Hyperpigmentary disorders are another group of skin conditions that frequently trouble patients, especially in sunny Singapore. These are typified by brown or black spots or blemishes on the skin that can be unsightly and can affect a patient’s self-image and confidence. For practical purposes, I like to classify hyperpigmentation in 3 groups, those that will clear on their own in time, those that can be completely cleared with treatment, and those that can be improved or controlled with treatment.
It is important to understand that our bodies naturally produce and remove pigment in the form of melanin all the time, which gives us our natural skin colour, and protects our skin from ultraviolet (UV) rays from the sun. Acute inflammation such as a sunburn from a beach holiday or an acne outbreak can lead to increased melanin production in the short term, which can lead to post inflammatory hyperpigmentation or PIH, which appear as brown patches on the skin over the affected areas. In the longer term, as we age, our cells gradually lose the ability to repair and regenerate themselves as effectively, which can lead to increased melanin production / decreased clearance, which gives rise in turn to the appearance of dull and uneven skin tone. Sun exposure and sun damage is a major contributing factor to this process, as excessive UV damage goes beyond triggering increased melanin production as the skin attempts to protect itself, to generating free radicals that damage our DNA and it’s ability to repair itself, accelerating the process of skin aging and reducing our skin’s natural ability to repair and regenerate. A good sunblock is ANY sunblock with SPF50++ that you will apply consistently (ie one with your preferred texture, smell, or tint), ideally reapplying once every 4 hourly, especially if you will be outdoors. Today, there are also modern sunblocks that provide additional protection against blue light from our devices (that we face far too often), as well as oral sunblocks that reduces the amount of UV that our cells absorb. Vitamin C is another important component of skincare for patients concerned with pigmentation or dull skin tone, as it is a powerful antioxidant that helps mitigate free radical damage on our cellular DNA, protecting our cell’s natural ability to repair and regenerate. Finally, laser toning with a specific wavelength that effectively targets melanin helps to break up any patches or blemishes which speeds up the natural process of clearance, while “cleaning up” scattered pigmentation so that light reflects off the face more evenly, giving rise to a clearer, brighter complexion and a refreshed appearance.