What gives skin its pigment?
Melanin is the pigment that makes up our skin tone. Melanin is produced by Melanocytes and then distributed into cells called melanosomes, which are transported near the skin’s surface and distributed among our other skin cells (keratinocytes) to create our unique skin color. Every person is born with the same number of melanocytes. Our genetics determine how much pigment will be produced. For example, someone with a lighter skin tone will have melanocytes that produce and distribute 2-3 small melanin particles per melanosome cell. An individual with a darker skin tone has melanocytes that produce and distribute melanin cells that can fill the entire melanosome cell.
Why do we have pigment?
The pigment in our skin is what protects us from Ultraviolet Radiation. When we are exposed to the sun, it immediately starts to damage our skin, breaking down essential structures that will damage our DNA and cause wrinkles, age spots, and even cancer. Our melanin will darken and move toward the surface of our skin to act as a shield. When we lay out in the sun and get a nice tan, we are damaging our skin and its structures! If we burn and turn red, that is a sign that our skin cells have self-destructed to prevent the possibility of turning into cancerous cells.
Hyperpigmentation Vs. Hypopigmentation
Hyperpigmentation happens when our melanocytes start to produce too much pigment due to hormonal imbalance, sun damage, or inflammation from picking or wounds. As part of our immune system, our melanocytes are triggered to protect the skin from further damage. This causes a cascade of effects that leads to darker skin in certain areas. Hypopigmentation is when your melanocyte dies in a particular area, without pigment in the skin, the area that the melanocyte used to supply will no longer have any pigment. An example of hypopigmentation is vitiligo. Many people have tiny hypopigmentation spots from sun damage or scarring from past wounds.
Treating Hyperpigmentation
Treating hyperpigmentation is a long process, with many different steps to take to remove the spots and prevent them from returning. First, we have to start at the source — the melanocytes themselves! When we have pigmented spots that we can slough off, or laser off, and they keep returning, it is a clear sign that our melanocytes are not functioning properly and producing too much melanin. We have to correct this core dysfunction first with ingredients that will slow, or inhibit, the production of melanin. This is where tyrosinase inhibitors come in. Tyrosinase is an enzyme that stimulates melanocytes to start making melanin. By inhibiting this vital function, or slowing it down, we can effectively stop dark spots from happening. But what do we do about what is already there?
Starting on a product that inhibits tyrosinase will take as long as 16 weeks to see results, why you ask? Because topical ingredients take time! Our skin has to be in a healthy state for the ingredients to penetrate, and then it takes time for our skin to get the message, get the ingredients to the melanocytes, and the melanocyte starts winding down. After that, we still have all of the pigment in our melanosomes that are slowly working their way to the surface. On average, it takes 30 days for us to regenerate a new layer of skin with proper exfoliation and a skincare ritual at home, throughout that 30 days, melanin is generated every 48 hours. For example, if we build a dam a few miles away from a waterfall, it is going to take time for the dam to regulate the flow and affect the waterfall, meanwhile, it is flowing normally until that occurs!
Simultaneously, we will work on exfoliating the skin’s surface while working deep within our skin. As we start to work on the deeper layers, pigmentation can become darker as it reaches the surface to be exfoliated. Keeping our skin active and functioning optimally will prevent the build-up of dead skin cells. Ingredients like Vitamin A and Retinoids will strengthen the skin and regulate the natural rhythm of cellular renewal while ingredients like AHA’s (Alpha Hydroxy Acids like Glycolic, Lactic, and Mandelic Acid) & BHA’s (Beta Hydroxy Acids like Salicylic Acid) will superficially exfoliate dead skin and pigmentation at our skin’s surface.
It is important to work with a professional when deciding on your treatment plan. Getting to know what type of pigmentation you have and what your skin needs to function optimally is crucial to getting your results. I recommend in-studio treatments with professional-grade products once monthly with an active home care ritual until your pigment is lightened. At this time, you can decide to space out in-studio appointments 6-8 weeks with your ritual or continue to treat other skin conditions.
