March 2011 Newsletter
Hyperpigmentation… Age Spots, Liver Spots, Brown Spots
Are you concerned about uneven dark patches on your skin?
Darker spots on your complexion can be any of a number of skin lesions. They can be superficial or deep. They can be lightened by creams, lightened by lasers, or require removal. They can be removed by either lightly freezing or burning and heal quickly or require excision like a mole. In rare cases they could be something serious like a skin cancer.
Hyperpigmentation is a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin. Hyperpigmentation can affect the skin color of people of any race. A more mottled complexion is usually payback for years of sun-drenched vacations.
Age or “liver” spots are a common form of hyperpigmentation. They occur due to sun damage, and are referred to by doctors as solar lentigines. These small, darkened patches are usually found on the hands and face or other areas frequently exposed to the sun in older individuals.
Melasma spots are similar in appearance to age spots but are larger areas of darkened skin that appear most often as a result of hormonal changes. Pregnancy, for example, can trigger overproduction of melanin that causes the “mask of pregnancy” on the face and darkened skin on the abdomen and other areas. Women who take birth control pills may also develop hyperpigmentation because their bodies undergo similar kinds of hormonal changes that occur during pregnancy.
Changes in skin color can result from outside causes. For example, skin diseases such as acne may leave dark spots after the condition clears. Freckles are small brown spots that can appear anywhere on the body, but are most common on the face and arms. These are seen in young people with light complexioned skin that is prone to sun burns and exposed to the sun.
Freckles, age spots, and other darkened skin patches can become darker or more pronounced when skin is exposed to the sun. This happens because melanin absorbs the energy of the sun’s harmful ultraviolet rays in order to protect the skin. Wearing a sunscreen is a must. The sunscreen must be “broad spectrum” (i.e. it blocks both UVA and UVB). A single day of excess sun can undo months of treatment.
Optional Treatments for Hyperpigmentation
Most prescription creams used to lighten the skin contain hydroquinone. This bleaching agent blocks melanin, which are the pigment cells that give our skin color. Bleaches lighten and fade darkened skin patches by slowing the production of melanin so those dark spots gradually fade to match normal skin coloration. In more severe cases prescription creams with tretinoin and a cortisone cream may be used. Topical retinoids (derived from Vitamin A) exfoliate skin and speeds up new skin cell growth, diminishing dark, uneven skin patches along the way.
Chemical peels are also recommended as another step. Lighter peels have little to no flaking but need repetition and more time to lighten. Medium strength peels will lighten more quickly but have more irritation and flaking. Alpha hydroxy acids, such as glycolic acid, are exfoliants and can help remove hyperpigmentation. Beta hydroxy acids, such as salicylic acids, are also exfoliants that can help address hyperpigmentation.
Intense pulsed light (IPL) is good for treating broad areas. IPL treatment improves the appearance of photo aged skin, removes age spots (sun-induced freckles), most benign brown pigments, and redness caused by broken capillaries through a process called photo rejuvenation for face and body. The process is ideal for patients with active lifestyles because the procedure requires no downtime and has a low risk of side effects. IPL treatments are quick, gentle and non-invasive. The gentle, non-ablative treatments use broad spectrum light to treat the face, chest, neck and hands-virtually anywhere that sun damage shows.
There are now effective laser treatments. A test spot in an inconspicuous place will need to be done as they sometimes make things worse instead of better. These are best for tiny spots and best for darker spots in a lighter completed individual. Think of the IPL treatment as a brush and the laser as a pencil.
In all of these treatments the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc dioxide is preferred over that with only chemical blockers. This is because UV-A, UV-B and visible lights are all capable of stimulating pigment production.
Cosmetic cover-ups can also be used to reduce the appearance of melasma. We carry Jane Iredale® mineral makeup.
Other lesions can appear brown, but since the pigment is deeper in the skin, they have to be treated differently. Seborrheic keratosis is raised, light brown irregular benign lesions. They can be removed by freezing or lightly cauterizing and will heal quickly. Nevi or moles are raised brown lesions that are excised if needed. Rarely, brown spots are premalignant or malignant including lentigo maligna, or melanoma.
IPS skin care products for your pigmentation problems
Gradual brightening skin products:
K Brightening cream Antioxidant skin brightener containing Kojic acid, hydroxyl-acids and Vitamin C. A more gradual brightening cream.
K Brightening pads. A brightening cream for oily skin.
K Dark Circle antioxidant under eye treatment. A gentle under eye brightener.
Weekly Mini Peel once a week exfoliating brightener. Use 1-2 times weekly to lightly exfoliate and brighten the skin.
Higher Intensity skin products:
K Lightening Pads Easy to apply pads contain hydroquinone for melisma and post inflammatory hyperpigmentation in convenient easy to use pads. Enhanced with Vitamin C, Kojic acid, and Salicylic acid.
K Lightening Stick An easy to apply touch stick to treat spots of melisma or other hyperpigmentation with hydroquinone, Vitamin C, Kojic and Salicylic acids.
Retinol Repair Gel 20 and 50 topical retinoids which when added to the lightening treatments will increase dispersion of melanin as well as improve dysplasia and increase collagen.
Retinol 20 pads same as above for oily skin.
IPL – Intense Pulsed Light Treatments
Diolite Laser Treatments