TREATING HYPERPIGMENTATION

What is hyperpigmentation?

Normal skin contains cells called melanocytes that produce the brown
skin-coloring pigment melanin. There are several conditions in which
melanocytes are either abnormal or abnormally distributed. Most skin
conditions that cause discoloration are harmless.

A pale area of the skin is the result of fewer or less active
melanocytes than usual, whereas a darker area (or area that tans more
easily) indicates more numerous or more active melanocytes.

What about the red/brown marks left behind after acne?

These kind of marks are postinflammatory hyperpigmented lesions and are
located at the site of a skin trauma after it has healed.They can
result from acne, bites, burns or skin infections. The lesions range
from light brown to black in colour. Lesions may become darker if
exposed to sunlight (UV rays).

Postinflammatory hyperpigmentation can occur in anyone, but is more
common in darker skinned individuals, in whom the colour tends to be
more intense and persists for a longer period.

What is the cause of postinflammatory hyperpigmentation?

Inflammatory responses of the skin to disease or trauma results in the
release and oxidation of arachidonic acid. The resulting reaction
alters the activity of immune cells and melanocytes. Melanocytes
produce more melanin (skin colour pigment), which is transferred to
surrounding skin cells. This is known as epidermal hypermelanosis and
can be treated with skin care products.


What about marks caused by sun damage?

Larger flat brown spots on the face and hands arising in middle age
also result from sun damage exposure. Unlike freckles they tend to
persist for long periods and don't disappear in the winter (though they
may fade). Commonly known as age spots or liver spots, the correct term
for a single lesion is benign solar lentigo (plural lentigines).
Lentigines are common in those with fair skin but are frequently seen
in those who tan easily or have naturally dark skin. Lentigines are due
to accumulated pigment cells (melanocytic hyperplasia).


What are the best non-surgical treatments for hyperpigmentation?
Usually, hyperpigmentation will gradually lessen over time and normal
skin colour will return. However, this is a long process that may take
up to 6-12 months or longer. It is advisable to use a good broad
spectrum sunscreen daily to reduce further darkening. A variety of
topical treatments are available to lighten and fade hyperpigmented
lesions. Varying degrees of success are achieved but combinations of
the treatments below are usually required for significant improvement.

Stabilised Vitamin C : Water Soluble - Magnesium or Sodium Ascorbyl Phosphate (note: L-ascorbic acid, the type of vitamin C available in chemists, is very unstable once it is dissolved in water and is not suitable for water based cosmetics. It is also irritating to the skin due to its acidity)Stabilised Vitamin C: Oil soluble -Tetrahexyldecyl Ascorbate (note: Ascorbyl Palmitate, which is a cheap oil soluble vitamin C added to numerous cosmetics, is not suitable for treating hyperpigmentation. This is because it is impossible to dissolve enough of the active in a cosmetic formula to get significant results (it is used at less than 1% concentration). Tetrahexyldecyl Ascorbate is new oil soluble form of vitamin C developed in Japan, and is unique in that it can be used at concentrations of upto 7%. It is still fairly rare and expensive ingredient. but shows excellent skin benefit.Retinoids
Alpha Arbutin (This is a compound found in Bearberry. It is very stable and in my opinion the best active for melasma)
Kojic acid (This is derived from reishi mushrooms. It works well, but will oxidise in water based creams, turning a brown colour)

N-Acetyl Glucosamine