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What are The Causes and Treatments of Skin Pigmentation?


A clear, flawless complexion can easily be achieved with effective treatments.

Pigmentation in the skin is due to the presence of melanin, a substance that is produced naturally by the skin. Most of us have native pigment in our skin which gives rise to our natural skin colour that is influenced by our genetic background, degree of sun-exposure, etc. Where melanin is found in dense “clumps” in the skin, it is seen as pigmented spots on the surface of the skin. These pigmented spots, though often harmless, can be a cosmetic problem, and even affect one’s self esteem.

The most common causes of pigmentation in the skin are:

  • Melasma - A condition with dark, irregular patches commonly found on the upper cheek, nose, lips, upper lip, and forehead. This is due to fluctuations in levels of female hormones in people who are susceptible.
  • Solar lentigines – “Sun spots or liver spots” due to chronic exposure to the sun.
  • Freckles – Due to genetic factors. Common among Caucasians.
  • Post-inflammatory hyperpigmentation – A consequence of inflammation in the skin from causes such as acne, dermatitis, irritation, insect bites, and laser treatment.
  • Hori’s Nevus – Dark brown spots over the cheekbone areas. This may be due to genetic factors, and is commonly seen in people of Oriental descent.

Some of the effective remedies to treat pigmentation are:

  • Topical therapy – Creams and lotions that bleach the skin, reduce the production of melanin, or cause exfoliation. The therapy can decrease the amount of melanin in the skin.
  • Chemical peeling – Causes skin exfoliation or may directly destroy the pigmented spot in the skin if the pigmentation is superficial. Not recommended if the pigment is deep in the dermis.
  • Intense Pulse Light therapy – Treats superficial pigmentation and improves skin texture. It is non-traumatic and not associated with downtime.
  • Laser therapy - Some systems are more effective but aggressive, causing crusting in the treated area which requires a prolonged period of recovery. Other laser systems are able to target pigment deep in the dermis without damaging the intervening skin. These do not result in burns. Downtime for these would take about a few hours to three days. However, these “gentle” treatments have to be repeated in order to achieve satisfactory results.

Regardless of the diagnosis and method of treatment, judicious protection of the skin from excessive exposure to the sun is vital for maintaining good results. The regular use of appropriate sunscreens and protective gear when outdoors can help prevent solar lentigines from developing again. Conditions due to genetic factors though, can recur. Inflammation of the skin from various causes can also result in the re-appearance of pigmentation on the skin.

Side effects from pigmentation treatments:

  • Skin irritation – This can result in a darkening of the affected skin due to post-inflammatory hyperpigmentation.
  • Unexpected burns and crusting – Might occur in procedures such as superficial chemical peeling and Intense Pulsed Light therapy resulting in a prolonged downtime.
  • Scarring – Due to poor laser treatment technique or poor posttreatment care of crusts or wounds in the skin.

Dr Cheong Lai Leng, dermatologist of LL Cheong Skin & Laser Clinic cautions: “Some procedures have downtime involved, hence it is important to take note of the post-treatment period, so that you can plan time away from your professional or social activities.” Also, be sure to inform your skin doctor should there be any change in your health or condition of your skin before the procedure.