Coping with skin pigmentation

All About You online 14.05.2008

Dark spots on the skin can add years to your age, so treat the problem with Eve Cameron's expert advice

Brunette woman with flawless skin A smattering of freckles across the nose can look pretty, but larger areas of pigmentation can make you feel very self-conscious. Now there's news that the evenness of your skin tone can indicate your age as much as wrinkles do. A recent study by behavioural biologists Dr Karl Grammer and Dr Bernhard Fink, and skin expert Dr Paul Matts of P&G Beauty, revealed that skintone alone can impact a woman's perceived age by a range of up to 20 years.

What causes pigmentation?

As with lines, sun exposure is a major factor in pigmentation. Dr Ginny Hubbard, Olay's consultant dermatologist confirms, 'Chronic sun exposure is the main factor, so pigmentation is likely to be damage that was done in childhood or your teenage years. Exposure to UV light makes the cells that produce melanin pigment (the tan of the skin) multiply and produce more tanning pigment within the skin. Although this is generally even pigmentation, patchy brown spots, called sun spots or solar lentigines, also develop'.

Pigmentation is also commonly caused by oestrogens, getting worse if you're on the Pill, pregnant or taking Hormone Replacement Therapy. This is known as melasma and is more commonly, though not exclusively, seen in people of Mediterranean, Asian and African descent. Sun exposure is a vital factor in making it worse. Additionally, some drugs and using perfume on areas of the skin exposed to sun can create pigmentation too.

What can you do about it?

So what can you do about pigmentation? According to Dr Hubbard, the key is to use a high factor sunscreen (she recommends SPF60) on a daily basis to prevent the pigmentation worsening. Even if it fades, either naturally or with the help of treatment, the moment you are exposed to the sun without protection, it will return.

Useful products

There are lots of creams on the market that promise a brighter, more even toned complexion and help to fade dark spots. These mostly work in one of two ways, as Dr Leslie Baumann explains in her book 'The Skin Type Solution' (£16.99, Hodder Mobius); either by inhibiting the enzyme tyrosinase, which prevents the formation of melanin, or by forestalling the transfer of colour into the skin cells. Ingredients in skin creams that do the former include liquorice extract, kojic acid and arbutin. Soy and niacinamide prevent the colour transfer and so are used in many skin lightening/brightening products.

Skin peels

Peels can also help pigmentation, from the at-home mild glycolic versions (No7 and L'Oréal both do good ones) to stronger in-clinic ones, done under the supervision of a doctor or nurse. These include glycolic peels at far greater concentrations than those used in beauty products and also trichloroacetic acid (TCA) peels. Laser, as well as peels, can work for freckles and sunspots. All of the treatments take time to see results, which is why the best advice for immediate action is to go and buy yourself a good high-factor sunscreen and get into the habit of wearing it every day.

Seek expert help

If the sunscreen/cosmetic cream treatment isn't yielding enough results for you, do consult a dermatologist for other solutions. Hydroquinone for example is banned from cosmetic creams here in the UK, but is available on prescription. The reason it's banned from cosmetic creams is because of evidence linking its use to an increase in patchy pigmentation, explains Dr Hubbard, the so-called 'confetti-effect', where the skin has patches that are lighter than the rest of the skin tone as well as darker patches.

However when used with caution and under expert supervision, she believes hydroquinone can be of use to reduce pigmentation. Dermatologists sometimes prescribe it at 4% concentration, together with topical tretinoin and a very mild steroid.

For expert medical advice on all skincare problems, visit www.netdoctor.co.uk