Set your sights on a com­plex­ion free of patches, as Michaela Wil­liams ex­plain how to com­bat both­er­some hyper­pig­men­ta­tion

Friday - - Contents -

Hyper­pig­men­ta­tion put you on the spot? Fri­day comes to the res­cue.

You’ve sur­vived the pim­ply teen years, and made it through the hor­monal acne and late nights of your twen­ties rel­a­tively un­scathed. So it’s a bit un­fair that you now have to deal with hyper­pig­men­ta­tion – ar­guably the next stage of an­noy­ing skin ail­ments. But don’t lose hope quite yet. There’s a num­ber of treat­ments – both from your lo­cal beauty counter, and friendly der­ma­tol­o­gist – that can help clear up your com­plex­ion.

Hyper­pig­men­ta­tion refers to ar­eas of skin that are darker than the sur­round­ing com­plex­ion, from teeny lenti­gos (bet­ter known as freck­les), patches of un­even skin­tone on the face and larger swathes that can cover a suf­ferer’s back. (Con­versely, hy­popig­men­ta­tion de­scribes paler patches ap­pear­ing on darker skin.)

This colour comes from an over­pro­duc­tion of melanin, usu­ally trig­gered by sun ex­po­sure or an ex­cess de­posit of hemosiderin (the end prod­uct of dam­aged red blood cells). It doesn’t take too much to set off a batch of hemosiderin-trig­gered hyper­pig­men­ta­tion, as it can be caused by ev­ery­day skin com­plaints such as bruis­ing, acne blem­ishes, al­ler­gic rashes, and der­mati­tis. Hyper­pig­men­ta­tion can also be a side-ef­fect of more se­ri­ous af­flic­tions, in­clud­ing Ad­di­son’s, Cush­ing’s and Grave’s dis­eases, which in those cases makes a few freck­les the least of your wor­ries.

Dr S. Man­jula Je­ga­sothy, a board-cer­ti­fied der­ma­tol­o­gist and the founder and CEO of the US’ Mi­ami Skin In­sti­tute, says that hyper­pig­men­ta­tion is more likely to oc­cur in darker skin types due to their ge­netic make-up. ‘Olive to darker com­plex­ions have more in­her­ent melanin in their skin to be­gin with,’ she ex­plains. ‘[They] are more eas­ily able to pro­duce ex­cess melanin after a skin in­flam­ma­tion,’ re­sult­ing in patches ap­pear­ing any­where on the body, although the face, neck and backs of hands are more prone due to their fre­quent ex­po­sure to the sun. With the ma­jor­ity classed as be­ing a be­nign melasma, marks caused by hyper­pig­men­ta­tion are usu­ally not a dan­ger to your health, but can still be an un­wel­come ad­di­tion to your com­plex­ion.

Out, out, spot!

As with the ma­jor­ity of skin ail­ments, preven­tion is the best cure, says Dr Je­ga­sothy. That means load­ing up on the SPF, avoid­ing pick­ing at your skin, and tend­ing to vi­ta­min de­fi­cien­cies, bruis­ing, al­ler­gens and stres­sors that can trig­ger changes in your skin. How­ever, spend­ing life swad­dled in sun­screen may not be enough to pre­vent marks ap­pear­ing. For ex­am­ple, with preg­nancy-in­duced hyper­pig­men­ta­tion, it’s the change in hor­mones com­bined with a ge­netic pre­dis­po­si­tion that then trig­gers your skin to pro­duce vari­a­tions in skin colour.

For 37-year-old Dubai res­i­dent Shima, the dark marks that first ap­peared just above her jaw­line when she was preg­nant with her sec­ond child were an un­ex­pected side ef­fect that she ini­tially blamed on long days at the beach. ‘They ap­peared al­most overnight, and I was des­per­ate to get rid of them as they looked like a stain from dirt,’ she re­calls. In frus­tra­tion, Shima used any­thing that promised a deep clean. ‘I started wash­ing my face with a body scrub made with salt, which only made my skin dry. My mother-in-law then sug­gested to use Fairy liq­uid [dish­wash­ing de­ter­gent], and in des­per­a­tion I did, but that made my skin feel rough, and still the marks stayed,’ she says, wincing at the mem­ory. ‘I was like Lady Macbeth, moan­ing and scrub­bing away at my stains ev­ery night.’ After al­most a year, she fi­nally booked an ap­point­ment with a der­ma­tol­o­gist who pre­scribed a course of clin­i­cally-tested prod­ucts with vi­ta­min C for hor­monal-in­duced hyper­pig­men­ta­tion.

‘It turned out that my fam­ily has a his­tory with hyper­pig­men­ta­tion – my mum had it when she was first preg­nant, and my aun­ties too. But we all thought it was from be­ing in the sun, which wasn’t the case at all.’

As Shima dis­cov­ered, hyper­pig­men­ta­tion isn’t some­thing that can be phys­i­cally scrubbed away, with ex­tra rough han­dling of­ten stress­ing skin out even fur­ther. In­stead, suf­fer­ers should take a more gen­tle ap­proach to coax away marks.

