Pigmentation – causes and treatments

Some skin pigmentation is inevitable in the harsh Australian climate. Whether your pigmentation is sun induced or a result of hormonal activity (Melasma), genetics or trauma to the skin, it ages your appearance and can erode your confidence.

The skin consists of two main layers, the epidermis which is the upper layer and the dermis which is the lower layer. Within the lowest layer of the epidermis are cells called melanocytes, which are responsible for producing the pigment called melanin. This melanin production is what gives our skin its genetically predetermined colour and when overstimulated, can produce excess pigmentation.


While we all know the telltale signs of spending too much time in the sun, hormonal pigmentation, or Melasma, is less commonly recognized. Melasma is characterized by patchy brown discolouration of the skin, commonly seen on the cheeks, chin, forehead and upper lip in a symmetrical pattern. It primarily occurs in women but can also appear in men. While it can affect all racial and ethnic groups it is more common in darker skinned individuals.

With Melasma, the melanocytes become over stimulated and over produce melanin in response to changes in oestrogen and progesterone levels. This melanin becomes trapped in the epidermis and may also extend to the dermis, making it difficult to treat. Pigmented cells then slowly migrate to the surface, making the pigmentation visible.  The most common cause is pregnancy or oral contraceptive use but it can occur for no apparent reason.

So how do you know what type of pigmentation you have and how to treat it? The best way is to have a comprehensive skin assessment by a medical professional. This should include a digital skin analysis called Sioscopy to see the extent, depth and type of pigmentation below your skins surface. This is vital information as it dictates how the pigmentation is treated.

Treating pigmentation of any kind in the skin can be complicated and there are many options. Often using a combination of technologies yields better, longer lasting results and this is why it pays to go to a medical professional with access to multiple technologies. One laser doesn’t fix all in this case! Melasma, being hormonally stimulated, is particularly difficult to treat as too aggressive or inappropriate treatment can often exacerbate the condition.

Some of the more common treatments for pigmentation include Intense Pulsed Light (IPL), fractionated lasers like Fraxel, lasers, peels and medical grade cosmecuticals. Intense Pulsed Light is a quick, simple and effective treatment, with no downtime, that helps fade the brown patches giving the skin a more even, ‘cleaner’ appearance within a few days. Usually only 2-3 treatments are required at 2-4 week intervals. Any area affected can be treated and these are most commonly the face, neck, décolletage, hands/arms and back.

For pigment that is more stubborn or deeper in the skin, fractionated lasers like the Fraxel re:store® Dual system are very effective. Fractionated lasers treat a fraction of the skin at a time while leaving surrounding healthy skin intact, delivering remarkable improvement with minimal downtime. This medical procedure lightens pigmentation with the added benefit of pore refinement, resurfacing of the skin as well as the stimulation of collagen. It can be used to treat Melasma and for prematurely aged, sun damaged skin, it is fantastic.

Various masks and peels containing lightening agents can be used either to maintain the results of light based technologies, or as a slower but gentler approach to pigmentation.

Whenever treating pigmentation of any cause, it is absolutely essential the home care regime contains medical grade cosmecuticals that have been individualised to your skins needs. An over the counter product will simply be wasting your time and money. Antioxidants like vitamins A, B3 and C, as well as Alpha and Beta Hydroxyl acids work synergistically to fade pigmentation, calm melanocyte activity, stimulate collagen and boost the skins natural immunity.

Treating pigmentation isn’t just about fading what is on the surface. It is also about restoring health and balance to the skin. Isn’t that what we all want? Of course, any skincare regime in Australia must include an SPF sunscreen. While most of us hate wearing them, there are new ‘superfluid’ sunscreens about to be launched in Australia that contain low actives, have extremely high SPF and best of all, don’t feel like a sunscreen at all. You may even be able to get your children to wear it!

If you do suffer from pigmentation, be reassured there is help available, but choose wisely where you go to get that help. Inappropriate or too aggressive treatment can be disastrous but with the correct treatment approach and the guidance of qualified doctors, nurses and dermal therapists you can regain control of your skin and start to get your confidence back.