they have never been regarded as potentially harmful.

Recent studies have found that visible light stimulates melanocytes to produce pigment. This is especially significant in darker skinned individuals and it seems that repeated long term exposure to visible light may cause hyperpigmentation. In addition, visible light may also cause inflammation and induce reactive oxygen species causing DNA damage, though it has not yet been established as a cause of skin cancer.

Important to note that most traditional sunscreens do not adequately protect against visible light. Fe oxide in sunscreens and antioxidants offer protection from visible light.

Infrared or heat represents the longest wavelength of solar energy and hence penetrates even further than visible light. IR activates matrix metalloproteinase and causes the breakdown of collagen causing skin ageing. Infrared also causes hyperpigmentation by inducing inflammation and vascularization (production of blood vessels). There is currently no effective way of protecting against infrared and only topical antioxidants have shown to offer some protection.

Traffic related air pollutants including a harmful form of ozone called tropospheric ozone and polycyclic aromatic hydrocarbons cause the formation of free radicals which depletes our skins antioxidant reserve. This leaves the skin vulnerable to further insult including DNA mutations and melanocyte stimulation.

Treatment for hyperpigmentation

Hyperpigmentation is treated with a combination of topically applied creams, and skincare procedures like chemical peels and dermal needling.

A complete treatment regimen should:

  • Protect against factors that cause melanocyte stimulation
  • Inhibit the production of melanin by inhibiting the enzyme tyrosinase
  • Improve the turnover of cells that have accumulated pigment

Maintenance treatment is critical to ensure that results are lasting as hyperpigmentation should be seen as a chronic condition that requires constant management.

The gold standard skin lightening agent is hydroquinone which has come under scrutiny as it was used to lighten skin generally, not just for treating hyperpigmentation.

Hydroquinone works by inhibiting the enzyme tyrosinase. This medication can be prescribed where appropriate by a dermatologist in various combinations and works well when used responsibly.

Kojic acid is an effective and well studied skin lightening agent. It is an ingredient in numerous creams and generally well tolerated

Neoretin Booster Serum is a lightweight serum containing Kojic Acid and other active ingredients which inhibit melanin synthesis.

SkinCeuticals Metacell Renewal contains Kojic Acid and other active ingredients to target the early signs of ageing and hyperpigmentation.

NeoStrata Enlighten Pigment Gel contains Kojic Acid, Liquorice extract, citric acid and multiple other active ingredients to target hyperpigmentation.

Arbutin is a glycosylated hydroquinone extract and has been considered one of the safest and most effective skin lightening agents. Its effects may also be optimised when combined with other substances like vitamin c, liquorice, glycolic acid and kojic acid.

Arbutin inhibits the enzyme tyrosinase decreasing the production of melanin pigment.

The active ingredient is slowly released making it suitable for those with sensitive skin.

Obagi Nu-Derm System

The Nuderm system combines Arbutin and exfoliating ingredients to inhibit melanin production and remove cells containing pigment. Arbutin is a smaller molecule that penetrates deeper into the skin reaching the basal layer of the epidermis and inhibiting the enzyme tyrosinase.

Obagi C Clarifying Serum combines 10% Vitamin C and Arbutin to protect against sunlight and environmental aggressors and inhibit production of melanin. This product targets early ageing and hyperpigmentation.

Vitamin C is a potent antioxidant which indirectly inhibits the enzyme tyrosinase leading to decreased melanin production

The anti inflammatory effect reduces cell injury and pigment production.

SkinCeuticals CE Ferulic and SkinCeuticals Phloretin CF are patented combination antioxidant formulations. Vitamin C is combined with other antioxidants for a potent synergistic effect that protects against ultraviolet light and visible light and offers some protection against infrared (IR) and air pollutants.

Obagi Professional C serum 10%, 15% and 20%.

The Obagi Professional C range contains different concentrations of Vitamin C to suit different skin sensitivities.

Ellagic acid

Is a natural phenol antioxidant that inhibits the transfer of melanin to skin cells.

SkinCeuticals Advanced Pigment Corrector contains ellagic acid, niacinamide , vitamin and salacylic acid. It lightens dark spots by gentle exfoliation and prevents the formation of new pigment spots.

