OTHER HYPERPIGMENTATION ARTICLES:
What is Melasma?
What hyperpigmentation treatment is available?
What are the causes of hyperpigmentation?
Hyperpigmentation after laser hair removal
Hyperpigmentation post Eczema
Hyperpigmentation on the Face
Hyperpigmentation and Pregnancy
Hyperpigmentation is the excess production of the skin pigment melanin, appearing as localised patches which are darker than the surrounding skin. The patches are typically non-raised, as the hyperpigmentation occurs beneath the top layer of skin.
Hyperpigmentation occurs in all skin types, however people with darker skin tones are more prone to it. Those of Asian, African and Mediterranean origin can get it with greater frequency and severity.
There are three main types of hyperpigmentation:
· Post-Inflammatory Hyperpigmentation (PIH) - This occurs following skin injury e.g. from acne lesions or laser burns.
· Melasma - This is caused by hormonal fluctuations, common, for example, during pregnancy,
through use of birth control pills and hormone replacement therapy.
· UV damage - UV light stimulates melanocyte activity, producing excess melanin. As Asian, Arabic and
African skin is more exposed to the sun, this factor plays a larger role in darker skin hyperpigmentation.
Chemical peels, Hydroquinone products, Laser and Micro-dermabrasion are the four main treatments available.
A) Chemical peels
In darker skin, the usual Glycolic/TCA peels can lead to ‘hot spots’ where penetration is very quick. This can lead to burns and Post Inflammatory Hyperpigmentation (PIH) in darker skin types.
We use Mandelic acid, a very large molecule which takes a long time to penetrate the skin. This is incapable of burning the skin and gives a more even treatment across the area.
B) Hydroquinone products
This is the typical prescription by dermatologists but can lead to rebound hyperpigmentation, which is more severe and resistant to treatment. Hydroquinone is a restricted substance and must be used with great care.
We do not use Hydroquinone in our peel due to the potential for rebound hyperpigmentation.
This can be effective in Caucasian skin, but can cause many problems for Asian & Black skin due to high chance of Post Inflammatory Hyperpigmentation (PIH)
Lasers work by photothermolysis. This means a particular laser wavelength is attracted to pigmented areas. However, this is not ideal for darker skin types where there is less difference between the dark lesion and the surrounding skin. Laser should be used with caution in darker skins where there may be scatter of this energy.
Laser works well in Caucasian skin, where the surrounding skin does not absorb this energy, and all its energy goes to the targeted pigmented area. Unfortunately, in brown skin, the pigment-producing cells are large & quick to over-react to this heat, causing PIH.
In addition, laser can totally destroy melanocytes, leading to hypopigmentation (white patches) in all skin tones. This risk is non-existent in our Mandelic acid-based peels, as it is not melano-toxic (destroys melanocytes).
This is the mechanical removal (rubbing) of the superficial layer of dead pigmented skin cells. This can irritate the skin causing PIH and cannot be used in Acute Inflamed Acne. Although micro-dermabasion will give you a smoother and clearer complexion, the effect is temporary, as the melanocytes are still overactive causing hyperpigmentation to reappear later.
IN SUMMARY: The typical treatments above are suitable for caucasian skin but should be avoided by all darker skin tones. PIH can result from TCA/Glycolic peels, Laser and Microdermabrasion. Rebound hyperpigmentation can result from Hydroquinone.
A) Our peel cannot cause PIH or rebound hyperpigmentation.
B) We remove the top layer of pigmented cells AND treat the underlying hyperactive melanocytes. This double action is unlike any of the typical treatments outlined above.
HOW IT WORKS:
It works by calming down the hyperactive pigment producing cells (melanocytes), bringing them back to their normal level. This equalises melanin production in-line with the surrounding skin cells, eliminating the colour difference and giving the skin a more even tone overall.
We use Mandelic acid, a very large molecule which takes a long time to penetrate the skin. This is incapable of burning the skin like the common treatments and gives a more even tone across the treatment area.
Our Mandelic acid peel with Tyrosinase inhibitors is the treatment of choice for darker skin types as it takes between
8-12 hours to penetrate the epidermis with no chance of 'hot spots' or PIH. The Tyrosinase Inhibitors including: Kojic Dipalmitate, Alpha Arbutin and Azelaic Acid, treat the new cells being formed on the basal layer to reduce the activity of the overproducing melanocytes.