Many pigment spots can appear on the face, décolleté, neck or hands due to age or factors such as intense sun exposure. It is possible today to provide several treatments whether at your dermatologist or at home.
From the age of 30, many women see the appearance of brown spots or pigmentary irregularities on their skin. These may be lentigos, also called age spots mainly due to aging (senile lentigos) and significant sun exposure (solar lentigos), melasma generally due to hormonal imbalances that can occur when taking certain medications or which can be caused by sun exposure without protection during pregnancy (mask of pregnancy or chloasma), post-inflammatory pigmentation, following an acne pimple or a scar for example (the spot is then caused by inflammation ).
These spots are due to an abnormal accumulation of melanin, a natural pigment that gives the color of the skin and ensures its protection against the harmful effects of UV rays (through tanning). The pigmentation becomes irregular and locally disordered. They occur with age on certain types of skin and in a privileged way on the uncovered parts of the body: face, neck, décolleté, forearms and hands. The circumstances of appearance of these spots are very varied. Pregnancy on the whole face (mask pigmentation), the use of certain contraceptives (upper lip and forehead pigmentation). Photosensitization, centered on the neck, décolleté, upper lip due to perfumes or certain medications, the use of eau de toilette on the torso in men before sun exposure, the use of bleaching products for down. Repeated sunburn on the neckline (very fragile area to be well protected by an index 50 + screen), driving in the car (more important melasma on the left), wearing sunglasses (pigmentation on the edge of the glasses due to the phenomenon reverberation), depilation with too hot wax (irritation phenomenon), discoloration of the upper lip (pigment impregnation), use of carrot oil, lemon, hammam, repeated friction (aggravation of spots on dark phototypes). Acne, especially in black skin, can trigger the appearance of spots on scars (post-inflammatory pigmentation). Genetics also come into play. For example, we often note the appearance of dark and hyperpigmented dark circles in women of North African origin.
Medical treatments at the dermatologist.
Depending on the origin, the number of spots and your skin color, several treatments may be offered by your dermatologist alone or in combination.
Cryotherapy (liquid nitrogen) which burns in the cold can be used if the spots are few. Microdermabrasion is a superficial peeling by projection of aluminum oxide micro-crystals. It will be used rather on resistant skin to prepare it for another depigmenting treatment. Peels exfoliate the skin to a greater or lesser degree for large-area depigmentation. They can be superficial (glycolic, salicylic, mandelic) or medium (TCA: trichloroacetic acid) depending on the patient. Pigment lasers (eg Q-switched ruby, QS alexandrite or Nd:YAG QS) whose radiation is absorbed by the melanin which it destroys, without damaging the surrounding tissues, are used for targeted depigmentation. Intense pulsed light (IPL or “flash lamps”) by delivering photons of several wavelengths will be used for the treatment of larger areas. In the field of innovations, note the more recent appearance of systems that optimize the delivery of cosmetic products to the skin by combining several technologies. We can therefore use combined treatments such as TMT (Mesoestetic) and the SKIN’ECLIPSE concept which combines several technologies such as chromatherapy, electroporation, LED technology and lithotherapy allowing treatment to be personalized according to skin type. , skin color and area to be treated. These different systems are used in combination with depigmenting cosmetic products, the action of which they promote.
How to treat them in institute and at home?
Specific lightening treatments, often inspired by the practices of aesthetic medicine, are carried out in the institute. They generally include several steps including a very light peeling often with fruit acids causing slight desquamation followed by a lightening mask. These treatments carried out in institutes are to be done as a cure of several sessions.
Treating at home serves as a relay or preparation for an act carried out in the office. It is often necessary and recommended by your dermatologist, after an intervention, to continue treatment at home. There are then dermocosmetic solutions aimed either at correcting or masking the spots. It should nevertheless be noted that the depigmenting cosmetic treatment is long (from 12 to 24 months).
The products to be used often contain several associated active ingredients. Among these, some ensure an exfoliation of the cells of the epidermis loaded with melanin, such as AHAs (glycolic, mandelic, phytic acids, etc.), beta-hydroxy acids (salicylic acid). They will promote the penetration of other components. Others will inhibit the formation of melanin, they are often tyrosinase inhibitors, the key enzyme in the production of melanin. We can cite the extract of licorice, bearberry (arbutin), mulberry, azelaic acid, kojic acid, vitamin C which also decolorizes melanin. Finally, some prevent the transfer of melanin to the cells of the epidermis (niacinamide). For your information, here are some depigmenting products: Mela D (La Roche Posay), Dermamelan (Bodyestetic), Lightening Gel (Mene&Moy), Pigment Regulator (SkinCeuticals), Depiderm (Uriage), Even Better (Clinique), Depigmenting Serum ( Skin’Eclipse).
To hide spots, specific correctors exist: Couvrance range (Avène), Dermablend range (Vichy), Color Control range (Cosmodex). Finally, we must emphasize the importance of photoprotection during and even after the treatment by using sunscreen products with a high protection factor (SPF 50+).
Prevention is particularly important to maintain beautiful skin knowing that the natural predisposition remains difficult to prevent. Nevertheless, we now know the harmful effects of the sun and the beneficial effects of antioxidants. It is therefore more than recommended to use anti-oxidant-based creams very early on, containing, for example, extracts of green tea, rosemary, selenium, vitamins C and E (e.g. Diode 1 Diode 2 Alchimie Forever, CE Ferulic Skin Ceuticals, Cellex C Cosmovogue, C 20 Mene&Moy lotion, etc.)
These anti-oxidants are to be applied before high factor sun protection. They create a protective shield for the skin. Finally, the cosmetologist has a place of choice in the depigmenting treatment, he will have to serve as a guide to the patient, in the education, the follow-up of the care contract which binds him to the patient.
Asian and black skins
Generally, Asian skin is found to have pigment spots, especially on the cheekbones, resistance to lasers (see the impossibility of treating them with lasers), very fragile skin, particularly at the periocular level, which is an area that is very easily irritated. It is necessary to carry out repeated light peelings based on glycolic acid (sugar cane) and to use in relay non-irritating depigmenting creams, leaving a cocooning care space so that the skin is soothed. You can also use almond-based peels (mandelic acid) combined with chromatherapy which will not irritate the skin and which can be performed throughout the year, which is the case with the Skin’Eclipse treatment.
This often acne-prone skin in general is oily skin with the appearance of numerous pimples resulting in post-inflammatory pigment spots. It is therefore necessary to treat the acne first, that is to say the ground, before treating the spot. I recommend peelings based on salicylic acid (willow bark) which will regulate seborrhoea and reduce acne in relay of exfoliating creams based on AHA, but you can also use microdermabrasion or a mask with vitamin A acid.
Many treatments to reduce pigment spots are available from your dermatologist, in an institute or at home: cryotherapy, TCA, microdermabrasion, pigment lasers, LEDs, corrective or preventive cosmetics.
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