All about skin spotting

HYPERPIGMENTATION BEFORE

Hyper-pigmentation or darkening of the skin is the most often complained about skin condition I hear in my practice.  Whether the spotting is from sun exposure (solar lentigines) or melasma/cholasma (hormone induced blotches) we all wish for the smooth, even complexion of our youth pre-pregnancy, pre-acne or pre-sun-worshipping.   It’s those darkened splotches that stare back at us in the mirror each day and remind us of our transgressions or hormones gone awry.  Most of us want them gone.

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Vanity aside, those darkened areas are the residual effect of our bodies immune system actually protecting our skin.  The darker the spot the more evidence we have of our skin working to protect us from the sun by releasing an extra dose of protective melanin [skin pigment].  Good job little spots!

But the greater implication of the skin spotting is the knowledge that our skin was vulnerable when exposed to the sun so it had to hyper-protect itself.  I hate to tell you this, but even a suntan is your skins way of trying to create a barrier of protection with its own darkened color!  If you think of the worlds genetic population, naturally darker skin tones originated closer to the equator where the sun is most intense as self-protection and the more fair skins originated further away where less protection was needed.

chloasma

Any injury or toxin in the skin leaves it sensitive to sun exposure.  An acne wound, a burn, a scratch, esthetic peels, plastic surgery… OR spikes of hormones* from pregnancy, birth control, hormonal replacement, stress…OR certain prescription drugs, recreational drugs… OR toxic topically applied compounds that the body wants to reject like synthetic fragrance, certain chemicals, …  there is an endless list.  Any healthy, active immune system will stimulate a release of pigment to protect its skin.

Unfortunately, once this protection occurs, it becomes permanent memory in the skin cells and pigment continues to be released at the site when ever the skin is exposed to the sun.  Fading these pigment clusters or spots requires sun avoidance and topically applying compounds that suppress the tendency for melanin to cluster and compounds that will bleach the existing pigmentation.  Removing pigmented skin cells through peeling products or treatments can be helpful too just as long as avoidance of sun is adhered to, otherwise the process can make new hyper-pigmentation.

chemical-lab

Like ingesting nutritional food will get the benefits to your whole body, ingredients that help fade spots must be administered in a way that can be penetrated into the skin.  There is a science to it; ingredients just rubbed on won’t significantly work just like rubbing carrots on your face won’t help your eye sight!  Ingredients carried into the layers of the skin through additional ingredients or specific processes will have the most effect. This is why using products formulated for professional use with a specific process in mind work and why the over-the-counter preparations are less successful.

To fully achieve lightening results, it is important to understand the process through which melanin is formed in the skin cells.  It is a highly complicated process involving a variety of proteins, enzymes, and amino acids.

  1. Stimulation occurs (sun exposure, injury, hormone dumps, topical skin sensitizers)
  2. The tyrosinase enzyme in the skin is activated and triggers the release of melanotropin, a  polypeptide hormone.
  3. Melanotropin MSH (Melanin Stimulating Hormone) activates the production of melanin pigment.
  4. Melanin transfers into the keratinocyte skin cells that will accept and hold the pigment.

natural-vs-chemical-ingredientsConsequently, there are several possibilities where the synthesis of melanin can be inhibited or decreased. The depigmenting compounds that are currently being formulated with achieve depigmentation by one of the following mechanisms; either by inhibiting tyrosinase synthesis or its activity, by inhibiting MSH synthesis, by helping the skin to resist spotting or by removing the pigmented cells.

Compounds that bleach darkened areas of the skin or help it resist pigmentation through sun exposure:  All forms of vitamin C and citrus oils (never apply directly to the skin and do not wear IN the sun – like a peel, the skin is sensitized initially), vitamin B-3, herbal extracts of peppermint, chamomile and mallow, kojic acid (derived from rice)

Compounds that inhibit the creation of melanin.  Azelaic acid (derived from wheat, rye and barley); hydroquinone (long-term toxicity and banned in many countries); mequiol (a derivative of hydroquinone); plant extracts: primrose, ladys mantle, veronica, melissa, yarrow, bearberry leaves, licorice root, mulberry, gooseberry, turmeric root, creeping saxifrage, grape-vine, skullcap; alpha albutin (a bio-synthetic); undecylenoyl phenylananine (amino acid); tetrapeptide (a synthesized protein), aloesin (from aloe vera); lemon peel ferment

Compounds that help to remove pigmented skin cells:  Alpha hydroxy acids (Glycolic acid, lactic acid, tartaric) beta-hydroxy acids (salicylic), pumice, enzymes, retinoids, trichloric acid, phenols, some essential oil plant extracts.

*estrogen, progesterone, testosterone, adrenalin and cortisol are the most common hormones produced in our body or taken orally that trigger the hyper production of melanin.

The protocol for fading hyper-pigmentation:

  1. For severe hyper-pigmentation, one or several on-going professional treatments to remove pigmented skin cells and to suppress the pigmenting process.
  2. For any hyper-pigmentation, regimented morning and nightly use of home care bleaching/inhibiting products specifically chosen for the clients skin type.  Constant adherence assures success of outcome.
  3. Daily use of sunblock/sunscreen 15 SPF or higher.
  4. Use of sunblock/sunscreen SPF 30 – 50 for prolonged exposure to the sun IN ADDITION to wearing hats and protective clothing.
  5. Avoidance of all chemicals or synthesizers causing the hyper production of melanin.

Further information on the treatments that I administer and products I make to address this problem: