Skin pigmentation, simply put, is a darkening of the skin or the development of dark patches on the face and body. While its effects are aesthetic, it can take an emotional toll on those who struggle with it, particularly after pregnancy, acne or physical trauma. Often, a hereditary tendency for skin discolouration makes the condition worse, but thankfully there are many treatments and products available to help.
Dr Katherine Mulrooney is a consultant dermatologist. She co-owns the Dr Mulrooney Clinic with her sister, Jane. Dr Mulrooney says that while the causes of pigmentation cannot always be avoided, there are ways to slow down and lessen its development.
“The main cause of pigmentation is sun exposure,” she explains, “especially in pale-skinned people. Female hormones, namely oestrogen, which is associated with pregnancy and also the use of the oral contraceptive pill, is another cause. Pigmentation can also occur post-inflammation of any type. For instance, after acne or after trauma such as physical or thermal,” she adds.
Jeanette Dunne, co-owner of Renew Skin Clinic (renewclinic.ie), says that before you decide on a treatment, you need to identify your pigmentation's provenance, because certain treatments can make it worse if incorrectly assessed. Consulting a dermatologist is always advised.
“If you are concerned, a diagnosis is vital. You need to identify the type of pigment in your skin and you need to recognise if the sunspot could be a skin cancer. Seek professional medical advice at a skin clinic that has medical staff, nurses and doctors, or visit your GP before you undertake any treatment plan,” she advises.
While skincare alone will make some improvements in pigmentation, medical-grade peels and lasers will have a more powerful and lasting effect. Dr Mulrooney says there are several in-clinic routes to take.
“At the Dr Mulrooney clinic, we use superficial chemical peels and lasers. For cumulative sun damage on skin types one and two, we use IPL laser. For melasma [the ‘mask of pregnancy’] and post-inflammatory hyperpigmentation, we use FRAXEL laser only, as IPL laser can, in fact, worsen the latter two conditions.
“It is also worth noting that superficial chemical peels can be carried out throughout the year but it is best to laser between October and April, thereby avoiding the sunnier months,” Dr Mulrooney explains.
Similarly, at Renew Clinic, Dunne recommends IPL and peels for pale skin, and microneedling for darker tones.
‘Microneedling’
“Microneedling is great for a slightly darker skin tone. It’s a much safer way to treat the pigment, as IPL is not suitable for darker skin tones and can actually cause the pigment to look darker,” she adds.
What you’re using at home could impact your pigmentation. For that reason, a home-care prescription is the safest way to go.
Dr Mulrooney says: “It is worthwhile having a consultation with a cosmetic doctor or consultant dermatologist to make sure you are optimising your skincare and avoiding any triggers that is worsening your pigmentation. The good news is the majority of anti-pigmentation skincare and clinically proven treatments have a potent anti-ageing effect on the skin.”
Being sun smart is key when it comes to avoiding pigmentation, or preventing more from occurring. Dr Mulrooney advises “strict sun smart behaviour”, which means wearing a broad-spectrum SPF of 50+ daily, whether it’s sunny, overcast or otherwise. “I would also advise a wide-brimmed hat and large sunglasses whenever outside,” she adds.
A prescriptive and carefully planned skincare routine, prescribed by your doctor, should include active ingredients like glycolic acid, vitamin A, vitamin C and kojic acid. Dunne also advises using retinol, a derived form of vitamin A, but with great care.
“Home care is vital to keep the pigment at bay following your medical treatments,” she says. “We advise the use of retinol at night only. A stronger retinol will give quicker results but can cause redness, dryness and peeling, so you really need medical advice and supervision while using it.
“Vitamin C is another great anti-inflammatory agent for the skin, so apply it every morning and then add your SPF. It’s not good enough to just use it in your make-up, as the manufacturing process will deplete some of that SPF potency.
“Also, a good cleanser with some AHA or BHA to lift off dead skin cells and allow your skin to gain optimum absorption of your other products,” says Dunne.
