Skin Pigmentation: What Is It?
The aberrant synthesis and deposition of melanin by the melanocytes causes excessive skin coloring. Melanocytes are cells that produce pigment. The quantity of melanocytes in our skin will decide the color of our skin. Melanin production is a natural defense mechanism for the skin that is reliant on UV or sun exposure.
Excessive melanin synthesis and deposition cause hyperpigmentation, or spots on the skin that are darker than the surrounding skin. Loss of skin pigmentation is referred to as hypopigmentation. This won't be covered here.
Skin pigmentation and its management are covered on this page. This topic will only cover skin-surface pigmentation; it will not include moles, elevated pigmented lesions, or skin malignancies.
What Causes Pigmentation in Skin?
Usually, an excessive rise in melanin is what causes excessive skin pigmentation, also known as hyperpigmentation. As a result, melanin is produced excessively, clumps together, and the skin develops brown or deeper pigmentation patches.
Issues with skin pigmentation include;
UV radiation: In the majority of cases, particularly in regions with high UV radiation levels, like Australia, issues with skin pigmentation can be brought on by too much UV or sun exposure (most common).
Hormonal: Melasma or chloasma, a form of pigmentation that is typically brought on by pregnancy or the pill (common).
Skin damage can arise from laser treatments, chemical peels, physical trauma to the skin, or acne. Post-inflammatory hyperpigmentation is the term for this (common).
Birthmarks and acquired pigmentation: Skin pigmentation can develop as a kid, as an adult, or even at birth (in the case of birthmarks). Congenital melanocytic nevus, cafe au lait spots, spilus nevus, hori's macules, and nevus of ota are a few examples of these.
How are Pigmentation Issues Handled?
Basically, topical lightening treatments or lasers can be used to address hyperpigmentation.
The primary distinction between the two is that, in most situations, lasers are able to deliver a quicker and more effective solution. Topical lightening techniques often just diminish pigmentation, not fully eliminate it.
However, compared to the use of lightening chemicals, using lasers has higher hazards. These dangers include skin scarring, loss of normal skin pigmentation (hypopigmentation), and worsening of the pigmentation (rare).
How to Use a Laser to Get Rid of Pigmentation
Some lasers can be used to correct skin pigmentation while having little to no effect on healthy skin. The method of selective photothermolysis makes this feasible. This phrase indicates how a certain laser wavelength is drawn to pigmented lesions and only weakly to healthy skin, enabling the eradication of specific lesions. This enables the laser to target the pigment while causing little to no harm to the skin around it. In pigmented lesions, the wavelengths that are often drawn to the melanin vary from 532 nanometers (nm) to 1064 nm.
Millisecond pulse width lasers are one kind of laser that can be used to cure pigmentation. These lasers produce light pulses that are drawn to the pigment's melanin, thermally heating the pigment to specifically damage it. Each pulse in this scenario lasts for a few milliseconds (1 millisecond = 1/1000th of a second), which, while sounding brief, is a significant amount of time. The Gemini Laser is an illustration of this laser.
A q-switched laser is another kind of laser that may be used to cure pigmentation. The melanin in the pigmented skin is drawn to the nanosecond pulses of light that these lasers emit (1 nanosecond = 1 billionth of a second).
They disturb the pigment by selectively heating it, but because the pulses are shorter, they also have a photomechanical impact, i.e. They break/shock the pigment, which causes it to degrade. This result also enables these lasers to remove tattoo pigment. These lasers often have the benefit of requiring fewer sessions than millisecond lasers to correct pigmentation. Because it is a more vigorous and successful therapy, it also has greater side effects, including a longer recovery period and a higher likelihood of post-inflammatory hyperpigmentation.
Pigmentation Types
Three categories can be used to group skin pigmentation; Solar lentigos, freckles, and cafe-au-lait macules are examples of epidermal (superficial) pigmentation, which is a form of skin pigmentation that often occurs at the skin's surface and is brought on by sun exposure.
Dermal (deep) pigmentation includes hori's macules and nevus of ota. These pigmentation types are often present in the dermal layers.
Mixed dermal/epidermal pigmentation is a form of pigmentation that affects the skin's outer and inner layers. A good example of this is melasma.
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