The process of hyperpigmentation occurs in multiple steps, and the process is complex. “Pigmentation starts with the melanocyte, whose primary function is to make melanin pigment packets called melanosomes,” explains Christi Roberts, educational program administrator, GlyMed Plus/Advanced Aesthetics. “The amount of melanin in the melanosomes, and the number of melanosomes distributed into the keratinocytes [outer skin cells], determine the color of skin. The basic unit of melanin is tyrosine. When melanocytes are activated, the tyrosine is acted upon by an enzyme called tyrosinase, and is ultimately transformed into dopaquinone [a metabolite that helps produce melanin].” The resulting packets of pigment formed, Roberts goes on to explain, are ultimately carried, via keratinocytes, to the surface of the skin.
There are several root causes of hyperpigmentation, which include photo damage and sun exposure, inflammation, hormones, illness, medications, and various skin injuries, including those related to acne. Because of this variation in causes, some cases of hyperpigmentation are harder to treat than others. Here, knowledge is key.
“Understanding the process by which pigmentation is triggered and produced enables the skin specialist to formulate a treatment that can block or slow down the production of pigment and thus help facilitate the resolution,” notes Roberts. “In addition to biological understanding, skin practitioners must also understand the different types of pigmentation that occur and whether they are epidermal or dermal pigmentation, and their causes. Not all pigmentation is created equally and thus should not be treated the same.”
For instance, melanin isn’t the only instigator, points out Karen Asquith, national technical training manager, North America, G.M. Collin. “There’s also lipofuscin, an aggregate of oxidized proteins and lipids that have lost their function and produce a pale yellow-brown pigment, made of free-radical-damaged protein and fat,” Asquith explains.
The goal of most depigmentation treatments is to inhibit the enzyme that plays a key role in the pigment synthesis, tyrosinase, but other objectives include inhibiting the transfer of pigment to the epidermal cells, stimulating turnover of stained cells and breaking down the accumulated pigment. “Brightening the skin can only occur if the skin is treated comprehensively—and prevention is key!” says Jurist. “Proper exfoliation, hydration, reparation and protection are fundamental pillars in skin care for both face and body; skin can show remarkable improvement when its delicate balance is maintained.”
Treatment often starts with preventing triggers. If sun damage is the problem, clients must always use broad-spectrum sunscreen. If acne is causing inflammation, the acne needs to be treated first. Hormonal changes (such as in pregnancy) may be addressed with a lightening product during the hormonal imbalance. Mark Lees, Ph.D., president and CEO of Mark Lees Skincare, has found that some clients have success simply by using sunscreen, avoiding tanning and removing already stained cells through an AHA product. However, he notes, if no improvement is shown after six weeks, or if the hyperpigmentation is too deep, a visit to the dermatologist may be in order.