© United Shades of Skin 2023
At some point or another, most of us will experience dark spots or discolouration of our skin, either on the face or body. The technical term for this is hyperpigmentation, which could include: sun damage or age spots, freckles, birthmarks, post inflammatory hyperpigmentation (discolouration left behind after a breakout or other injury to the skin), or melasma and occur anywhere on the face or body but is most typically seen on high points such as the cheeks, nose, forehead, shoulders and chest.
Within our skin we have a cell called a melanocyte, which is responsible for creating and evenly dispersing melanin to provide colour to our skin. Sometimes this cell can get the wrong message and start to produce too much melanin uncontrollably.
Rosacea is categorized into three types, each with their own presentation and symptoms. In some cases, rosacea may progress into more aggressive stages if left untreated.
Technically known as ephelis, will increase in number and darkness with sun exposure. Lentigines, on the other hand, will stay consistent in number and darkness regardless of sun exposure or season. Freckles or Lentigines can appear all over the face and body, even on the lips or eyeballs.
These are flat areas of discolouration that can be tan or varying shades of brown. They appear on the parts of your body that get the most sun exposure, such as your face, shoulders, back, and the backs of your hands. They often start to appear around the age of 30-40, though some people may develop them earlier or later in life, depending on the amount of sun exposure they’ve had.
Birthmarks are one of the most unique types of pigmentation because there are so many varieties. Most commonly we see ‘cafe au lait’ birthmarks, which are a sort of ‘coffee with milk’, brown kind of colour. However birthmarks can also be red (port wine stains, salmon patches), vascular (hemangiomas and cherry angiomas), or even a grey-blue bruised-looking colour (Mongolian spots). In some cases, a birth mark may be hypopigmented, meaning it lacks colour.
Melasma is a chronic and very common skin condition that causes dark, discoloured patches (usually muddy brown or grey-brown patches) of pigmentation on the skin. Most people will get melasma on their cheeks, bridge of the nose, forehead, chin and above their upper lip. Melasma may also appear on other parts of the body that get significant sun exposure, such as the forearms and neck, although this is less common.
Pigmentation leftover from injury or infection, like acne, may be either PIE or PIH. This is a type of inflammatory pigment that the body uses in part due to wound healing and as protection. With PIH, the pigment producing cell itself (the melanocyte) is malfunctioning. Think of the melanocyte like your skin’s bodyguard — it uses pigment as a way to protect the deeper tissue and cells that sit below in the dermis. Our melanocyte cells can become stimulated to produce pigmentation from injury and inflammation, such as with acne.
There is minimal to no downtime post procedure, depending on the treatment performed. In some cases you may experience slight redness, dryness, and temporary darkening of pigment until it sloughs off (like coffee grounds on your skin). Since treatments are highly customizable, you will receive specific detailed instructions for post-treatment care.
When it comes to treating hyperpigmentation, you’ll need to address the damage that is already existing as well as protect the skin to prevent new pigment from forming. This means treating the skin with a combination of in clinic procedures and home care.