Dark spots on the skin, also known as hyperpigmentation , are a common aesthetic concern as they have a direct impact on the quality of life and self-esteem of those who have them.
There are different types of stains and it is essential to differentiate them before starting treatment to eliminate them. Most spots are of melanic origin , that is, they are caused by an overproduction of melanin , the pigment responsible for skin color. Within this category, the main types of skin spots are melasma, solar or senile lentigines, freckles and post-inflammatory hyperpigmentation.
TYPES OF STAINS
1.Solar Lentiges
These are typical spots that appear with aging. They are caused by sun exposure over time. They are flat, dark and rounded and appear in areas frequently exposed to the sun, such as the face, hands and arms.
2. Freckles (Ephelides)
They are small, flat spots that appear on people with fair skin after sun exposure. They are caused by genetic predisposition and exposure to the sun.
3.Melasma
They are dark, irregular and symmetrical spots that appear on the face, especially on the forehead, cheeks and upper lip. They are caused by exposure to the sun, genetic predisposition and hormones (pregnancy, contraceptives).
It is the most difficult type of stain to treat due to the multiplicity of causes and “chronic” nature, tending to reappear.
4. Post-inflammatory hyperpigmentation
They vary depending on the nature of the lesion and can be more or less dark. They result from physical trauma or injuries such as cuts, scars, acne lesions.
They have an inflammatory component and worsen with sun exposure.
With the exception of freckles, all other spots are more likely to appear on darker skin, due to having a greater quantity and activity of melanocytes and, therefore, greater production of melanin.
WHY DO DARK SPOTS APPEAR ON THE SKIN?
Hyperpigmentation is the skin's natural mechanism against UV radiation.
Solar radiation is the main cause of the appearance of dark spots, since melanocytes, the cells specialized in the production of melanin (the brown pigment responsible for skin color), produce this protein that has the function of protecting DNA against damage. caused by the sun's rays, which is why its quantity increases with sun exposure, resulting in a tan.
Melanin is produced by the action of the enzyme tyrosinase , so most depigmenting agents act by inhibiting this enzyme.
The number of melanocytes is the same in all phototypes, but the number of melanosomes and the type of melanin (eumelanin and pheomelanin) and the amount produced depend on genetic factors, which explains the different skin colors.
There are disorders that can affect melanocytes, generating diseases such as melasma, vitiligo, melanoma, therefore, it is essential to have a medical diagnosis to identify the spot and decide the type of treatment, since only melanin spots can be treated with depigmenting methods. .
There are other factors , in addition to solar radiation, that can lead to the appearance of brown spots.
- Skin aging: it is common after the age of 40, thanks to oxidative stress and changes in the metabolism of the skin and melanocytes, disturbances in the production and distribution of melanin can occur.
- Inflammatory Processes: inflammatory processes such as acne, burns or aesthetic treatments such as laser or chemical exfoliation can pigment the skin, causing PIH (post-inflammatory hyperpigmentation).
- Genetic Factors: can contribute to a predisposition to developing abnormalities in skin pigmentation, such as freckles or ephelides, which occur more frequently in people with lighter skin and redheads.
- Hormonal Factors: hormonal fluctuations in female sex hormones (estrogen and progesterone) stimulate the overproduction of melanin during sun exposure and can lead to melasma. This can happen with contraceptive pills and during pregnancy.
- Photosensitizing Medication : some drugs such as ibuprofen, contraceptives, antihistamines can cause photosensitivity and cause the appearance of spots.
- Exposure to Chemical Agents: certain products such as perfumes and oils can cause phototoxicity and cause hyperpigmentation.
HOW TO PREVENT THE APPEARANCE OF STAINS?
Prevention is the most important step to prevent the appearance of blemishes, and therefore, there are some measures you can take to protect yourself from the sun, avoid irritation and inflammation, and keep your skin healthy. Here are some important tips:
1.Use Sunscreen: apply a broad-spectrum sunscreen with high or very high SPF (at least SPSF30) every day, even if it is cloudy. Reapply frequently.
There are numerous options for reapplication of the protector, such as powders, sticks and compacts with SPF that can be easily applied anywhere, even over makeup.
2. Apply a serum or cream with vitamin C, ferulic acid, vitamin E or other antioxidants before sunscreen to help prevent oxidative damage and blemishes and enhance its protective effect.
