Pigmentation

There can be several internal or external factors that cause skin pigmentation. Mainly factors like hormonal changes, sun exposure, skin type, trauma, and the natural aging process can be held responsible for pigmentation issues. People with lighter skin tones often suffer from epidermal sun damage, therefore, leading to pigmentation issues like sun spots, age spots, freckles etc. On the other hand, dermal pigmentation or deeper pigmentation can be caused by trauma, side effects of medicines and other hormonal factors. Pigmented acne scarring, birthmarks, melasma are examples of dermal pigmentation.

However, pigmentation is not just restricted to the facial area. It is also found on the shoulders, neck, back of the hands and the bikini area. Pigmentation issues affect all skin colors and types.

Treatment Options

Several procedures can assist in the reduction of various types of pigmentation. The options include:

1. Laser treatment

Laser pigmentation removal is a great way out of trouble. It is such a method that uses laser light, which absorbs the pigment in freckles or age spots, without harming the surrounding tissue. However, the results may vary from person to person. The number of treatment sessions required may also vary depending on the intensity of the pigmentation. Commonly most of the patients require 2 to 3 treatment sessions to clear most of the pigmentation. Some patients often report a slight stinging sensation during the laser pigmentation removal procedure. Some redness may persist immediately after following the treatment, but that usually settles down within 2-4 hours.

Recovery

The laser treatment for pigmentation can last for 30 to 45 minutes, though larger areas may take longer. Patients may feel some discomfort at the site of the treatment but the procedure is not painful. For the first 24 hours after undergoing the treatment, the skin may appear red and swollen. The use of fragranced makeup, skin products or excessive exposure of the skin must be avoided for a few weeks. Sunscreen with SPF30 or more must be used when going outdoors.

ND YAG

The q-Switched ND YAG laser emits high energy light towards the affected area that helps to reduce the number of unwanted skin cells. This allows the skin to initiate the growth of new cells to replace the old ones. When the q switched mode is on, the laser produces two wavelengths out of which one addresses the target area and the other addresses the skin lesions. This laser can penetrate deep into the layers of skin without injuring the top layer of the skin and also stimulates the growth of collagen and other vital proteins which is important to achieve healthy skin. However, it is a painless and swift treatment procedure that is suitable for all types of skin.

2. IPL

IPL or Intense Pulsed Light is also an extremely effective treatment for many types of pigmentation. It is a completely non-invasive treatment that uses light to absorb melanin (the dark pigment) and hemoglobin (the red blood vessels). This light gets converted into heat which damages the target cells without disrupting the skin surface. However, at the end of the treatment, the pigmented areas usually go darker and sometimes totally black which diminishes within 7 to 28 days depending on the area of treatment. The IPL treatment is most suitable for fair to olive skin tones. Those with dark to very dark skin tones are not suitable for the treatment.

Procedure

Before beginning the procedure, the skin of the patient is cleansed and a cold gel is applied to the skin to help improve the conductivity. Cold air supply may be arranged directly on the face to keep the skin cool during the treatment. The therapist then applies the beam of light to the skin and then exposes the pigmented area to the strong light. At the end of the treatment, the skin is usually cleansed and protected with a UV protection cream.

Recovery

Immediately after undergoing the IPL procedure the skin may show up with some redness though makeup can be used to camouflage the effect. However, after a few days, the targeted area of treatment may appear red or brown that diminishes over a few days. After that, clear and bright skin will be visible. Patients are warned about the continued exposure of the skin to the sun or other harsh factors that may be a factor to develop skin pigmentation over time.

3. Mesotherapy

It is a non-surgical treatment that involves using a very fine needle to inject the medicine into the middle layer of the skin. Vitamins, enzymes, glutathione are a few products that are used to treat pigmentation. This procedure also helps in rejuvenating the skin, rebuilding collagen fibers.

4. Chemical Peels

Chemical peels are categorized as per their effectiveness on the basis of the depth of the skin. Depending on pigmentation and skin concerns superficial, medium, and deep peels are used. Usually, 6-8 sessions are recommended which can be repeated at an interval of 15 days or as prescribed by the dermatologist.

4.1 Superficial or Light Peels

These are alpha-hydroxy acid peels. They penetrate up to superficial layer i.e. stratum corneum. They are used to improve the appearance of mild skin, discoloration and to treat acne.
Peels used:
Salicylic acid -20-30%
Mandelic acid - 10-20%
Glycolic acid - 20-30%
Lactic acid

4.2 Medium Depth Peels

The medium depth peels penetrate deep into the epidermis and go up to the basal layer. This treatment is used to improve age spots, sun damage, and moderate skin discoloration.
Peels used:
Glycolic
Pyruvic acid
Modified Jessner
Nomelan fenol 

4.3 Deep Peels

This peel penetrates up to the dermis. They are used for deep skin rejuvenation and exfoliation for resistant stubborn pigmentation.
Peels used:
Phenols
TCA – 30-50%
Glycolic – 70%

5. Microdermabrasion

It is minimally abrasive treatment. It helps in gently exfoliating the top damaged sun-tanned skin and in improving:
Age Spots
Reducing fine lines and wrinkles
Eliminating large pores
To improve hyperpigmentation

6. Fractional CO2

Fractional CO2 lasers are used for non-surgical skin rejuvenation treatment to improve texture, wrinkles, and blotchiness.

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