Hyperpigmentation Pure Serenity Column

Esthetician Marjan Kashi performs a NeurotriS Microcurrent anti-aging skincare treatment on a client. Microcurrent facials, which tighten and smooth the muscles and connective tissues, are often used in combination with retinols and serum lighteners to treat hyperpigmentation.

Hyperpigmentation is discoloration of the skin caused by unregulated overproduction of melanin in the epidermal or dermal layer of the skin. Hyperpigmentation commonly presents as sunspots, birthmarks or melasma – those blue-gray or brown patches or freckle-like spots.

Several factors play a role in the formation and distribution of melanin, including hormonal imbalance, UV radiation, medications, physical trauma, cellular dysfunction, inflammation and/or genetics.

Following is a rundown of the three major types of hyperpigmentation and their respective treatments.

• Post-inflammatory hyperpigmentation (PIH) is an inflammation caused by trauma or injury to the skin. This type of pigmentation has a better recovery than the other two types on its own, with time.

Mechanical trauma such as burns, picking at acne and other skin disorders like eczema can leave marks on the skin. Certain medications, like antibiotics, can lead to PIH because there are existing receptor sites on the melanin for specific chemicals. That’s why doctors recommend limiting exposure to the sun while on such medications. For some aesthetic procedures, including deep chemical peels and light procedures, professionals highly advise clients to prep their skin a few weeks in advance of treatment, depending on their skin color, to prevent PIH and to enhance the outcome.

• Excessive ultraviolet rays can wreak havoc on the skin, leading to darkening of freckles, those yellowish-brown spots that appear on the nose and cheeks by genetic predisposition. UVA, with a longer wavelength, reaches the dermis and breaks down the collagen, causing aging and wrinkles; UVB has a shorter wavelength, reaches the epidermis and makes the skin red or tan. Excessive UV exposure can lead to mutation in the DNA and ultimately cause cell death (apoptosis). Sunspots, liver spots or solar lentigines are usually seen on the face or hands of elderly adults with fair skin, a result of overexposure to the sun’s harmful rays.

The treatment that works best on such dark spots is intense pulsed light therapy every four weeks in a series of three to six, depending on how the skin responds.

• Melasma, also known as pregnancy mask or chloasma, is a deeper pigmentation induced by hormones. Not all women are prone to melasma; we don’t know why some suffer from it but others don’t. Pregnancy, oral contraceptives and hormone therapy can trigger melasma, which appears in a symmetric pattern on the forehead, cheeks and upper lip.

Clinical treatments such as a trichloroacetic acid and Jessner peels, as well as resurfacing lasers, are safe treatments for melasma. People with melasma should be careful not to get sunburned, as the pigmentation can remain permanent. Melasma with proper treatment can become lighter, but it never really vanishes, and once exposed to UV rays or a melanocyte-stimulating hormone, it can unfortunately return.

Skin solutions

Treating the above pigmentation problems requires a diligent at-home care regimen. The three main products recommended to speed up and prevent further damage to the skin are sunblocks, lighteners and retinols.

• Sunblock is the most important product to use on a daily basis, in accordance with all treatment protocols and a maintenance program. Any sunblock you choose should contain titanium dioxide and zinc oxide. They work as a protective mirror on the skin and prevent heat absorption. I recommend not using chemical sunscreens, as they tend to absorb partial UVB.

• Lighteners are most effective when used twice daily, because they interfere with the melanogenesis cycle in multiple steps. They slow down the production of melanin, yet protect the DNA. The one I highly recommend is 100% L-Ascorbic Acid in dry powder form – it never expires and remains inactive until it is mixed with another product.

• Retinols in conjunction with serum lighteners work their magic, as one regulates the amount of melanin being produced and the other hydrates the skin and increases cell turnover.

When treating hyperpigmentation, the best chance for a successful outcome will include a combination of the methods and products noted above, as well as additional clinical treatments such as collagen induction therapy, NeurotriS Microcurrent and Omnilux phototherapy, followed by proper, diligent home care. Proper diagnosis by a skin professional is important prior to any treatment. Early detection of the underlying cause by a professional and a thoughtful plan with set goals and realistic expectations are the first steps to healthier and more youthful-looking skin.

Los Altos resident Marjan Kashi is a licensed medical esthetician, electrologist and the founder of Pure Serenity Skincare. For more information, call 999-7873 or visit pureserenityskincare.com.