Tranexamic acid reduces pigmentation by its effect on the plasminogen activator pathway.

SkinCeuticals Discoloration Defense

Combines tranexamic acid (inhibits the UV induced production of melanin by melanocytes), Kojic acid , niacinamide and HEPES which work synergistically to inhibit melanin production and remove epidermal cells containing pigment.

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Note from Dr. Kesiree

HYPERPIGMENTATION should be regarded as a chronic condition that needs to be constantly managed. Be consistent with your treatment regimen. Treatment protocols generally combine intense phases of prescription treatment and procedures with maintenance regimens.

No treatment regimen for hyperpigmentation would be complete without strict daily sunscreen use.

Book an appointment with your dermatologist or skincare professional for advice on how best to treat your hyperpigmentation

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What to expect from your skin when you’re expecting

Physiological skin changes of pregnancy occur in virtually all pregnant women.

Various forms of Hyperpigmentation (increased pigmentation) occur in as many as 90% of pregnant women. Melasma also known as ‘mask of pregnancy’ is probably the most disturbing form of pigmentary alteration. Other forms of hyperpigmentation include darkening of the areola, linea nigra (vertical pigmented line than runs down the middle of the abdomen) and darkening of pre-existing moles (melanocytic naevi).

Melasma – the mask of pregnancy

Changes in the circulation also present with reddening of the palms (palmar erythema), spider veins and varicose veins. This is as a result of increased circulating oestrogen and an increase in the circulating blood volume.

Varicose veins

Hair changes during pregnancy result from higher levels of oestrogen which prolongs the growth phase of the hair, resulting in less shedding and thicker healthier looking hair. Some women also notice that hair becomes shinier during pregnancy or that it changes in texture. Another consequence of this is increased hair growth on the upper lip, chin and cheeks. Thankfully this reverts to normal after delivery. Unfortunately the hormonal alterations that occur after delivery may cause hair to transition the resting phase of the hair cycle, which can result in hair loss 6-12 months after birth of the baby. This kind of hair loss called telogem effluvium  thankfully corrects itself as the hair follicle goes back into the growth cycle.

Pregnant women may develop harder, thickened nails, while others find that their nails are softer or more brittle. These changes are temporary, and the nails should return to normal after giving birth.

Eccrine and sebaceous glands have increased activity in pregnancy, resulting in increased sweating during pregnancy and an oilier skin.

Stria gravidarum (stretch marks) are caused by changes in the connective tissue or literal ‘stretching of the skin’ in pregnancy. Many women notice stretch marks on their belly, hips, buttocks, breasts, or thighs during the later stages of pregnancy when the body is rapidly growing. How much and how quickly you gain weight when you’re pregnant may determine whether you get stretch marks. Genetics may also play a role. Most stretch marks fade to pale-or flesh-coloured lines and shrink postpartum, although they usually do not disappear completely.

Pregnancy stretch marks

 

What is ‘PREGNANCY GLOW’ ?

The physiological changes that occur in women during pregnancy contribute to a facial ‘pregnancy’ glow. So yes there is a scientific explanation for this: During pregnancy your body produces 50% more blood. The increase in blood flow through your body and skin causes your face to be brighter or ‘flushed’. The increase in hormones cause facial oil glands (sebaceous glands) to produce more sebum, making the the face more shiny. The combination of the flushing from the blood flow and the shine from the increased sebum create the happy ‘glow ‘ that we see on pregnant women.

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Pregnancy Skin Conditions

Pregnant women are still susceptible to everyday skin concerns that plague other women, though the treatment may need to be tailored to suit the changes of the skin and body in pregnancy and take into account the effects on the developing fetus. Here is some of our advice followed by a few product recommendations for common pregnancy concerns.

ACNE BREAKOUTS


Higher levels of hormones called androgens are at least partly responsible for pregnancy breakouts because they prompt the sebaceous glands in your skin to get bigger, and boost production of sebum. This often occurs during early pregnancy and may make the skin appear or feel oily. Acne during pregnancy may be mild, moderate or severe. It may be of new onset or an exacerbation of a pre-existing problem. It is important to remember that not all treatments and products are safe to use during pregnancy and if you were on a treatment regimen before you fell pregnant this may need to change. Consult your doctor, dermatologist or skincare professional to make sure you are on the right medication.

