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  • Ewa Doszczak

Skin Discolouration – Everything You Need to Know About this Problem

The facial discolouration is a problem that can happen in any of us. It is an aesthetic issue - it makes the skin look old and unattractive. It is often difficult to hide it under make-up. Fighting against it can even cause stress. How does hyperpigmentation develop? How can they be removed? How can you prevent them? You can find it out in this blog article.

There can be various reasons for discolouration. They can be caused by hormonal imbalances or excessive exposure to ultraviolet rays.


What to do if your skin discolours irregularly? Where do all the spots, dots, or blemishes come from? Is it something you can avoid?



What is discolouration?


Hyperpigmentation is a change that occurs due to excessive production of melanin by pigment cells. Melanin is responsible for the colour of the skin. High levels of melanin, i.e., overproduction, cause the skin to become darker, while low levels, in turn, lighten it.


Women are more prone to facial pigmentation than men. It is because women deal more with hormonal changes, use contraception or hormone replacement therapy. Hormones sensitise to the sun, resulting in pigment disorders in the skin.



Melanin, the skin's natural pigment, is a polymer produced by melanocytes (cells found in the basal layer of the epidermis, eyes, and hair follicles) through the process of melanogenesis. Melanogenesis is an enzymatic, i.e., the naturally occurring process in the body, of melanin formation, which determines the formation of skin pigment, i.e., facilitates the formation of a tan, for example).


The primary function of melanin in the body is to protect the DNA of epidermal cells from the sun, or rather from harmful ultraviolet radiation. So, it is not an aesthetic or beautifying mission. When we tan, we 'catch the colour,' but it is in the cells that significant changes take place - the skin literally defends itself against UV radiation by producing pigment.


What happens when melanocytes malfunction and distribute pigment incorrectly or when they cluster or produce too much pigment? It is when pigmentation starts to form, darker spots or even freckles.



What causes discolouration of the skin?


There are many causes of hyperpigmentation. They may be caused by hormonal changes associated with pregnancy, contraception or menopause, or inflammatory conditions such as acne, psoriasis, lichen planus. They may also have a genetic basis.


They can also be caused by excessive exposure to UV radiation, such as tanning beds.


The use of photosensitizing substances in some medicines (also herbal) is responsible for them, e.g., antidiabetics, antiarrhythmics, anticancer drugs, sedatives, diuretics, non-steroidal anti-inflammatory drugs, drugs used to treat psoriasis (read the leaflets, they usually contain information about photosensitizing medications).

Other causes include age, use of perfumes, retinol in cosmetics, and citrus fruit juices.


Hashimoto's thyroid disease, hyperthyroidism, some antibiotics, e.g., acne ointments, essential oils, e.g., bergamot oil, sandalwood oil, vanilla oil, cedar oil, or lavender oil, also contribute to the formation of hyperpigmentation. Herbs and plant extracts, e.g., St. John's wort, chamomile, calendula, and often herbal compositions of unknown composition added to dietary supplements.


Cosmetics that contain the ingredients mentioned above, i.e., retinoids, essential oils, or plant extracts, are also responsible for the process.


Other causes include ovarian tumours, parasites in the intestines, stress (after affective disorders such as depression), or even the influence of metals such as copper, silver, gold, arsenic, iron.


Changes do not have to appear immediately. They can appear on the face after some time, even if you have not been in the sun recently. It can result from melanin accumulation or some factor that has made them visible (e.g., hormonal changes).



What are the discolouration types?


Pigmentary disorders are classified as hypo- and hyperpigmentary (also known as skin discolouration and hyperpigmentation).


Hyperpigmentation includes albinism (partial or complete lack of pigment caused by a gene mutation) and vitiligo - drug-induced or senile.


Skin hyperpigmentation is a generalised or limited change in the colour of the skin. The leading cause is an uneven accumulation of melanin in the cells. These pigmentations can be acquired or congenital. They differ from healthy skin by their increased intensity of the colouring.


We can distinguish between local (spot) and diffuse (extensive) hyperpigmentation. There is also a division into epidermal (shallowly located), dermal (reaching deeper into the dermis), and mixed (a combination of both).



Which discolouration are most common?


Freckles


Freckles are tiny, uniformly sized, light yellow to dark brown spots that form symmetrical arrangements. They tend to accumulate. They are located on exposed skin - exposed to sunlight, e.g., face, arms, backs of hands. They tend to recede with age. Their occurrence is genetically determined. They intensify in the spring-summer period.


Lentigines


Lentigines are shallow, primarily located in the epidermis. They can be congenital or acquired as a result of overexposure to UV radiation. They have various shades of brown colour. They can be scattered in large numbers on the back, chest, skin of the hands, face, forearms, or other areas. Compared to freckles, they are larger, darker, and more demarcated and do not tend to darken in the sun. They can develop into malignant lentigines. They increase with age and are a result of photoaging of the skin.


