Question 1

How can I tell if I have pigmentation and are there different types?

Accepted Answer

Pigmentation refers to uneven skin tone. It happens when melanocytes, or the pigment-producing cells in the skin, are overstimulated. Pigmentation will tend to look brown, or occasionally can have a blue/black tinge depending on your skin tone. This can happen for a variety of reasons, which is why there are different types of hyperpigmentation. The biggest culprit is sun exposure, with UV light causing the skin to want to protect itself, stimulating melanin production, which is what we all see as a tan. But if in certain patches your skin has had to form more melanin to protect your skin’s DNA from damage then you can develop a solar lentigo, commonly called an age spot.

Melasma is another common form of pigmentation, caused by a combination of sun exposure and hormones. It is more common in women and often develops in women who are pregnant or taking oral contraception. This would appear in a symmetrical pattern, often described as looking like a butterfly across the cheeks. The forehead and upper lip are also commonly affected. Post-inflammatory hyperpigmentation is another form that develops when your skin forms dark patches after a form of trauma, for example this could be after a procedure or acne and will be localised around the site where the trauma has happened.

Question 2

What are some of the misconceptions around pigmentation?

Accepted Answer

That all skin tones are prone to hyperpigmentation. Just because you may have a darker skin type, this does not protect you from hyperpigmentation. Pigmentation can also affect all age groups, it is not a condition of the elderly, even though it is often nicknamed "age spots". You can develop pigmentation in your 20s and if you are not careful with sun protection, have hormonal risk factors or skin trauma.

A final misconception is that genes determine pigmentation more than lifestyle, whereas actually, we can fight genetic influences through good lifestyle choices. Wearing sunscreen, not smoking, combatting pollution and maintaining a good skincare routine will all help to moderate genetic risk. Even once you have gotten rid of your pigmentation, it will still need to be something you continuously work on. For example, by making sure to protect your skin in the summer with a good SPF.

Question 3

How can medical grade skincare help manage my pigmentation?

Accepted Answer

Medical grade skincare is the single most important component of managing hyperpigmentation. There are excellent prescription and non-prescription ingredients which can help. The gold standard is a prescription ingredient called Hydroquinone. Clinicians often prescribe this in a 4% concentration, which helps to moderate melanocyte activity and help to reduce pigmentation. Hydroquinone is often combined with retinoids, which can be either prescription or non-prescription depending on the severity of the skin condition and your lifestyle. Retinoids will help to reduce pigmentation as well as increase cell turnover, helping the pigmentation to clear more rapidly. Another excellent alternative to hydroquinone is a non-prescription ingredient called Cysteamine, which is found in Cyspera. Kojic Acid, Vitamin C, Isobionic Amide, Licorice Extract, and Arbutin are also excellent non-prescription options that are often found in combination with one another. A broad-spectrum sunscreen with an SPF of at least 50 should be mandatory every single day, no matter what the weather.

Question 4

How can pigmentation be minimised or prevented?

Accepted Answer

Symptoms of pigmentation may also be reduced at later stages by combining powerhouse medical grade ingredients into your skincare routine. In-clinic treatments can also be helpful, with chemical peels and lasers being the best options for treating pigmentation, however, do ensure to consult your practitioner first for guidance.

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