Facial Pigmentation: The Dark Side of Aussie Sun Culture.

Facial pigmentation is common and often an extremely distressing condition. While camouflage is an option, its not the only option anymore! Yes, you can “break up with their make-up”, ladies! There are better ways to treat skin pigmentation!

Fact: If you are concerned about pigmentation on your skin, your not the only one!
Around 14% of GP consultations are for the management of skin diseases and a large proportion of these are due to pigmentation issue and 10% of new dermatology referrals are for facial pigmentation.

“With the options of creams, oral medication, dermabrasion, chemical peels, IPL and laser therapies, Australians have many options to treat facial pigmentation – even in the general practice setting”. Dr Suzan Bekir MBBS FRACGP

 

About Facial Pigmentation:
Facial pigmentation can either be localised or generalised. Irregular shaped areas of pigmentation may require biopsy to exclude melanoma as pigmentation can sometimes indicate an underlying disease. While Melanin is what differentiates the appearance in the colour of our skin and important in protecting us from UV radiation, it is the proliferation of melanocytes that cause hyperpigmentation and become an aesthetic issue.

About Melasma:
Melasma is considered the most common facial hyperpigmentation worldwide. It is more prevalent in women than men, and has been found to be even more prevalent in women with darker skin and occurs in approximately 25% of pregnant women. While melasma has a genetic predisposition, UV radiation, oestrogen and progesterone are the most common intensifiers of pigment.

Melasma

A skin trained Doctor assessing facial pigmentation understands there are many causes of hyperpigmentation and are aware that investigations such as a punch biopsy or even blood tests may be required to work out the cause. Some localised hyperpigmentation may in fact be from birthmarks such as naevus or may be age related such as actinic keratosis or seborrheic keratosis.

Treatments:
Hydroxyquinone is still the gold standard treatment for the treatment of melasma. These bleaching cream preparations effectively lighten skin and create a more even skin tone. It can be used in various concentrations although 4% appears to have the most benefit and improvements can often be seen in approximately six weeks and treatment can be continued throughout the year.

Many hydroxyquinoline creams are used in combination with other agents to improve effect as well as reduce irritation. Retinoids typically used for acne treatments have also been shown to reduce pigmentation, however they can take up to 24 weeks and should be avoided during pregnancy. Azelic acid and vitamin c are also used to post inflammatory hyper pigmentation.

Physical therapies such as chemical peels, dermabrasion as well as light therapies (IPL/Laser) are well renowned for success in reducing skin pigmentation. They can be used in combination with topical treatment.

Chemical peels: Although glycolic acid maybe best to solidly damage the pigmentation, salicylic acid 20-30% has been shown to be best in the last month and post inflammatory hyperpigmentation. Chemical peels have the advantage of being able to be used safely in dark skin types. Patients must be warned about burning and redness and irritation and ATM to deep chemical peels should be performed under general anaesthesia by a trained doctor in a clinical setting.

Laser/IPL: Light therapy is extremely effective: IPL and fractionated treatments are typically used particularly if first line topical treatments have been in effective.

Want to speak with a skin Doctor who understands Facial Pigmentation?
Taylor Clinic Doctors are trained in pigmentation and skin and offer consultations and treatments for pigmentation. Bella Vista, Wollongong, Double Bay. Call 1300 00 3223 for an appointment or click here.

references:
Thomas, S & Rosen, R 2016, ‘Facial pigmentation: Common causes and how to manage’, Medicine Today, vol 17, iss. 10

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