How to care for trouble skin issues: Skin Pigmentation

I am rather fair skinned, the type that gets this slight golden tan after a month at the beach (wearing tons of sunscreen, of course,) while everyone else is sporting this deep brown color. Needless to say, when I become pregnant for the second time, dark brown spots decided to come for an extended vacation on my face. I was raising a toddler then and my sunscreen routine was often neglected. I went to the dermatologist, and he said that it was normal with pregnant women and would eventually go away.

Discouraged after a few years, I decided to dig deeper and truly understand what caused this change in my skin pigmentation. Let me share with you what I have found out.

Skin pigmentation just means the color of your skin. We get our skin color from melanin, a natural pigment within our skin. There are some special cells in your skin, the melanocytes, that produce melanin. Melanin is our own body defense against sun exposure. Most dermatologist agrees that the skin cells produce melanin as a natural sunscreen against UVA rays preventing skin cancer, and that is why you get tanned after being exposed to the sun.

However, when your body produces abnormal quantities of melanin, you experience a skin pigmentation disorder. Some disorders affect only small patches of skin, while others can affect your whole body, such as vitiligo, a skin disorder that causes patches of light skin all over your body due to low production of melanin.

You also need to consider Addison’s disease, a rare but severe disorder, also called adrenal insufficiency, where your adrenal glands produce too little of the hormones cortisol and aldosterone. It occurs in all age groups and both sexes, and without proper treatment can be fatal. One common symptom is skin hyperpigmentation. So, if you feel extreme fatigue, loss of appetite, abdominal pain, salt craving, and skin hyperpigmentation, go and see a doctor immediately.

For more information, check out the American Academy of Dermatology.

So, the bottom line is that if your body produces too much melanin, your skin will get darker. Which is great in a tan, not so much if you get a form of hyperpigmentation doctors call solar lentigines.These are the small brown spots, commonly called age or liver spots. They are spots of skin damaged from constant exposure to the sun, and usually appear in more exposed areas, such as the face and the hands, regardless of skin color.

Nevertheless, there are causes, other than sun exposure, that can increase the excessive production of melanin. Pregnancy, some birth control pills, hormonal imbalances in general are known causes for the dark brown patches on your skin, the doctors call melasma (muh-laz-muh).

Melasma is a skin condition that causes brown patches to appear on your skin, usually on your face (cheeks, forehead, bridge of nose, upper lip and chin), and sometimes on your neck and arms. It is caused by sun exposure and the hormones from pregnancy or birth control pills seem to aggravate the problem. Sometimes a bad reaction to a skin cream or treatment may cause these dark patches to appear.

Women with medium to dark skin tones are more prone to melasma then men or very fair skin color people. According to dermatologists, having a good amount of melanin already present help trigger the problem. It is not painful or uncomfortable, but it is notesthetically pleasing. 

Other common causes for dark spots are other skin diseases such as acne, that may leave dark spots, due to tissue damage, when the condition clears, and freckles. Freckles, the small brown spots that usually appear on the face and the arms, run in the family as they are a hereditary skin characteristic.

Regardless of the cause, the sun is your worst enemy here, as sun exposure will increase melanin production, and excess melanin will darken your already dark spots.It’s virtually impossible to escape sun exposure, so prevention is your best ally in your battle against skin pigmentation. Sunscreen must be worn every day, without exception, regardless of weather conditions. And make sure to use one that effectively protects your skin from sun exposure, with a broad spectrum, meaning it blocks UVA and UVB rays and a high SPF (level of protection) such as 50-60.

Skin hyperpigmentation disorders are likely to disappear on their own when proper prevention in in place. Using sunscreen, and reapplying it every two hours or after a swim or a strenuous bout of exercise, avoiding exposure to the sun in hottest time of day, and wearing a wide brim hat, are key steps to preventing further sun damage and possibly reverse the hyperpigmentation altogether. However, these brown spots might be persistent, so how to treat them?

Your dermatologist might recommend an initial approach using hydroquinone, a skin bleaching agent. This product comes in cream, lotion or gel forms. It is applied to the skin damaged areas and gradually lightens the skin. Over-the-counter (OTC) products tend to have less hydroquinone than those the dermatologist can prescribe. Alternatively, your doctor might prescribe creams with azelaic acid or kojic acid to lighten your brown spots, as both acids work to prevent melanin production.

Here is an OTC alternative containing 2% hydroquinone, Azelaic acid and kojic acid.

However, if you prefer a more natural approach, you can try using products infused with antioxidants, such as vitamins A (retinol) and C (ascorbic acid). They work to fight the signs of aging, brightening the skin, and with consistent use might help lighten your unwanted brown spots.

Another vitamin that proves effective in fighting dark spots is Vitamin B3, also known as niacinamide.  It clears away skin, promoting a blemish free complexion and even skin tone. Over time it reduces the appearance of dark spots.

Or you could give plant-based acids a go. Many skin care products trending right now have plant-based acids, like glycolic acid, an alpha hydroxy acid derived from sugar cane, or citric acid. These acids are exfoliants and that helps to lighten dark spots and promote a smooth wrinkle-free complexion.  

You also have the aforementioned kojic acid, derived from the Japanese Koji mushroom. It works by impeding melanin production straight at the skin cell, but some people found it to be too aggressive and have had skin irritation after using it.

Do consider that, when using a bleaching agent, either chemical or natural, you are exposing your skin to greater damage, as you are stripping away the defenses it had erected. Dermatologists recommend you apply these products at night and use tons of sunscreen, and, all in all, avoid sun exposure. Keep in mind that a single day of excess sun can undo months of treatment.

If despite using the prescribed treatment religiously, you are still plagued with dark spots, you might want to consider undergoing a dermatological procedure, such as a chemical peel, dermabrasion, microdermabrasion, laser treatment, or light-based procedure. Keep in mind that these procedures are dangerous and should only be performed by a dermatologist, so seek advice from a licensed professional beforehand.

Other areas may suffer from skin hyperpigmentation, like your elbows, knees, armpits, and inner thighs. Elbows and knees, being naturally lean, are more prone to dryness and hyperpigmentation. You can remedy this by cutting a lemon in half and rubbing on the affected areas, then washing thoroughly and moisturizing. Or by using a body scrub, insisting on these two areas, and moisturizing. It also helps if you extend your nightly moisturizing routine to include your elbows and your knees.

 Armpits and inner thighs have to deal with chaffing that over time leads to dryness and skin discoloration. They are also subjected to hot waxing, pulling, stretching, etc. that in time damage the tissue and turn it an unsightly dark brown. Moisturizing is again of vital importance, but you can tackle the most tenacious dark spots by either using the face treatments mentioned above, or by using some specifically formulated for the intimate area.

As with all skin conditions, do seek advice from a professional if you are thinking about more radical solutions. Remember that consistency is the key to maintaining a dark spot free complexion. I spent nearly ten years experimenting with a lot of skin lighteners, and, finally, my melasma is nearly gone.

Moreover, you need to fake it till you make it, so just rely on concealers, foundation and CC creams. They will provide the coverage you need to hide the unsightly spots. And be patient.

Consistency in treatment is important, but consistency in applying sunscreen is paramount. We all want to look our best, and our skin is our calling card. Keeping it cleaned, moisturized and protected is the best gift we can give ourselves.