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Written by the Elucent skincare community
Pigmentation of the skin is a current skin topic that many people want to know more about. We asked prominent dermatologist Dr Esther Hong to explain what skin pigmentation is and what to do about it. Dr Hong has 8 years of experience working in clinical and research dermatology across New South Wales and currently consults at St George Dermatology and Royal North Shore Hospital.
What causes pigmentation?
Pigmentation occurs by production of melanin (a type of skin protein) by melanocytes (a specialised type of cell in the skin). Melanin is then deposited in the top layers of the skin and is responsible for our skin colour.
Melanocytes numbers are the same for each racial group, but the amount of melanin produced by the melanocytes differs in each person. Darker skin tends to produce more melanin, while fair skin produces less.
What causes hyperpigmentation?
Hyperpigmentation often refers to a secondary process of skin darkening due to injury to the skin, as in post-inflammatory hyperpigmentation. In these cases, injury to the skin such as an oven burn or insect bite can activate melanocytes to produce increased amounts of melanin.
Melasma is a type of hyperpigmentation affected by exposure to UV radiation. It also occurs through a combination of other factors including genetics and hormones.
What are the different types of hyperpigmentation?
Hyperpigmentation may be classified by cause (e.g. hormonal, post-inflammatory, drug-induced), and type of hyperpigmentation – for example, epidermal (where the pigmentation is superficial) and dermal (where pigmentation is deeper). Dermal hyperpigmentation can appear as grey/blue tones and is often harder to treat.
How is skin pigmentation associated with pregnancy?
Hormones of pregnancy, mainly oestrogen, can activate melanocytes and cause darkening of skin. “Mask of pregnancy” refers to facial hyperpigmentation or melisma. Linea nigra (dark line down the centre of the lower abdomen) is a type of hormonal hyperpigmentation seen during pregnancy.
How to avoid pigmentation during pregnancy?
You can’t entirely avoid pigmentation during pregnancy, but strict sun protection helps prevent worsening of pigmentation and so does avoiding other potential sensitizers (medications, perfumes and fragrances etc).
Does pregnancy pigmentation go away?
Hormonal skin pigmentation usually fades within a few months after giving birth.
What advice would you give to someone concerned about pigmentation during pregnancy?
Sun protection is very important! But due to pregnancy, you have to be careful when using certain products. In this sense, it’s best to always consult with a doctor before using any products.
How to prevent hyperpigmentation?
Prevention is key! Sun protection with SPF 30 and above sunscreen and a wide brimmed hat helps greatly. Treatment using a combination of creams that incorporate ingredients that help fade and stop formation of new pigmentation. Products containing hydroquinone, kojic acid, soybean extracts, vitamin C and azelaic acid. Combining fruit acid (AHA) peels can help remove existing pigment. Stubborn cases may need review by a dermatologist who can recommend the best approach. Laser treatment can also play a role in some cases.
Dr Esther Hong is a highly regarded general Dermatologist with a special interest in skin cancer detection and treatment, psoriasis, eczema, acne, paediatric and vulval dermatology, as well as Cosmetic dermatology and axillary hyperhidrosis. She has 8 years of experience working in clinical and research dermatology across New South Wales and currently consults at St George Dermatology and Royal North Shore Hospital.Dr Hong is a graduate with honours of the Sydney Medical School at the University of Sydney and holds a Masters Degree in dermatology research. She has published widely in medical journals and presented at Australian and International dermatology conferences.
