WHAT IS HYPERPIGMENTATION?
There are many causes of hyperpigmentation, such as genetic makeup, hormones, and ultraviolet exposure. The biggest culprit, which is also the most avoidable, is the sun. Melanin gives skin its color and is produced by melanocytes, cells located in the bottom layer of the epidermis, through a process known as melanogenesis. There is a very high number of melanocytes in the skin, between 1,000 and 2,000 per square millimeter.
The Importance of Melanin
All humans have approximately the same amount of melanocytes; however, skin color variations are due to the amount of melanocytes produced. Melanin is produced to shield the skin and protect it from the sun. When skin is exposed to the sun, melanin production increases and causes a tanning effect; the tanning process is the skin's natural defense mechanism against sunburns. Melanin absorbs light and the pigment produced is able to dissipate over 99.9 percent of absorbed ultraviolet radiation. Because of this property, melanin is able to protect skin cells from UVB radiation.
CAUSES OF HYPERPIGMENTATION
There are many causes of hyperpigmentation, some of which include ultraviolet radiation, inflammation, and post-inflammatory hyperpigmentation. These factors have different mechanisms that can lead to the formation of melanin on all parts of the body. Clients should be careful to protect themselves from activities that can lead to hyperpigmentation.
UVA and UVB Rays
The skin is continuously bombarded with ultraviolet radiation from the sun. Ultraviolet rays are made up of long wave UVA and short wave UVB. UVA rays tend to penetrate deep into the dermis layer, resulting in damage to the skin and is the main reason skin wrinkles prematurely. This phenomenon is called photoaging. UVB rays cause the skin to tan. Extended exposure to UVB rays also causes sunburns as UVB rays are absorbed by the epidermis. The intensity of UVB rays peaks between 10 a.m. and 4 p.m. The sun is essential to life, however. Humans need the sun for the absorption of vitamin D; without vitamin D, calcium would not be absorbed, leading to osteoporosis.
Unfortunately, hyperpigmentation is not caused only by the sun. Although sun exposure is the largest contributor to age spots later in life, some antibiotics can induce phototoxic inflammation in the skin that can lead to hyperpigmentation. For those suffering from acne, the long-term use of strong oral prescription medication can sometimes increase the skin's sensitivity to sunlight and cause inflammation.
Although dermatologists have prescribed retinoids for quite some time, when they are overused and when sunscreens are not applied regularly, sensitivity and inflammation can be triggered.
Melasma is caused by a hormonal imbalance between estrogen and progesterone. This type of hyperpigmentation is frequently seen in pregnant women.
Post-inflammatory hyperpigmentation causes the skin around a wound, typically an acneic pimple, to darken and discolor, making the skin look grey or brown. This phenomenon occurs when melanocytes go into overdrive and produce an excessive amount of melanin, an action that occurs due to the inflammatory reaction of the skin. If the excess melanin is produced in the top layer of skin, the discoloration is a darker brown, whereas excess melanin produced in the lower layer of skin has a gray-blue discoloration. Although post-inflammatory hyperpigmentation can occur in all skin types, it is seen most often in ethnic clients. It also affects men and women equally.
The majority of clients are concerned with age spots and brown spots and skin care professionals can greatly capitalize on this concern by offering specific lightening and brightening facials at the spa.
Light Brown Spots
For this type of hyperpigmentation, professionals can perform a medium-to-strong exfoliating step followed by a light glycolic peel. Once this treatment is complete, apply a post-facial cream that contains high concentrations of vitamin C, kojic acid, niacinamide, or arbutin, all of which are proven to ameliorate skin tone and reduce brown
Medium Brown Spots
Microdermabrasion is very popular and helps to polish the skin and improve its tone. Microdermabrasion exfoliates the skin more deeply than exfoliating creams and helps remove the top layers of the stratum corneum. This action, in turn, helps the cells that are trapped under this layer migrate more easily to the surface, resulting in an improved clarity of the skin. Professionals should follow microdermabrasion with a glycolic or salicylic acid peel with a pH of 3. These light peels help to brighten the skin and will not actually lift or destroy the skin layer, allowing the client to return to their normal routine immediately after the treatment.
Deep Brown Spots
Chemical peels are extremely effective, but tend to scare some clients as they are worried about downtime and potential burns. Chemical peels that are done correctly work wonders for deeper brown spots. Many varieties of deeper peels exist and professionals should consider offering them at their spa. More complex treatments, such as IPL and fractionated laser, require expertise and the supervision of a medical professional; those treatments are typically performed at a medical spa. Laser treatments and peels offer good results, but require more downtime and can have more substantial side effects.
Many ingredients have been shown to help lighten the skin, including hydroquinone, which is a highly effective topical lightening agent that works well on all forms of discoloration; retinol; and glycolic acid. Hydroquinone, however, is not without controversy and tends to be strong; if its use is not well-managed, it can be misused. There are also lesser-known ingredients, including kojic acid, arbutin, absorbic acid,
Retinol is the retail alternative to retinoids; both of which are derived from vitamin A. Retinols have been available for some time and have been studied extensively. They can be very effective, particularly when combined with other lightening ingredients, such as vitamin C or niacinamide. Retinols are not as strong as hydroquinone and take much longer to show results.
Glycolic and Salicylic Acids
Glycolic acid and salicylic acid are almost universal and work significantly well on many Fitzpatrick types. These acids are gentler than other acids and work by first exfoliating the skin, which often fades brown spots. It is important to know that overuse of high concentrations of glycolic acid can sometimes lead to skin irritation in certain clients, so educating clients about the ingredient is key to preventing
Kojic Acid and Arbutin – These ingredients inhibit tyrosinase, which is an enzyme that catalyzes the formation of melanin.
Ascorbic Acid (Vitamin C) – In all of its forms, vitamin C is a gentle ingredient that helps reveal a beautiful complexion, particularly when combined with niacinamide.
Azelaic Acid – This acid is commonly obtained through prescriptions by dermatologists, however, certain brands have started incorporating it into their formulations. Azelaic acid works by inhibiting the formation of tyrosinase.
Skin care professionals should educate their client on the importance of using sunscreen daily, regardless of the temperature or time of day. When it comes to applying products, professionals can recommend that clients cleanse and tone before using an anti-aging moisturizer. They should follow that application with the use of sunscreen or makeup containing sunscreen.
During the daytime, skin is stressed and is exposed to UVA and UVB rays that accelerate aging, air conditioning in the summer, and heating during the winter, all of which accelerate transepidermal water loss. The skin is also exposed to hot and cold weather, environmental pollution, and free radical attacks. This exposure may cause increased levels of cortisol, the stress hormone that is responsible for inflammation and can cause the breakdown of collagen and hyaluronic acid.
Skin care professionals can make things simple for their clients by telling them to remember the PRB skin care principle: prevent moisture loss, replenish lost nutrients, and block ultraviolet rays.
There is no such thing as too much information when dealing with clients. It is best to over-explain and over-educate. The client may cling to a small fact, but that is all that is needed to influence and convince them to take care of their skin and provide good business for the professional.
Christiane Waldron is the founder and CEO of Jenetiqa, a professional, luxury skin care company focused on providing highly bio-available skin care products that combine scientifically-proven antioxidants with natural botanicals and skin vitamins. Waldron is a chemical engineer by profession and is the chief scientist for Jenetiqa. She personally hand picks each ingredient in the formulas. Waldron's philosophy is to design and formulate multi-tasking products that help address all signs of aging.