Product recommendations:

Neostrata Sheer Hydration-Sheer Hydration is a light, oil-free ,daily hydrator formulated with NeoGlucosamine to gently exfoliate the skin, promote cell turnover and help with minor acne problems.


Obagi NuDerm Foaming Gel – This foaming gel cleanser cleans the skin thoroughly of makeup and impurities. This product is safe to use during pregnancy.

MELASMA / CHLOASMA (PREGNANCY MASK)


Hyperpigmentation can occur for the first time during pregnancy as a result of hormonal and genetic factors, together with increased sensitivity to sun exposure The melanocytes in pregnant women are more sensitive to increased levels of melanocyte stimulating hormone(MSH), oestrogen and progesterone. Hyperpigmentation is one of the most common skin changes during pregnancy, and is also very hard to treat as options are few. It is often very distressing for pregnant women to deal with, in addition to all the other changes that come with pregnancy.
It may gradually improve or disappear after childbirth (normally 3-6 months after) but may persist in some women. There are numerous ingredients in cosmeceutical products that work synergistically to lighten and control pigmentation, but many of these are not suitable for use during pregnancy.

Product recommendations:

Heliocare 360 mineral – This innovative mineral fluid sunscreen is ideal for sensitive skin.


Neostrata Brightening cleanser – The Neostrata Enlighten range is clinically proven to treat and control pigmentory disorders, dark spots and signs of sun damage, while also reducing the appearance of fine lines and wrinkles.
Please note that not all products in the Enlighten range are safe in pregnancy.

DRY SKIN


Dryness of the skin is a common skin complaint and may occur for the first time during pregnancy or part of an ongoing problem. The skin feels tight and uncomfortable and may appear rough and dull. Pregnant women often look for more hydrating creams during pregnancy as their regular moisturiser may not provide enough hydration.

Product recommendations:

Neostrata Bionic Face Serum – Bionic Face Serum is a concentrated oil-free serum with 10% Lactobionic Acid designed to work synergistically with other Neostrata anti-ageing products in your regimen to improve radiance, skin texture and the signs of ageing.
It provides comfort and hydration for dry skins.


Neostrata Bionic Face Cream– Bionic Face Cream is an ultra-rich, anti-ageing emollient cream which provides intense hydration and skin smoothing effects without irritation.

SENSITIVE SKIN


Some pregnant women have the impression that their skin in more sensitive than before pregnancy. This may mean different things to different people, but in general, the skin is easily inflamed and irritated and reacts to numerous cosmetic products. Sensitive skin is a common complaint among pregnant women and is most likely due to changes in hormone levels. Pre-existing skin conditions such as eczema and rosacea may improve or worsen and your regular skin care regimen may no longer be suitable.

Product recommendations:


Obagi Soothing Cleanser – This calming gel cleanser offers relief from inflammation and irritation. It effectively removes make-up and impurities without disrupting the skins natural moisture barrier.


Obagi Skin Calming Cream– This non-irritating moisturising formulation contains plant-derived growth factors Kinetin and Zeatin. It effectively calms and soothes a sensitive and irritated skin.

Can I continue with my anti-ageing treatment during pregnancy?

A well-tailored anti-ageing skin care regimen can help slow the process of ageing. While you are pregnant you may need to change your existing regimen for one that doesn’t contain ingredients that are unsafe or have high irritation potential. In general vitamin A and its derivatives, including retinol, are not safe for use during pregnancy.
Please take our Skinsmart Skin Assessment to see our recommendations for anti-ageing skin care that is safe to use during pregnancy and while breastfeeding.

If you would like our advice on whether you can still use any of your existing creams, please email us on [email protected] or alternatively book a consultation with our medical therapist or dermatologist on 021 521 1107.

 

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Ingredients to look for in skin brightening products

The mainstay of treatment of hyperpigmentation is topical therapy, and skincare procedures like chemical peels and dermal needling. Combining products with different modes of action gives better results.