Chloasma


Chloasma (melasma, "mask" of pregnancy) is one of the most common acquired skin discolorations of the face. It predominantly affects women (90%), but it also occurs in men (10%) of all ethnic and racial groups. Irregular patches, ranging from light brown to dark brown, sometimes even black. May appear on different areas of the face, e.g., upper lip, cheeks, nose, forehead, neck. The main inducing factor is ultraviolet radiation. The cause is genetic, hormonal changes associated with pregnancy, menopause, hormonal contraception, thyroid disease, adrenal disease, chronic liver disease. Occasionally, chloasma that developed during pregnancy may resolve spontaneously. Unfortunately, this cannot be said when chloasma arises due to hormonal therapy, such as contraception - then it does not show such a tendency.


Post-inflammatory hyperpigmentation


Postinflammatory hyperpigmentation (PHI) develops due to inflammatory diseases such as atopic dermatitis (AD), acne vulgaris, psoriasis, lichen planus, contact dermatitis, impetigo, folliculitis, or even insect bites. They may also occur as a result of complications following poorly performed chemical peel or laser treatments. The frequency of their occurrence decreases with age. It also happens that they can disappear on their own, but unfortunately, this happens rarely.


Drug-induced hyperpigmentation


Drug-induced hyperpigmentation (postmedicamentosum hyperpigmentation) occurs due to interactions between the drug, its metabolites, and melanin. They are also often induced by ultraviolet radiation.


Breloque-dermatitis


Breloque dermatitis is hyperpigmentation most commonly found on the skin of the décolleté and neck. It is often caused by the phototoxic effects of perfumes, such as bergamot oil found in perfumes.


Perioral and periorbital melanosis


Perioral and periorbital melanosis occurs due to resolution of inflammation (e.g., perioral dermatitis) or under UV exposure (phototoxic effect). It is most often permanent. The characteristic feature is the shoulder discolouration around the mouth.

How to get rid of skin discolouration?


The therapeutic procedure depends on the type of hyperpigmentation, i.e., how deep the pigment is located (i.e., whether it is epidermal, dermal, or mixed).


It is beneficial to combine the treatment of hyperpigmentation in a beauty salon (e.g., lasers, chemical peels, etc.) and home care.


Treatment is time-consuming, requires patience, and, unfortunately, does not always bring the full effects. In the meantime, you must apply complete sun protection systematically throughout the year.


It is vital to take an honest approach and systematically apply the products recommended by your beautician or dermatologist at home. Unfortunately, lesions can return at any time. What's more, new lesions can appear as a result of UV rays if you neglect photoprotection. Causal factors, such as hormonal changes, can also contribute.


Ingredients that have a brightening effect include kojic acid, azelaic acid, aloe vera, orchid extract, vitamin C, retinoids (retinoic acid is photosensitive, so use it only in autumn and winter), lactic acid, glycolic acid, niacin (niacinamide), liquorice (glabridin), bearberry (arbutin).



How to prevent hyperpigmentation?


Avoid overexposure to UV rays, and remember to use a high sunscreen.


If your skin is inflamed, such as acne, do not scratch or squeeze blemishes - this will minimise the appearance of post-inflammatory hyperpigmentation.


Read the ingredients of medicines and cosmetics - usually, the leaflets contain information about the possibility of discolouration, so you will know to use a stronger sunscreen during treatment.


Get tested and check what is happening with your thyroid, liver, and adrenal glands.


Watch what herbal teas you drink; check the ingredients of your supplements carefully.


Keep your eyes open for everything, especially if you are prone to hyperpigmentation. And most importantly, use the sun with caution and in moderation. Of course, we all crave the sun, especially after winter. The sun gives us energy and induces the formation of vitamin D.


However, the use of the sun must be kept in balance. Applying sunscreen every day, wearing baseball caps or hats is essential. By remembering to do this, you will also slow down the ageing process, so your skin will continue to look younger and healthier.


All these rules are so necessary to eliminate or inhibit, to some extent, the appearance of hyperpigmentation is the only way to go. There are no excuses that you don't like sunscreen, and you love the sun. After the summer, you will start to panic because spots will begin to appear. Every step, every preventative action is essential.


Remember, too, that in addition to UV radiation, which induces discolouration, there is the blue light surrounding us everywhere, emitted from electrical appliances. Aggressive, penetrating deep into the skin layers, contributes to the formation and perpetuation of already visible discolouration.


With this in mind, use a protective cream that also has blue light filters in it. There are not many such creams on the market, but I can strongly recommend a product I use myself - SENTE cream protection with SPF 49++++, which protects the skin against the harmful effects of blue light.


People who have used bleaching agents (bleaching creams or medicated ointments) or who have undergone more invasive treatment methods, such as laser procedures, should remember special protection before their holiday. It can increase the risk of recurrence.


Antiseptic, acne, and antibacterial products can also cause sunburn, so if you suffer from skin inflammation or acne, you need to be especially careful in the sun.


In summer, it is also advisable to limit the use of coloured cosmetics, lipsticks, blushes, and shadows, as they may contain dyes and preservatives that exacerbate reactions to radiation. It creates inflammation in the skin and paves the way for the formation of discolouration.



Final words


Remember that hyperpigmentation is not a disease, but if you notice strange, irregular, convex, dark, and multi-coloured spots on your skin, be sure to see a dermatologist for a consultation.


What are your experiences with skin discolouration? What was your approach? Please let me know in the comments. 