As always, education will yield results. It is crucial to understand that the sun, while it is beautiful, bright, and warm, is not our friend. Sun damage is the number one cause of almost every skin condition from wrinkles to pigmentation to cancer. We want to do the following things to ensure our products have the optimal environment to enact change in our skin, and that our results are maintained for the rest of our life.
- Apply SPF after your skincare ritual every morning. Bring it with you to apply if going back out into the sun for any length of time. For instance, if you plan to spend 6 hours outside (any time of the year!), plan to reapply your sunscreen 3 times or every two hours.
- Wear protective clothing. Hats are going to be your best friend. When starting treatment of hyperpigmentation, your skin is going to be told not to produce melanin, without this, your skin isn’t going to have as much of the protective shield it normally did. It is much more likely that you will damage your skin cells and DNA, which will make pigmentation worse and can lead to cancer.
- Complete your skincare ritual morning and night. Our skincare is set up in a way that will protect you during the day, and repair at night. Some products will be required to only use at night, so skipping nighttime routines will lead to inconsistency that will affect your results. Same as skipping your nighttime routine, skipping your morning routine will render your progress useless, as sun damage will break down our cell structures and bring us back to square one.
That is why all skincare professionals stress the importance of SPF. You can spend hundreds of dollars on skincare, and thousands of dollars on aesthetic treatments for pigmentation, and it will all come back and be for nothing if you do not protect your investment from the sun. It is, of course, the main reason for hyper- and hypo-pigmentation conditions!!
To tan or not to tan? Practicing Sun Safety
I do not recommend tanning in any capacity. As most of you reading this, I too was a regular at the local tanning salon — but that was before it was labeled a carcinogen. The FDA states “It’s well established that UV radiation from the sun causes skin cancer,” … “Since lamps used in tanning beds emit UV radiation, the use of indoor tanning devices also increases your risk of skin cancer.”
The time we spend out in the sun at barbeques, on the water, and hanging with friends is plenty enough to activate our melanin and stimulate our body to make its Vitamin D.
I think it is important to take a deep dive into why you feel the need to lay out in the sun or on the tanning bed. Any skin condition that you feel is resolved by UV radiation from the sun or the tanning bed is just a temporary side effect of DNA damage. If you are more concerned about how you feel about your complexion and its color and tone, this can be resolved with spray tans or buildable tanning lotions just as easily.
I recently read an amazing book called The Body’s Edge by Marc Lappe, Ph.D. It was enlightening at the advancements and discoveries made in regards to our skin as an organ, as well as historical facts on different cultures’ relationship with their skin and the skin of others. It is always important to take a deep dive into our issues with ourselves and how we naturally look, it can be enlightening to embrace ourselves as we are, and can influence others to do the same.
Medical Alternatives: Lasers
Let’s talk a little bit about alternative treatments and procedures that you can receive in a medical atmosphere, like a MedSpa. Hands down, I believe that lasers are amazing for all sorts of skin conditions, but my two favorites to recommend laser treatments for are visible capillaries and pigmentation. BUT there are only certain conditions where I think the results are lasting.
For pigmentation, lasers can give you almost immediate results! Within a few days, your pigmentation will darken, come to the surface, and flake off. Left underneath is your beautiful even complexion. However, if you decide that this treatment was it, and continue with your regular lifestyle, you will find the pigment will return within a few months…I know, all of mine came back. But here is how to get lifelong results with lasers.
- You have to get on a skincare routine that has all of the above-mentioned ingredients. This routine should be looked at or recommended by your esthetician or medical professional administering the lasers.
- Budgeting right away to plan at least 3 laser treatments to start, the number of initial treatments may vary depending on your consultation. Then budget at least 1 to 2 per year if needed. Our skin is constantly regenerating, but pigmentation conditions can sometimes be life-long. Especially from those with pigmentation issues that are a result of hormones or inflammation.