Skin brightening or lightening ingredients target uneven skin tone, dark spots, sun spots, post inflammatory hyperpigmentation(PIH) and melasma. The results are variable from person to person and there is much ongoing research to find effective yet safe ingredients. Use of many of these products is limited by the potential for irritating the skin and in this way worsening hyperpigmentation.

The gold standard for skin lightening is hydroquinone which is only available in prescription products in South Africa. Although it is very hard to treat hyperpigmentation on the skin we look at some of the ingredients with established efficacy and list some of the skincare products available.

Kojic Acid

Kojic acid is a frequently used and well studied skin lightening agent. It is generally well tolerated in topical applications.
MOA: Kojic acid inhibits the enzyme tyrosinase decreasing the production of melanin pigment.
It is also a potent antioxidant.

Products:
Neoretin Gelcream SPF 50
This product contains Kojic acid and a sunscreen.
Neoretin booster serum
This is a lightweight, rapidly absorbed formulation containing Kojic acid and other active ingredients which inhibit melanin synthesis. Retinsphere technology increases epidermal turnover.
SkinCeuticals metacell renewal B3
Metacell Renewal B3 contains Kojic acid and other active ingredients to target the early signs of ageing and hyperpigmentation.
NeoStrata Enlighten Pigment Gel This potent formulation contains Kojic Acid, Liquorice extract, citric acid and multiple other active ingredients to target hyperpigmentation.

Liquorice Extract


Liquorice extract is a natural skin lightening alternative to hydroquinone. It contains an active ingredient called glabridin, and is suitable for sensitive or rosacea prone skin as it also decreases redness and inflammation.
MOA: Liquorice extract inhibits the enzyme tyrosinase, increases epidermal turnover and is anti-inflammatory.

Products:
Lumixyl brightening crème
This gentle skin brightening product may be used while pregnant or breastfeeding. It improves the appearance of hyperpigmentation without irritation.

Citric acid

Citric acid is an effective product for treating several skin problems including mild acne, hyperpigmentation, blocked pores, sun damage and wrinkles. Citric acid is found in chemical peels, toners and skincare products.
MOA: Citric acid increases epidermal turnover and has antioxidant effects.

Products:
Neostrata Enlighten Pigment controller
This product is specially formulated with citric acid and retinol to target hyperpigmentation and sun spots.

Arbutin

Arbutin is a glycosylated hydroquinone extract. Arbutin has been considered one of the safest and most effective skin lightening agents. Its effects are optimised when combined with other substances like Vitamin C, Liquorice, glycolic acid and Kojic acid.
MOA: Arbutin inhibits the enzyme tyrosinase,decreasing the production of melanin pigment.
The active ingredient is slowly released making it suitable for those with sensitive skin.

Products:
Obagi Nu-Derm Blend FX
This product containing Arbutin penetrates deeper as the molecules are smaller. It is able to reach the basal layer of the epidermis and inhibit tyrosinase.
Obagi Nu-derm Clear FX
This light weight serum containing Arbutin targets epidermal hyperpigmentation.

Ellagic acid

Ellagic acid is a naturally occurring antioxidant found in fruits and berries that improves hyperpigmentation. It is gentle on the skin and safe to use.
MOA: Ellagic acid inhibits the enzyme tyrosinase, decreasing the production of melanin pigment.
It is safe to use on sensitive skin.

Products:
SkinCeuticals Advanced Pigment corrector
This product is formulated with ellagic acid and salicylic acid to target areas of hyperpigmentation and promote an even skin tone.

Other ingredient recommendations which have been shown to reduce melanin production include White Mulberry Extract, niacinamide, and azeleic acid
Vitamin C is a potent antioxidant which indirectly inhibits the enzyme tyrosinase leading to decreased melanin production. The anti-inflammatory effect reduces cell injury and pigment production.
Retinoic acid has many anti-ageing skin benefits. It reduces hyperpigmentation by increasing epidermal turnover.

Note from Dr. Kesiree

The management of hyperpigmentation requires a consistent and dedicated treatment routine. The results may be slow and vary between individuals. Your regimen should include preventative as well as treatment measures. Follow up your intensive treatment phases with a good maintenance regimen to maintain results.
Seek the advice of a dermatologist to assist with integrating topical treatments and skincare procedures.

