Preventing Brown Spots, Melasma, and Pigment Problems
Dermatologist Dr. Brandith Irwin:
I get asked a lot about skin type and whether it matters with pigmentation. It absolutely does. The darker our skin, the darker our hair color or eye color, the more skin will pigment when it’s injured by inflammation, sun damage, hormones, eczema and all sorts of other problems. So, it’s important to know that those problems can be solved. And you will tend to have more of those problems if you are a darker skin type. A lot of patients ask me about exfoliating their skin to help with pigment problems and there’s kind of a fine line with that so be careful. If you exfoliate too much, it actually aggravates the problem. If you want something just right and you want something very gentle and don’t use it more that once or twice a week it can help. Many people ask if there are products they can use that are non-prescription that will help with pigment. There are, and the things that are important of course are your sunscreen, anti-oxidants an then you can buy 2% hydrocortisones in most places in the world over the counter. Just don’t overuse those and remember if you get irritated, they may actually make the problem worse. One option for pigment is to have peels or microdermabrasion done in your esthetician’s office or with a physician. It’s really important that those be done well, though, because if they’re overdone or done badly, they can actually make the problem worse. It’s very important if you have pigment problems, not to be using extra estrogens. So, if you are using hormones, you want to try and find with your doctor, and alternative to those. I get asked all the time in the office and on my bold about lasers for pigment. Please be very careful. As many of you know, many of these lasers can actually make this problem worse; much worse. And so, the choice of the laser is key. It’s important to think about why you have the problem in the first place. For example, sun damage will almost always respond to Fraxels or carbon-dioxide lasers or even IPLs. Malasma , for example, is almost always made worse by an IPL; often by a Fraxel and with carbon-dioxide laser there’s still data on both sides. So again, you need to know your diagnosis, because the choice of your laser will depend on your diagnosis.