- Say goodbye to sunbathing. Say hello to sun safety. Being out in the sun will immediately send your skin into a spiral of melanogenesis, no matter what treatments or skincare you have. In most cases, your skin is too sensitive to be exposed to the sun for long lengths of time which can result in some catastrophic sun burns and damage.
If you are interested in my thoughts about what lasers can do with capillaries, drop your question in the form below and we can chat about it!
What about Chemical Peels?
Chemical peels are always on the menu when you are working with skin conditions, especially pigmentation. However, your skin has to be prepped and you must already be getting professional treatments with me before being a candidate for several reasons. First, we need to know the condition of your skin and get it to optimal functioning before going in with an aggressive peel. This includes monthly treatments with professional exfoliation to ensure your skin is prepared. Another commitment is to your skincare ritual at home. You must be on a routine that will prepare your skin for a peel and soothe it afterward. If you are not committed to your home care, there is a high probability that your skin will either be damaged from the peel, or you will not see any results that last.
Recommended Treatments + Home Rituals
This section is one of the most important because it is where you are going to see the real investment and commitment it will take to get the skin you want, in real dollars! For some, skin conditions like pigmentation wreak havoc on our mental health, keeping us from feeling confident in our skin. There have been many times when I did not want to leave my house to go to the beach because I still was wearing a full face of foundation. There is a light at the end of the tunnel! I am still in the tunnel but there are now some cafe lights, a little music, and margaritas. It isn’t so bad!
My Favorite Pigmentation Busters
Below I have outlined two different routines based on the two award-winning skincare brands that we have at Oasis Skin Studio. As a client, your plan of action may look different than these; I take an intuitive and customized approach to each client individually based on lifestyle, restrictions due to diet or allergy, career, and more to ensure your plan will work for you with ease.
Pigmentation Plan #1: Results Driven with Circadia By Dr. Pugliese $679. This treatment plan will be based on your goals and lifestyle as well as working with other products you may have that we can finish first before switching to Circadia. All results and research is based on using Circadia’s products and can’t be guaranteed if you use other brands at home.
Treatment #1: Consultation & Expectations, Yang Customized Facial $65, Treatment Plan Discussion, Treatments will be spaced 4-5 weeks apart, and Recommended Skincare Ritual $254 (3-4 month supply)
- Amandola Milk Cleanser – Cleanse Morning and Evening
- Licorice & Bearberry Brightening Mist – Spray on the face, or apply with fingers like a serum in the Morning after cleansing.
- Bright White Serum – Apply to areas of pigmentation in the Evening
- Light Day Sunscreen with SPF 37 – Apply to face and neck in the Morning after Licorice & Bearberry Mist. Apply as needed if exposed to the sun directly or through a winder for more than 2 hours
- White Veil Brightener – Apply to the face in the Evening after Bright White Serum
Treatment #2: Enlightened Dermaplaning Facial $90
Treatment #3: Renewal Firming Peptide with Radio Frequency Facial $90
Treatment #4: Solstice Chemical Peel with After-care Kit $90, restock any skincare that is running out.
Treatment #5: Enlightened Dermaplaning Facial $90 – Re-Assessment of skincare goals and current plan.
Pigmentation Plan #2: DMK Skin Revision 6 Treatment Program $1130. This program includes Consultation with expectations, Treatment Plan Discussion, and a complimentary 30-day supply of home care products. Treatments will be spaced one week apart and the first 3 will focus on rebalancing and getting your skin to function at optimal levels while simultaneously working to inhibit melanin disfunction. The final 3 will be more advanced in creating real change in the skin by sloughing off the pigmented areas. During our first appointment, we will go over a lot of educational aspects and you will have a lot of information to take him. DMK believes that education will yield skin revision. The more we know, the more we grow. This is a heavily committed treatment that will require 6 weekly appointments and home care to be completed morning and night with DMK’s products only to guarantee results.
If you have pigmentation issues that you would like to address, please fill out this form. I would love to talk skincare with you!