Focal hyperpigmentation is most often postinflammatory in nature, occurring after injury (eg, cuts and burns) or other causes of inflammation (eg, acne, lupus). Focal linear hyperpigmentation is commonly due to phytophotodermatitis, which results from ultraviolet light combined with furocoumarins in limes, celery, and other plants.
Hyperpigmentation also has systemic and neoplastic causes.
Lentigines: Lentigines (singular: lentigo) are flat, tan to brown oval spots. They are commonly due to chronic sun exposure (solar lentigines; sometimes called liver spots) and occur most frequently on the face and back of the hands. They typically first appear during middle age and increase in number with age. Although progression from lentigines to melanoma has not been established, lentigines are an independent risk factor for melanoma. They are treated with cryotherapy or laser; hydroquinoneSome is not effective.
Nonsolar lentigines are sometimes associated with systemic disorders, such as Peutz-Jeghers syndrome (in which profuse lentigines of the lips occur), multiple lentigines syndrome (Leopard syndrome), or xeroderma pigmentosum.
Post inflammatory hyperpigmentation is a common skin problem characterized by increased melanin formation. It commonly occurs following acne and It appears to be more severe in darker skin.
The melanin, our natural pigment that protects us from solar radiation, is produced by certain specialized cells of the skin, known as "melanocytes" that under certain conditions can irregularly "work".
Sometimes, however, the melanin increases, resulting in light areas and dark areas, the so-called iperpigmentarie spots, which from an aesthetic point of view, represent a real problem.
Acne and even some laser acne treatments can cause persistent post inflammatory hyperpigmentation.
Only if a color change or skin defect is still present after 1 year, it is considered to be a permanent acne scar.
The first step in the treatment of hyperpigmentation is by topical agents. There are many commercial depigmenting agents capable of interacting with the synthesis of melanin by inhibiting tyrosinase (phase enzyme) or by acting on non-enzymatic phase.
These topical agents generally are:
- Azelaic Acid
- Kojic Acid
- Glycolic Acid
- Salycilic Acid
- Licorice Extract
The best standard routine generally is made by a conbination of 0,1 percent retinoic acid cream, 4 percent hydroquinone and triamcinolone acetonide, a tyrosine inhibitor.
A combination of a 10 percent glycolic acid with 4 percent hydroquinone is also generally very effective.
A superficial peel or a light microdermabrasion that exfoliate without causing inflammation, can accellerate the positive response of the skin.
Some types of laser can be useful to improve hyperpigmentation but they are very expensive.
Any bleaching agent shlould be applied to the dark area twice a day.
To reduce the risk of dark spots after acne, it is suggested to start the treatment immediately after the first signs of darkenig.
For severe hyperpigmentation you can consider the following methods:
- Chemical Peels
- Obagi Face Peel or Obagi blue peel, is a new system to chemically peel dead skin cells.
- Dermabrasion is a traditional skin clearing procedure in which the surface of the skin is removed by abrasion.
- Afa Clay Peel is a unique two-step in-office procedure.
- 70 percent Lactic Acid works mainly on the skin's surface and it can be very effective to improve your skin texture and pigmentation irregularities.
During the Hyperpigmentation Treatment it's essential a good sun protection. Practicing strict sun protection is important for the skin at all stages of acne treatment, because sun damage can trigger or worsen hyperpigmentation.