Pigmentation results from melanin, a pigment molecule that appears as black or brown, distributed beneath the skin. This pigment shields the skin cells from the sun’s rays and is present in everyone. However, we typically don’t perceive a uniform distribution of melanin. It’s not simply about desiring a tan; humans are naturally drawn to a balanced complexion, irrespective of its lightness or darkness. Remarkably, evolutionary biologists have demonstrated that the evenness of skin coloration plays a significant role in how we perceive faces as young and attractive. In fact, it has a greater impact than the presence of wrinkles or lines.

Pigmentation is the colouring of the skin caused by a pigment molecule called melanin, which resides in the keratinocytes of your skin cells. It serves as protection against sun damage; however, when unevenly distributed, it can affect the freshness of your face. This uneven distribution, known as pigmentation, can stem from various causes, including hormonal factors (melasma), acne or eczema scarring (post-inflammatory hyperpigmentation), and primarily, sun damage.

While hyperpigmentation garners more attention in the industry, hypopigmentation, which refers to lighter areas of skin, remains less explored. Vitiligo, an autoimmune condition characterised by patches of depigmentation, offers insights into this form of hypopigmentation. Albinism, a congenital disorder associated with pigment irregularities, is another relevant area of study; however, it involves a complete absence of melanin, unlike the gradual depigmentation we’re discussing here.

In cases of hypopigmentation, lighter color results from a lack of melanin or melanin inactivity in the affected area, sometimes caused by trauma or chemical reactions. Genetic factors also play a role in conditions like vitiligo.

It’s worth noting that over-treatment with certain procedures like laser or skin peels, as well as skin resurfacing methods like dermabrasion, can induce hypopigmentation.

The connection between hypopigmentation and various causes provides a complex picture to understand and address.

Melasma, a pigmentation condition driven by hormones, typically occurs during pregnancy, contraceptive pill usage, hormonal fluctuations in menopause, and can also affect men.

This type of pigmentation often manifests as a butterfly-shaped patch across the middle of the face. Dr. Natalia Spierings, a renowned UK consultant dermatologist, treats melasma similar to other pigmentation issues. She combines a prescription-strength retinoid (like tretinoin) and hydroquinone, a prescription pigment-buster. Don’t forget to apply sunscreen on top!

Learn more about tackling melasma and achieving clear, radiant skin with Dr. Spierings’ expert guidance.

Tranexamic acid is an additional treatment that can effectively control melasma. It comes in pill form and works by blocking oestrogen receptors in the body, preventing excessive pigmentation. Combining it with prescription hydroquinone and a retinoid, as recommended by Dr. Spierings, can yield exceptional results. Notably, you can obtain tranexamic acid from UK pharmacies without a prescription, commonly used for reducing heavy menstrual bleeding. However, it’s important to be aware that there have been isolated cases involving deep-vein thrombosis associated with this medication.

While there are prescription steroid creams that have demonstrated effectiveness in treating vitiligo, it is important to note their potential side effect of skin atrophy. Skin atrophy results in thin and translucent skin, making veins more visible. Unfortunately, there are no over-the-counter products available for vitiligo treatment.

Hypopigmentation’s origins are still largely unknown. It presents difficulties in providing effective prevention strategies. However, it is interesting to note that this condition tends to manifest on sun-exposed areas. Therefore, the key to reducing the likelihood of hypopigmentation is maintaining healthy skin in these regions. Focusing on the face and hands, it is imperative to establish a comprehensive skincare routine, both in the morning and at night, and consistently moisturise the hands. Additionally, staying well-hydrated by consuming ample amounts of water assists in maintaining skin hydration and facilitating the delivery of essential nutrients to the skin’s targeted areas.

Yes, your skin does accumulate damage from UVA light throughout your lifetime. As you age, this damage manifests as hyperpigmentation, such as age spots. The evenness of your skin’s pigmentation serves as a reliable visual indicator of your facial age. Additionally, there is a chance of developing melasma later in life, especially if it initiates during pregnancy or hormone replacement therapy (HRT). Unfortunately, it’s impossible to predict whether or not you will experience melasma by the time you reach your twenties.

Light treatments utilise targeted light beams to break up pigment clusters in the skin, allowing the body’s lymphatic system to clear them away. This technique works by attracting the light to the skin’s pigment, making it more effective on lighter skin tones to minimise the risk of hyper- or hypopigmentation. However, certain lasers can still provide good results on darker skin. If you have concerns, consult your chosen practitioner for more information and personalised advice.

It’s worth noting that both IPL and lasers are commonly used for hair removal, but different settings or types of lasers are used for pigmentation treatments. Surprisingly, there is no regulation on practitioners or clinics that can use lasers and IPL machines, so it’s crucial to do your research and choose a reputable practitioner. The expertise of the practitioner greatly influences the final outcome, which is true for many areas of aesthetics.

Using bleaching agents like lemon juice to remedy hyperpigmentation is not recommended due to the potential for skin damage. Instead, focus on strengthening your skin through healthy living and a nutritious diet. However, it’s important to note that direct action is necessary to address hyperpigmentation as it doesn’t fade on its own.

Interestingly enough, in a 2011 metastudy of 436 patients with vitiligo, it was found that Dead Sea climatotherapy – which involves sun exposure and bathing in the Dead Sea according to a medically prescribed routine – effectively stimulated repigmentation. This therapy has shown promising results for those seeking treatment for vitiligo.

Post-inflammatory hyperpigmentation (PiH) is a common concern resulting in flat spots of pink, red, brown, or black discolouration left behind by acne. Thankfully, there are effective skincare treatments mentioned on this page that can help with PiH. Additionally, light treatments like laser therapy and skin peels can offer significant improvements. Laser treatment specifically targets pitted acne scars and aids in stimulating the growth of new collagen and elastin. It also breaks up pigment beneath the skin, allowing the body to clear it naturally.

Another remarkable treatment for post-inflammatory hyperpigmentation is microneedling. As mentioned earlier, microneedling is versatile and can also be used to treat hypopigmentation. The procedure involves creating thousands of tiny punctures in the skin using either roller or pen-like devices. This process triggers a wound-healing response, leading to the production of growth factors and the formation of new, firming collagen. Don’t worry, though, you’ll be given an anaesthetic cream to minimise any discomfort beforehand. The results of microneedling can be truly remarkable.