Founder of Synergie Minerals and Synergie Skin, Terri Vinson, explains how to win the battle against hyperpigmentation.

In its various forms, skin hyperpigmentation affects over 80 per cent of women over the age of 25 and is the number two skin concern besides facial wrinkling. The skin lightening market is growing at an exponential rate and formulators are continually challenged with creating products to address this major concern. But is pigmentation curable and what ingredients really work to address this condition?

What is hyperpigmentation?

Hyperpigmentation refers to changes in the melanin content and distribution of the skin. There are considered to be three major types of skin pigmentation:

Solar lentigines

These are non-cancerous, UV-induced pigmented lesions with a clearly defined edge. This damage is primarily superficial and present in the upper layers of the skin (epidermis). Lentigines may evolve slowly over years or appear suddenly and may occur anywhere on the body and vary in colour from light brown to black. These spots are caused by UV sun-exposure and the degree depends on how much UV light the melanin pigments are exposed to. These must be monitored as they may develop into skin cancer and melanoma.

Post-inflammatory hyperpigmentation (PIH)

This is a response to injury of the skin and can be the result of acne, burns, friction or overly aggressive clinical treatments such as chemical peels, dermabrasion, laser and IPL. This condition often resolves with time and generally responds well to topical products.

Melasma / Chloasma

This is pigmentation that is deeper in the skin’s dermis. It appears on the face as larger brown patches, which are often symmetrical, with a non-distinct border. This type of pigmentation mostly affects Asian and fair skinned people and is more common in women. Though causes are unknown, it is often linked to hormonal imbalances and can be made worse with UV exposure, overheating the blood, some medications, pregnancy and stress. Unfortunately melasma is not curable. However, with the correct treatments and topical home care, it can be reduced and controlled.

Treating hyperpigmentation

Topical treatments

In terms of home skin maintenance the following non- prescription ingredients will help reduce pigmentation:

  • Vitamin A – In the form of stabilised retinol (retinol molecular) enables surface hyperpigmented cells to be sloughed of evenly in addition to reversing the damaging effects of UV light on the skin cells, which result in hyperpigmentation. Retinoids are also responsible for tyrosinase inhibition, reducing clumping of melanin and reducing melanosome size.
  • Vitamin B3/Niacinamide – Prevents transfer of the melanin pigment from the melanocyte to the keratinocyte in the epidermis.
  • Vitamin C – In the form of L-ascorbic acid (dry crystals or stabilised) acts on the melanin pathway by converting O-Dopaquinone back to Dopa. This results in reduced formation of oxidised melanin. It also inhibits the enzyme tyrosinase which causes melanin production.

Specific hyperpigmentation active ingredients will help reduce uneven skin tone and skin discolouration without harmful ingredients, which may inflame the skin. These ingredients include:

  • Dimethyl methoxy chrominyl palmitate – a cutting edge tyrosinase inhibitor that also increases skin cell viability. Clinical studies show this ingredient to be as effective as Hydroquinone and more effective than arbutin and kojic acid in lightening skin tone.
  • Alpha Hydroxy acids (lactic and glycolic acid) – help to remove surface cells and therefore superficial pigmentation due to increase exfoliation.
  • Kojic acid – derived from mushrooms, this acid is a potent tyrosinase inhibitor but may occasionally result in skin irritation.
  • Soy protein – acts by inhibiting uptake of melanosomes by keratinocytes. However, the molecular size of this molecule makes delivery to target cells difficult.
  • Liquorice extract – a tyrosinase inhibitor. However, cosmetic elegance is a concern as pure liquorice powder at the recommended dosage turns formulations a dark green/brown tone.

Prescription\tproducts\tsuch\tas\thydroquinone/ corticosteroid/retinoic acid compounds (e.g. Kligmans formula) offer effective results but are not recommended for long term application due to potential cellular toxicity and must be prescribed by a doctor only.

Prevention and protection with sunscreen really is the vital key to preventing sunspots and protecting the skin from harsh UVA and UVB rays. To prevent future pigmentation use natural mineral sunscreen containing at least 20 per cent zinc oxide. Mineral (physical) sunscreen is also less likely to result in skin sensitivity compared to organic (chemical absorbing) sunscreens.

Clinical treatments

Treating hyperpigmentation is highly complex and depends on a number of factors including the type of pigmentation (epidermal/dermal/hormonal/UV-induced) and the skin type and ethnicity of the client. Caution should be exercised with skin of colour (Fitzpatrick 4+), as darker skin tones are prone to post inflammatory hyperpigmentation (PIH). Galvanic infusion of L-ascorbic acid, superficial peels, fractional laser, topical products and low level laser can be used conservatively for higher Fitzpatrick skin types. Lower Fitzpatrick skin tones can tolerate more aggressive chemical peels, IPL, laser and microdermabrasion.

The best results are always achieved with combination therapy including cosmeceutical grade skincare, lifestyle modification, individualised clinical treatment and hormonal analysis if required. Not all forms of hyperpigmentation can be permanently removed, however, with education and a clear understanding of the client’s skin, good results can be achieved and maintained in successfully treating this complex skin condition.