3.Wear Sun Protection Clothing: wear long sleeves, a wide-brimmed hat and sunglasses to protect yourself from radiation.
4.Avoid Excessive Sun Exposure: Avoid sun exposure during peak solar hours (generally between 10am and 4pm). Be in the shade whenever possible.
5.Do not squeeze pimples or skin lesions: squeezing pimples or skin lesions can lead to inflammation and darkening of the spots.
6.Avoid Abrasive Products: very aggressive exfoliating cosmetics can irritate the skin and worsen blemishes. Use gentle exfoliants sparingly.
7.Avoid Solariums and Photoepilation: solariums and the heat from photoepilation can aggravate existing blemishes.
8.Moisturize your skin: keeping your skin hydrated helps prevent flaking, irritation and blemishes.
9. Consult a Dermatologist: if you have blemishes or are predisposed to them, consult a dermatologist and follow their instructions strictly.
WHAT CAN I DO TO ELIMINATE OR IMPROVE THE APPEARANCE OF STAINS?
Various depigmenting and whitening active ingredients can be used in cosmetics such as serums and creams. These have to be used for prolonged periods, usually between 4 to 6 weeks. Consistency in the application of products and the daily use of sunscreen is essential to obtain satisfactory and lasting results.
As the pigment is already installed in the skin, its elimination also depends on its renewal.
It is common for formulations to include several types of active ingredients with different mechanisms of action and with a synergistic effect between them, since many of them are not very effective when used individually.
The active ingredients used in stains belong to several families:
- Chemical exfoliants: help remove cells from the skin's surface and accelerate cell renewal to eliminate pigment more quickly. They are generally used at night. Examples are alpha hydroxy acids (glycolic, malic and lactic acid), polyhydroxy acids, retinol and retinoids, salicylic acid.
- Melanin Production Inhibitors: prevent or reduce the production of melanin. They normally act by inhibiting tyrosinase. Examples are resorcinol, thiamidol, tranexamic acid, arbutin, Kojic acid.
- Others: there are still other active ingredients with different mechanisms, such as preventing the “spreading” of the pigment or anti-inflammatory action, such as niacinamide and azelaic acid.
Below we list the most common assets and their actions:
1.Hydroquinone
It is one of the most effective depigmenting agents. It inhibits the activity of tyrosinase, the enzyme involved in the production of melanin, thus reducing the amount of pigment produced by the skin. It is a medicine and must be prescribed by a doctor.
2.Resorcinol and Thiamidol
They inhibit the action of tyrosinase and consequently the production of melanin.
3.Kojic Acid
Derived from fermented rice, it inhibits tyrosinase and melanin production.
4.Ascorbic Acid (Vitamin C)
It has an antioxidant effect and helps to inhibit the production of melanin and increase the effectiveness of sunscreen, as well as brightening and evening out skin tone.
5.Alpha Hydroxy Acids (AHA)
They exfoliate the top layer of the skin, removing dead cells and promoting cell renewal.
6.Salicylic Acid
Helps exfoliate the skin, with beneficial effects on superficial blemishes and acne.
7.Retinol and Retinoids
They stimulate cell renewal, promoting skin regeneration and helping to reduce the appearance of dark spots and hyperpigmentation.
8.Niacinamide (vitamin B3)
It inhibits the transfer of melanin to skin cells, helping to reduce irregular pigmentation and also has some anti-inflammatory effects.
10.Tranexamic Acid
It inhibits skin inflammation and reduces melanin production, being particularly useful for post-inflammatory dark spots .
11.Azelaic Acid
It works by inhibiting tyrosinase and reducing inflammation, being useful in treating blemishes caused by acne.
The right choice of the best cosmetic for blemishes depends on several factors, such as the type of blemish (melasma, lentigo), its location (face, groin, armpits, hands) and the type of skin (more or less light, more or less sensitive, dry, normal or oily). You can always turn to a professional to help you choose the best solutions for your particular case.
You should also adopt simple routines to avoid, for example, sunscreen crumbling, which would lead to the area becoming unprotected.
Remember that more serious cases of blemishes may require more aggressive procedures such as chemical peels, microneedling or laser and must be carried out by a dermatologist or an aesthetic medicine professional.
Dark spots can be eliminated or corrected, but never forget that prevention, especially through sun protection, plays the main role in having healthy, even skin.
Consult a healthcare professional to access the most personalized care and maintain radiant, glowing and uniform skin, WITHOUT BLEMISHES!