A pop­u­lar so­lu­tion is in­tro­duce a spot-light­en­ing step to your skin­care rou­tine to fade away older marks. Here, the ‘whiten­ing’ ac­tion is ac­tu­ally a chem­i­cal ex­fo­li­a­tion, us­ing po­tent in­gre­di­ents to safely fade away un­wanted marks, with­out dam­ag­ing or dis­colour­ing the sur­round­ing skin. These for­mu­las en­cour­age skin cells to turnover and re­plen­ish at a faster rate, and even­tu­ally evening out the un­wanted pig­men­ta­tion. One of the hero in­gre­di­ents fea­tured in the more ef­fec­tive bright­en­ing creams, vi­ta­min C, aka ascor­bic acid, is par­tic­u­larly good at shift­ing sur­face skin cells with­out caus­ing fur­ther dam­age, with re­search by Ore­gon State Univer­sity sug­gest­ing that vi­ta­min C is

up to 20 times more ef­fec­tive when ap­plied top­i­cally. By adding a form of the pow­er­house vi­ta­min to your skin­care rou­tine, whether as a serum, night cream or fad­ing treat­ment, you can start eas­ing your way back to a more even com­plex­ion.

For fresh cases of hyper­pig­men­ta­tion, Dr Je­ga­sothy rec­om­mends to seek help from a der­ma­tol­o­gist as soon as you no­tice any tonal changes in your com­plex­ion. She ex­plains that early de­tec­tion is the best way to im­ple­ment a strat­egy and long-term treat­ment plan for hyper­pig­men­ta­tion, giv­ing you the best chance of re­turn­ing to com­pletely blem­ish-free skin.

‘Der­ma­tol­o­gists of­ten use pre­scrip­tion top­i­cal agents such as Tri-luma cream or dif­fer­ent types of fruit-based acid peels such as sal­i­cylic acid, lac­tic acid, man­delic acid and pyru­vic acid to help pa­tients with their hyper­pig­men­ta­tion,’ says Dr Je­ga­sothy, point­ing out that these op­tions are usu­ally pre­scrip­tion-based only. ‘Many of these so­lu­tions are very safe and can be used in darker skin types with­out a pos­si­ble threat of caus­ing even more hyper­pig­men­ta­tion.’

Tougher tac­tics

While turn­ing to over-the-counter top­i­cal so­lu­tions first is the safest – and most bud­get-friendly – way to tackle dark blem­ishes, there are cases that will re­quire fur­ther in­ter­ven­tion to see sat­is­fy­ing re­sults, points out Re­becca Tre­ston, man­ager of Re­becca Tre­ston Aes­thet­ics at Euromed Clinic Cen­tre in Dubai. ‘If some­one has a per­sis­tent hyper­pig­men­ta­tion that does not fade or go away after us­ing creams, this is when it is time to seek pro­fes­sional help with an ex­pert who can as­sess your type of pig­men­ta­tion and ex­plain how it can be treated most ef­fec­tively,’ she says. ‘If the pig­men­ta­tion or melasma is deep, then you can opt for lasers, but you should only have laser treat­ments given by some­one who has been rig­or­ously trained in the pro­to­cols, as it takes a huge amount of ex­per­tise and care.’

The Dubai-based prac­ti­tioner says that it’s im­por­tant to keep ex­pec­ta­tions re­al­is­tic when it comes to fad­ing hard-to-budge marks, es­pe­cially if you’ve pre­vi­ously put off seek­ing treat­ment – or had a crack at it your­self with the dish­wash­ing liq­uid. ‘Pig­men­ta­tion is faded but never cured,’ she says. ‘You need to un­der­stand lim­i­ta­tions and re­al­is­tic out­comes of any treat­ment, which a good prac­ti­tioner will ex­plain to you.’ In her clinic, Re­becca prefers to treat her busy clien­tele with tar­geted lasers, a method that is ef­fec­tive, but that doesn’t cause peel­ing and the as­so­ci­ated down-time.

‘Spec­tra or Evo Q-switch lasers are my favourite treat­ments for pig­men­ta­tion,’ re­veals Re­becca. Both of these lasers can help fade marks by pro­duc­ing an acous­tic vi­bra­tion that shat­ters the darker pig­ment. But there’s a catch for those who don’t pay at­ten­tion to what they do after leav­ing the clinic, with Re­becca warn­ing that dis­re­gard­ing home-care in­struc­tions and get­ting too much sun, too soon, can re­sult in the is­sue’s swift reap­pear­ance and a waste of your dirhams – not how we’d sug­gest mak­ing your mark.

Keep ex­pec­ta­tions RE­AL­IS­TIC when it comes to fad­ing hard-to-budge marks, es­pe­cially if you’ve pre­vi­ously put off SEEK­ING treat­ment – or had a crack at it YOUR­SELF with the dish­wash­ing liq­uid

It is im­por­tant to con­sult a der­ma­tol­o­gist as soon as you see any changes to your com­plex­ion

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