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Types of Pigmentation and treatment

Postinflammatory hyperpigmentation(PIH)


This type of hyperpigmentation occurs in all skin types but is most common in those with darker skin.

It occurs after a skin condition or skin injury that causes the skin to become inflamed with resultant damage to the melanocytes, which are the cells that produce melanin pigment. Sometimes the preceding condition is barely noticeable.
Damage to the melanocytes causes melanin to be deposited in the dermis or epidermis (upper layer of the skin). This is important as epidermal hyperpigmentation fades faster than dermal hyperpigmentation, and in fact the dermal type may be permanent.
This type of hyperpigmentation can occur at any age, and on any part of the body.

It may appear tan, various shades of brown or blue gray. A blue gray appearance points to dermal melanin and a more prolonged and difficult treatment. Sometimes a dermatologist may be able to see lesions of the preexisting condition making it easier to make a diagnosis.

Common causes of post inflammatory hyperpigmentation that I see in my practice every day are acne, eczema, insect bites and skin infections. We need to treat the underlying disorder if it is still present to prevent more PIH from developing. If left untreated PIH may take years to resolve.

Melasma


Melasma or chloasma is a common disorder of hyperpigmentation that mainly involves the face. It usually affects both sides almost symmetrically and occurs in both males and females, though commoner in females. At least 90% of patients with melasma are women.
It can affect all races but is most common in darker skins where it is also the most difficult to treat.

Nevertheless melasma is a very distressing condition as it occurs somewhat out of the blue, sometimes seemingly without any precipitating factors.
Common precipitants are sunlight and hormonal influences (OCP and pregnancy). There is a genetic predisposition as in most diseases.
It may not seem fair that some of us will never get melasma even with reckless sun behavior and others will get it even with strict sun avoidance. The hyperpigmentation of melasma is due to increased melanin production by melanocytes i.e. increased activity of the melanocytes and not an increased number in the cells.

These melanocytes are called ‘reactive’ melanocytes. They produce an excess of melanin pigment, which is transferred to the skin cells called keratinocytes. Some of this pigment also ‘falls’ into the dermis where it gives a blue gray appearance to the skin. The key enzyme in the process of melanin pigment production is called tyrosinase.

Melasma is a clinical diagnosis based on a typical presentation. We do not do any tests to confirm the diagnosis. The hyperpigmentation of melasma can be described as flat coalescing brown, gray or bluish patches with irregular edges.
There are three typical patterns of distribution.

Centrofacial involves the forehead, nose, chin and cheeks. Malar pattern involves the cheeks and nose and mandibular pattern involves the area over the jawline.
Melasma may also occur on the neck and forearms i.e. extrafacial melasma.

Melasma is a common condition, but the treatment remains difficult particularly in darker skinned individuals where the condition may often either persist or recur.
Apart from classification according to distribution on the face, melasma is also classified according to where in the skin the pigment sits. As with PIH, epidermal melasma is more likely to respond to treatment than dermal melasma.

Melasma is managed with a combination of treatment modalities. Treatment needs to target various stages in the production and clearance of the excess melanin pigment.

Treatment of hyperpigmentation

Three pronged approach.
1. Avoid factors that stimulate melanocytes and cause them to produce more melanin ie avoidance of sun exposure, meticulous use of sunscreen and protective clothing. I must stress that protecting your skin from the sun is critical to the treatment and ongoing maintenance for patients with melasma. If you are on an oral contraceptive pill, consider an alternative form of contraception.

2 . Inhibit the production of melanin by melanocytes by targeting the enzyme tyrosinase.
The gold standand treatment to inhibit tyrosinase is hydroquinone. This treatment is only available by prescription. Other options are Arbutin, Kojic Acid and ellagic acid which are gentler and less likely to cause a worsening of the hyperpigmentation when discontinued.

3. Increasing the epidermal turnover will help to shed those keratinocytes which have been loaded with melanin pigment.
Topical creams and chemical peels help to remove the pigmented epidermal skin layers. Good options for accelerating epidermal turnover include glycolic acid and lactic acid

Proceed cautiously especially with darker skin types as there is no quick fix and epidermal injury from aggressive treatments could worsen hyperpigmentation

Remember that to maintain results as long as possible you will need to continue with your maintenance products.

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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.