Pigmentation

The term pigmentation literally means any form of pigment (or colour) that appears on the skin.

The term is most commonly used however to refer to the brown pigmentation – melanin – that occurs on the skin as we age. It is almost always associated with sun damage in the past. A lot of people underestimate how much sun exposure they have however it is the cumulative effect of the sun, over a great number of years, that finally results in the characteristic appearance of sun damaged skin. The best treatment option will depend on the extent of the sun spots, and the other associated signs of ageing that are also present.

Non-surgical treatments for pigmentation include:

IPL

This is broadly considered to be one of the most effective treatments for open pores. It is also one of the most aggressive treatments. The treatment works by burning the top layers of the skin off, which in turn generates a healing response. Traditional laser resurfacing burns the entire surface of thThis treatment uses very bright light, in a short burst, to target pigments within the skin. The pigments that are targeted are red and brown, which generates a burst of heat, which typically destroys red blood vessels and brown age spots. The treatment can be quite painful, but is usually over with very quickly. It is most effective for people who have sun damage where ‘dyschromia’ – uneven skin colour – is the predominant feature. It is best for most isolated patches of sun spots.

Light Chemical Peels

A course of lighter chemical peels can sometimes be used to treat sun damage. A lighter chemical peel is one using a more dilute acid, so it does not penetrate as deeply. Consequently, these have a much more rapid recovery with people usually returning to work straight away. There is normally some dry skin and peeling around days 3 – 5, although it is usually not significant enough to stop people going about their normal day-to-day activities. Normally a course of 3 or 4 treatments would be suggested, one each week. The philosophy behind this treatment is that the constant inflammation produced the more minor peels results in more collagen remodelling in the deeper layers of the skin.

Medium Depth Chemical Peel

A medium depth chemical peel is one which peels down to a slightly deeper layer in the skin. When using this technique we prepare the skin, via the use of a prescription skin care regime, for six weeks prior to the peel. The peel itself can be quite painful, and normally takes around 1 hour to perform. After the peel the skin is usually healed within about 1 week, following which you go back onto the prescription skin care regime for another six weeks. This is probably the most effective treatment for pigmentation we have available. Usually one cycle of treatment is enough to significantly reduce – if not eliminate – the existing pigmentation. In severe cases a number of cycles may be required.

Fractional Laser

This is broadly considered to be the gold standard treatment for advanced sun damage. The CO2 laseworks by burning the top layers of the skin off, which in turn generates a healing response. Traditional laser resurfacing burns the entire surface of the skin off. More recently advances in ‘fractional’ technology means that only a percentage of the skins surface is removed, using microscopic laser beams. This has the effect of still stimulating a healing response, but with a shorter recovery period afterwards. The CO2 laser we use is the CO2RE from Syneron-Candela, which has the ability to work in both full field and fractional mode. For treating sun damage with age spots we normally use it in fractional mode, typically using a combination of medium and deep settings. The down time from this procedure is usually around one week. You will normally notice a benefit from this treatment after one session, although occasionally two or three sessions are required to achieve optimal results in the most severe cases.

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