Skin Pigmentation

What is skin pigmentation?

Pigment is brownish discolouration of the skin. Pigment is usually due to a protein called melanin that is deposited unevenly in the skin. Melanin protects our skin cells from UV damage and can be very beneficial. 

The melanin pigment is produced in Melanocyte cells. Packages of melanin are then transferred to keratinocyte skin cells. This is the pigment we end up seeing in the skin. 

When pigment is made and deposited at normal levels, our skin develops an even complexion. But when this process is disordered as we age, it results in irregular deposits of pigment in our skin, causing “age spots” and an uneven complexion. We look older. 

The skin is made of the outer epidermis, and the inner dermis. Melanin pigment can be in either layer. Pigment in the epidermis (outer layer) is much easier to budge than pigment in the deeper dermis. 

The irregular production and depositing of pigment in the skin can be very sensitive to hormones, heat/UV exposure, some medications and really anything that overstimulates melanocytes to make more melanin pigment.  

Are treatments available to treat unwanted skin pigmentation?

Pigment can be very tricky to treat. Conditions such as Melasma and Cloasma are complex medical conditions that can't ever be cured, just managed with sunscreen/hats, peels and home care. 

Here are some products and treatments that are excellent for pigment. All can be found at Phenotype and we assure you, they are best in class. 

Vitamin B/Niacinamide 

The second member of the basic “Essential 3” (vitamins A, B and C) of skin care is Vitamin B. It’s also called Niacinamide.  

It is an anti inflammatory and antioxidant, but Niacinamide is amazing at reducing pigment! 

How does it work?  

Niacinamide inhibits the transfer of melanin pigment to the keratinocyte cells of the outer skin surface.  

Vitamin B is so effective that a study in 2002 showed a 68% decrease in transfer of melanin pigment from melanocytes to keratinocytes. Niacinamide resulted in skin appearing younger, with less unwanted, irregular pigmentation. 

Tyrosinase inhibitors

Big words, but let us explain briefly. 

The production of melanin pigment is dependent on an enzyme called Tyrosinase inside the factory cells for melanin production, the melanocyte. 

The main driver of unwanted skin pigment is usually UV light. It causes a misfire of tyrosinase activity resulting in increased pigment production.  

If we inhibit or dampen this tyrosinase enzyme then excess melanin isn’t produced inside the melanocyte. You’ve got to wear a sunscreen too, though! 

Many experts are saying everyone needs to be on a Tyrosinase inhibitor (and sunscreen).  

There are a few things that inhibit Tyrosinase, including Licorice extract, Kojic acid, Phytic acid and hydroquinone.  

Phenotype's Biopelle Brighten XPC is your best bet, as it combines a few ingredients in a stable formulation. 

Mela Cream

This is the gold standard for pigment treatment and it is remarkable in its removal of UV related pigment, but also for stubborn melasma. 

Mela cream contains a stable combination of Mandelic and Salicylic acids. These are alpha/beta hydroxy acids (AHA/BHA). Kojic and Phytic acid are also ingredients of Mela, and these are Tyrosinase Inhibitors. 

AHA/BHA moisturise the skin, but for pigment we harness their ability to promote exfoliation. They cause the outer layer of the epidermis (the stratum corneum) to become thinner. This is a good thing because the stratum corneum is mostly dead skin cells, which often contain the unwanted pigment. Reducing the bulk of this layer makes the skin more luminous, clear and even. 

Mela cream also contains Retinol (vitamin A), Liquorice extract and Niacinamide.  All are excellent at turning over new cells, promoting exfoliation of old cells, and reducing pigment production in the first place.  

If you require an easy to apply, single nightly cream for pigment, this stabilised combination of multiple ingredients is possibly your best friend. 

Mela cream is potent. Sometimes we may need to work up to it by first using a retinoid formulation (vitamin A) on its own. See Dr Tina’s blog on retinoids and their uses, they are fantastic for pigment reduction and prevention. 

In-clinic Medical Grade Peels

Now, don't panic. A medical grade peel conjures images of severe redness, down time and skin falling off in sheets. Clients often worry about "chemical" peels and "medical grade" peels. 

Although our peels are potent and can stand up to any competitors on the market, they have been developed to maximise results, while minimising down time. All these peels are combinations of various components such as lactic acid, glycolic acid and salicylic acid in various concentrations.  

You will not be disfigured, and you needn't worry about prolonged down time. A few hours of redness and some mild-moderate skin flaking for 3-4 days are the usual side effects. Just exfoliate and moisturise through this recovery period and your skin will recover quicker. 

We have several peel options in the clinic, but the one specifically designed for photo-ageing (sun damage) and pigment is the Mela Peel Forte. This is a more robust treatment, so sometimes we start with a gentler peel - we can discuss a plan in more depth during a complementary skin consultation. 

We usually recommend having 3-4 Mela Peel Forte treatments in the clinic to kick things along, one every 4 weeks or so. With nightly use of Mela cream, you'll be delighted with the results. 

At Phenotype, we know what we’re doing and will be happy to advise you on the best course of action. 

That's about all you need to know about pigment. I hope this has been helpful.  

Dr Paul

Dr Paul Robinson