What causes pigmentation on the skin?
Pigmentation on the skin is one of the commonest reasons for someone to visit a dermatologists office. It is extremely common. Pigmentation is often a sign of ageing of the skin. The commonest causes for pigmentation are:
- UV exposure
- Hormone therapy (especially the oral contraceptive pill)
- Within a year of childbirth
- hormonal imbalances like thyroid disorders
- Genetics (if a parent has pigmentation, you are more likely to suffer from the same)
- Sometimes certain nutritional deficiencies may be responsible for pigmentation.
In most people the commonest causes tend to be UV exposure and hormonal changes during pregnancy or within a year of delivery.
Preventing facial pigmentation
If one is at a risk of facial pigmentation, the risk can certainly be minimised by using certain precautions. You should always use a broad spectrum sunscreen. A sunscreen with spf 30 or more and PA ++ or more should be generously applied on the skin 15 minutes before stepping out and should be repeated every 2 hours when you are outdoors. The sunscreen should ideally be used 365 days a year including cloudy and rainy days.
You should try and avoid hormones like the pill. During periods of hormonal changes in the body like pregnancy, you should be particularly careful about using sunscreens.
You can ensure that your nutritional status is good by eating a wide variety of food. Eat plenty of brightly coloured fruits and vegetables. Mix and match your diet so that you get all the micronutrients in adequate quantities.
You can get annual blood tests to check your thyroid status and your blood glucose levels are within acceptable levels.
Treatment of facial pigmentation
Once somebody develops facial pigmentation, it can be quite a challenging problem to treat. Often, one needs to try out a few treatment options until one finds some treatment that will work. In many people, it tends to be a stubborn problem and needs to be managed all the time.
- Medicated creams: This should be done in all people. You should certainly continue to use the sunscreen as outlined in prevention of pigmentation. In addition, your dermatologist may prescribe medicated creams which would help reduce the pigmentation.
- Tablets: This takes several forms. There are sunscreens which are available as tablets. The oral sunscreens or anti-oxidants may be used in summer months or when you are out on a holiday. Certain anti-inflammatory tablets are available that help reduce pigmentation and would help slow down the spread of pigmentation.
- Chemical peels: I use superficial and medium depth peels for treating pigmentation. The peels will need to be carried out once a month. We may be able to combine the peels so that you can continue your regular work.
- Mesotherapy: In this skin lightening agents are injected into the superficial layers of the skin to help lighten the pigmentation. This is done with a numbing gel to reduce the pain.
- LASER: I usually reserve LASER as the last resort. In Indian skin, there is always a high risk of post-inflammatory hyperpigmentation. In this after a LASER, there may be a risk of rebound increase in pigmentation. The LASER needs to used very cautiously and needs to be combined with oral sunscreen tablets and strict UV avoidance for a month after each LASER session.