Skin pigmentation: How to deal with dark spots

Memories of sun-drenched holidays, garden gatherings and outdoor festivals are fading from our memories, but are perhaps remembered in front of the mirror when we notice some skin pigmentation and dark spots from summer sun exposure.

Pigmentation of the skin is a multifactorial issue however excessive sun exposure is responsible for much of it. So at this time of year, brown spots/patches are often at their darkest and many of our clients report them as their most significant skin issue. In this blog post we look at skin pigmentation and how to deal with dark spots.

What is pigmentation?

When our skin is unprotected (no or very low strength sunscreen) and exposed to UV rays, our melanin producing cells produce excess melanin as a protective function to prevent UV light from damaging our skin cells and DNA. Melanin gives our skin colour. Excess melanin has nowhere to go and will show on the skin as dark spots or patches. This is commonly referred to as sun damage.

Before we blame the sun entirely for skin pigmentation, it is important to highlight that pigmentation can also present for other reasons including:

Post-Inflammatory Hyperpigmentation

These are the marks that remain after a spot has subsided, after insect bites or post eczema or psoriasis flare ups.

Melasma

Hormone fluctuations e.g. during contraceptive use, pregnancy or menopause can cause pigmentation on the skin. It usually presents as symmetrical brown patches on the forehead, nose and upper lip.

Certain Medications

e.g. antimalarials, non-steroidal anti-inflammatory drugs, antiepileptic meds.

Prevention is better than cure

Applying sunscreen daily will protect the skin from UV rays and this should be at least SPF30 and ideally SPF50 in the summer. Sunscreen should be reapplied every 2 hours if out in the sun or even if sat next to a window for prolonged periods.

This advice is great, however the reality is that most of us don’t reapply often enough, if at all. It is for this reason that we usually say that despite best efforts, some skin pigmentation by the end of the summer is likely.

In terms of sunscreen use, there are no longer any excuses as the number of beautifully formulated products available these days is immense! They are lightweight, oil-free, some are tinted so can replace makeup and also for those with skin of colour – some have no white cast.

Melasma can be a more tricky condition to treat and this must be discussed with a healthcare professional before any attempts are made to treat it. Underlying causes such as medical conditions and medication use must be taken into consideration.

What can you do at home to help reduce dark spots?

If the months of summer fun are very prevalent on your face manifesting as dark patches, do not worry – all is not lost!

Here are our top recommendations of products to try at home for skin pigmentation and dark spots:

Retinoids

Whether you use prescription strength tretinoin (we do prescribe this for some of our clients) or clinic-grade retinol, it is essential to use a retinoid if your skin tolerates it.
These products treat and fade brown spots while also addressing lines, wrinkles and texture. It’s a win-win!
Do invest in a good clinic-grade product to see results and have a recommendation made by a professional.

Anti-Pigmentation Skincare

Certain serums are formulated specifically to treat pigmentation.
They include ingredients which disrupt the formation of excess melanin.
These can again be prescription strength or clinic-grade products.
Our favourite combination of products to treat pigmentation are from SkinBetter Science. The combination of their Even Tone Correcting Serum with their AlphaRet Overnight Cream is, in our experience, exceptional.

The Pigment Control Plan from All Skin Med

The clever scientists at Cantabria Labs have come up with a superb plan for treating and preventing pigmentation.
They have thought outside of this beautiful box and incorporated not only their excellent Pigment Control Serum (the ingredients in this product are *chefs kiss *), a beautiful sunscreen from Heliocare but also – to treat the pigmentation from the inside out – their new Pigment Control Capsules – the data behind these capsules is very impressive!
Our skin has two sides and should be treated as such.

Exfoliating Acids

Removing the top layer of dead skin cells regularly (but not too regularly!) will help in the treatment of pigmentation.
If you prefer a face wash containing AHAs and BHAs (exfoliating acids) we are big fans of Revision Skincare particularly their Brightening Facial Wash.
AHA serums are another easy option and we love the Retexturising Serum from AllSkin Med.

What treatments help to fade pigmentation?

We have plenty of options to help treat pigmentation but it is important to understand that treating it is a journey. Don’t expect immediate results and be aware that what you do outside the clinic is equally as important.

Consistency is key. Using the right skincare at home will enhance your results and using sunscreen will preserve the good work that you are investing time and money into.

If post-inflammatory hyperpigmentation due to acne is your primary concern, the acne needs to be addressed first. This may warrant prescription-strength treatment or clinic-grade products depending on the severity.

Let’s delve into treatments to treat dark spots and brown patches of skin:

Chemical Peels

Skin Peels are a great option for skin pigmentation and they are totally customisable. There are varying strengths and ingredients that can be recommended according to your suitability. During a chemical peel consultation, we consider factors such as depth of pigmentation, skin type, lifestyle, skin colour and capacity for downtime in your life.

Some peels are very deep and the downtime after these is considerable. Although these peels have their place, we recommend a course of lighter peels that are much easier to incorporate into everyday life. Results can be very impressive with no downtime and no visible peeling. These treatments are nothing like the old days where the skin would be very red afterwards.

We are huge fans of Retinol peels, especially for treating pigmentation. It is a prerequisite that you have used retinol before and your skin is able to tolerate it. Again, we have varying concentrations within the retinol peel range.

Microneedling

This fantastic all round skin treatment is not widely known for its effect on pigmentation, but it’s a great option. Let’s think about the science; we often talk about microneedling as ‘rebooting your skin cells’. It normalises many skin cell functions that are getting sluggish with age. One of these functions is the production of melanin and movement of it through the skin. Normalising these promotes a more even skin tone.

We can also use mesotherapy solutions alongside that specifically target pigmentation, introducing pigment reducing ingredients deeper into the skin.

The downtime is minimal with redness usually subsiding within 24 hours.

The Final Word

I have already stressed the importance of consistency. Another point to consider is that these skincare products and treatments work best in combination. It is essential that you put in the ‘homework’ if you are having in-clinic treatments and have a good homecare routine in place.

Certain treatments also work well in combination, especially peels and microneedling. The results on pigmentation, dark spots, brown patches, sun damage (or whatever terminology you use!) are superior when these treatments are carried out in close proximity timewise.

Lastly, what is good for your friend is not necessarily what is good for your skin. These treatments need to be customised to your individual skin needs after a thorough consultation, not a quick chat. The science behind microneedling alone is vast. It is not a beauty treatment – far from it – so please ensure you see an adequately trained and qualified professional.