Pigmentation is becoming increasingly common worldwide. I see lots of clients who come to me at their wit’s end for help and advice with their skin – and equally hear from many more on social media who are struggling, too. On top of that there’s a lot of misinformation out there – making pigmentation even harder to deal with!
So here’s a comprehensive guide – to help you to understand pigmentation better, including the causes behind it and the treatment options available (things that actually work).
This is a two-part blog – so if you’re only looking to learn about treatments, you can jump to part two here. I do recommend reading both however, as the treatment options are of course closely linked to the causes behind your pigmentation. There are also a lot of pigmentation myths out here that I’ll be busting through the course of this blog and the next!
So without further ado, let’s dive in and learn more about pigmentation.
‘Pigmentation’ is a casual umbrella term that refers to any issue affecting the colouring of your skin. Usually when people say ‘pigmentation’ they mean conditions that cause darker patches of skin that don’t fade, although there are conditions that affect the skin’s ability to make pigment, such as vitiligo. Today, we’re focusing on the former – medically known as hyperpigmentation, where darkened patches of skin affect confidence and can prove
difficult to reduce or remove. Skin gets its colour from a pigment called melanin which is found in the basal layer of the epidermis. Our natural skin colour is determined by genetics, but other factors can cause the special
cells in skin responsible for producing melanin (melanocytes) to over- or under-produce, causing patches of darker or lighter skin on the face and body.
‘Why is this happening?’ is a question I hear a lot in relation to pigmentation – understandably so, as it often proves frustrating to treat and seems to ‘pop up’ unexpectedly. Without knowing and understanding the different causes behind pigmentation, it’s impossible to properly treat and minimise its appearance. The process of our skin colouring up when exposed to UV light its its natural defence process But in order to answer the question above, we need to know the different types of pigmentation to determine why and how it’s occurring.
One of the biggest myths surrounding pigmentation is that it is always caused by sun exposure. But whilst excessive or unprotected sun exposure can cause pigmentation and it is the largest cause its not the only one – in fact, there are various different types of pigmentation with a number of underlying causes.
Pigmentation from sun damage:
Solar Lentigines Hyperpigmentation can occur as a result of excessive sun exposure including sunbathing without protection and sunbed use, but also general exposure over time even without too much sun – even when the skin hasn’t burned, UV exposure over time can cause skin darkening. Pigmentation usually shows up in our 30s and 40s and beyond – when we’re being more sensible with our skin. I often see clients around this age who are shocked when they start experiencing pigmentation when they’ve finally started wearing spf and have a solid skincare routine – unaware that the damage behind occurred years before, when they were slathering on baby oil every summer in an effort to win the ‘darkest tan’ competition! It’s important to note that skin damage from physical trauma can also result in hyperpigmentation – and it can affect all skin tones and ages.
Melasma: Melasma is not sun related – it is in fact governed by our hormones, which cause melanin cells to overproduce resulting in dark patches. When we consider that the types of pigmentation covered above come from the top down as a result of damage or triggers on the surface of the skin, we should think of melasma as coming from within, where internal factors then show up on the outside. Because melasma is linked to hormones, it commonly affects women and often occurs during times of hormonal imbalance or disruption – such as pregnancy,
menopause and starting or coming off hormon treatments such as the IUD, HRT and the pill.
Although melasma isn’t caused by UV radiation, it certainly is made more visible with sun exposure, sometimes heat is enough to make it more visibly prominent. Melasma can also have a circulation connection – fuelled by a blood supply within the dermis, and this vascular element tends to cause flares in sun and also heat.
Post-Inflammatory Hyperpigmentation (PIH)
PIH is often the result of acne, burns, friction or aggressive clinical treatments such as chemical peels, dermabrasion, laser and IPL which may be been too harsh. This type of pigmentation will improve with time, it can take up to two years, it is treatable with topical products and specific treatments.
Determining the type of pigmentation you’re experiencing pre-treatment is important – because each naturally has a different course of remedial action associated with it. If you have melasma, for example, failing to address the imbalance within will cause it to continue to show up and some treatments will make it worse.
The differences are so subtle and need an expert eye to take a look at them (more on that next), but as a general rule of thumb:
Hyperpigmentation: Can occur as spots or patches of darker skin all over the body, including on the face. These are sometimes called liver or sun spots, and appear more as blotches of darker colour.
Melasma: Mostly occurs on the face – specifically the chin, nose, cheeks and forehead. It often mimics one side of the face to the other, cheek bones, forehead, upper lip are all common areas – can appear more as leopard splodges.
As you can see, the differences are minimal and not easy to determine for. A full assessment, including skin analysis, discussion around your lifestyle and skincare routine to give a definitive answer on what you’re dealing with.
I strongly recommend seeing a skincare expert if you suspect or concerned about pigmentation, and find you’re struggling to treat it yourself at home. Having a solid idea of what type of pigmentation you’re dealing with and knowing for sure the root cause (or causes) behind the symptoms you’re experiencing is the first step to finding effective treatments that will minimise the pigmentation you currently have and help to prevent further instances occurring.