Uneven Skin Tone and Pigementation

A lot of patients are curious to know about the causes and treatment of uneven skin tone and pigmentation in Bangalore. Uneven skin tone is a common concern for many people. Pigmentation around the mouth and forehead are also common complaints in millennial patients. Both pigmentation and uneven skin tone are multifactorial in nature. We need to understand the basis of pigmentation and then we will discuss treatment options in Bangalore and safe remedies for pigmentation. Let us understand how pigment is formed and which factors cause increase in melanin (scientific term for pigment).

How is melanin or pigment formed in the skin?
Human melanocytes produce unique secretory granules known as melanosomes which contain melanin pigment. Melanin and melanosomes are the major determinants of skin pigmentation. Melanin-forming enzyme tyrosinase is the major component responsible for melanogenesis, which occurs within the melanosomes. Inside the melanosomes, tyrosinase catalyzes the first two reactions of the biochemical pathway leading to the formation of two types of melanin pigments, eumelanin or pheomelanin. Tyrosinase catalyzes the hydroxylation of tyrosine to form dopa (L-3,4-dihydroxyphenylalanine) and then the oxidation of dopa to dopaquinone. The latter is rapidly converted to the brown-black pigment, eumelanin and pheomelanin. The exposure of human melanocytes to UV light or melanocyte stimulating hormone increases the production of melanocytes as well as melanin pigments.

How Sunlight or radiation cause tanning or pigmentation?
UV light of which Sun is the major source causes increased melanin synthesis  by increasing tyrosinase activity which is actually a protective mechanism ( to prevent DNA inside the nucleus of cells).  But Tanning is not acceptable cosmetically and may even be very severe in nature.

What are age spots or Lentigines?
Lentigines are circumscribed, pigmented macules (flat lesions), usually brown in color, that range in size from a few millimeters to a few centimeters in diameter and may join into even bigger lesions .They typically appear on sun-exposed areas of the skin such as the neck, face and forearms and increase in number with age.

Lentigines result from increased amounts of melanin in the basal and suprabasal layers of the epidermis. They require radiofrequency or Q switched Laser for removal.

What is Melasma?
Melasma is a common acquired condition of symmetric hyperpigmentation which typically occurs on the face. It has a  higher prevalence in females and darker skin types. Multiple causes include light exposure, hormonal influences and family history have been implicated in the pathogenesis of this disorder. 

What is post inflammatory hyperpigmentation?
Pigmentation developing after an inflammatory skin disorder is a very common complaint in patients. There are certain skin diseases which show a proclivity to develop PIH. Especially Acne vulgaris causes black spots commonly. Dark skin type and tendency to squeeze pimples is the biggest risk factor for developing PIH. Insect bites and even atopic eczema can cause pigmentation. Psoriasis and lichen Planus can cause black spots or pigmentation. Cosmetic procedures especially if performed without priming and adequate sun protection can cause PIH.

How to prevent pigmentation and black spots?
 As a Dermatologist , I would like to suggest a few points to prevent pigmentation and black spots:

1. Strict Sun and Radiation protection – Yes, you heard it right. You need to protect from UV light and also Infrared and visible light from sources like natural light, screen . It is imperative to use a broad spectrum Sunscreen which protects from UV A, UV B and Visible light. Please prefer a sunscreen with iron oxide to prevent visible light.

2. Oral Antioxidants- They are ‘oral sunscreens’ and hence prevent pigment cells from free radical induced damage. You can include natural sources like citrus fruits, yellow vegetables and lots of fruits in your diet.

3. Avoid scrubbing or over exfoliation- Mechanical scrubbing can aggravate pigmentation and make it worse. Do not pick or squeeze your pimples.

4. Please treat your pimples on time to prevent black spots. A delay in treatment can increase the black spots and PIH.

5. Check your nutritional status as deficiency can make your skin dull.

Treatment of pigmentation and dark spots in Dr. Divya’s Skin and Hair Solutions Clinic
At Dr. Divya’s Skin and Hair Solutions Clinic, we use few standard treatments in line with International standards.

1. Chemical Peels – Dr. Divya Sharma uses very superficial to superficial for Asian patients while Caucasian skin needs medium depth peel. Glycolic peels, TCA peels and Cosmelan Peels are a few examples. All the Chemical Peel agents are sourced from abroad and a protocol based approach is followed to give our patients best results. Dr. Divya Sharma is very particular for priming of the skin before such procedures to prevent any untoward results and get best results.
2. The Pink Revolution - Pigmentation around the private parts are also managed by our flagship treatment ‘Pink Revolution’. Dr. Divya Sharma is the first Dermatologist to bring peels for lightening the private areas especially the bikini area. We also use special lightening agents for underarms and dark neck.
3. Q- switched Nd: YAG Spectra Gold treatment- For deeper pigmentation like Lichen Planus pigmentosus and Lichenoid Contact Dermatitis, we use Internationally acclaimed Spectra Gold laser for permanent lightening of black spots.
4. Laser Toning- It uses a lower fluence Q switched laser for fragmenting the melanin and removing it permanently. It is a popular procedure for uneven skin tone and removing permanent pigmentation especially around the mouth. It is a safe and effective procedure under expert hands of our Dermatologist.
5. Hollywood Peel or Carbon peel- This procedure involves application of Carbon Especially sourced from parent company Lutronic. Spectra Gold is the first device to start this procedure and is patented by Lutronics. This procedure is effective for removing black heads, open pores and dullness of the skin. It is safe and the patients are carefully chosen by the doctor. It is a hit with our patients especially the ones looking for glow before marriage or party.
6. Rejugold- this is a procedure which is the brainchild of our Dr. Divya Sharma. We use gold plated tiny microelectrodes to use radiofrequency for removing pigmentation and fine lines and other signs of ageing. It is a particular favourite of our working class women who particularly prefer it over injectables to prevent ageing and age spots.

Pigmentation and black spots require a multimodal approach for best results. A lot of emphasis is laid on safe and effective solutions along with lifestyle changes to prevent pigmentation at Dr. Divya’s Skin and Hair Solutions Clinic in Whitefield, Bengaluru.