Skin pigmentation is a natural process determined by melanin, a pigment produced by cells called melanocytes. Melanin production is influenced by various factors, and dysfunctions in this process can lead to the appearance of pigment spots, which can be aesthetically bothersome.
Indeed, a bright and even-toned skin without spots is a frequent request.
In most cases, skin pigmentation is harmless.
However, when brown spots appear, it is essential to consult a doctor for an accurate diagnosis.
Apart from nevi (moles), pigment lesions may include :
• Age spots (lentigos).
• Melasma.
• Freckles.
• Hyperpigmentation spots : due to increased activity of melanocytes, the cells responsible for melanin synthesis, following stimulation (trauma, blemish, medical procedure, application of chemical agents…).
• Spots secondary to fungal infection.
Skin spots, whether brown spots, melasma, sun spots or hyperpigmentation, are a common aesthetic concern that affects the clarity and uniformity of the complexion. In aesthetic medicine, several treatments are available to correct
these skin imperfections and restore smooth, radiant skin. Pigment laser, chemical peels and depigmenting treatments effectively reduce pigment spots for an even skin tone.
Spots result from excessive or irregular melanin production by melanocytes. Melanin is the pigment that gives skin its color, and melanocytes are the cells responsible for producing it.
Pigmentation issues are caused by factors that influence melanin production :
• Sun exposure : UV rays stimulate melanin production, which causes tanning, but excessive production leads to persistent spots.
• Hormones : hormonal changes, especially during pregnancy or with oral contraceptives, play a major role in the appearance of melasma.
• Aging : with age, cell renewal slows down and melanocyte activity changes.
• Genetic factors.
• Skin inflammation : infections, acne, skin trauma and even some aesthetic procedures can cause local inflammation that results in post-inflammatory pigmentation.
The main depigmenting ingredients used in aesthetic medicine and creams include :
• Hydroquinone : a powerful inhibitor of melanin production, very effective but regulated to avoid irritation risks. It is found in onions, fruits, seeds, tea, coffee, beer, and wine. Its use is limited to compounded formulations like Kligman’s trio and is banned in over-the-counter cosmetics.
• Arbutin : a hydroquinone derivative found in cranberry and blueberry leaves.
• Kojic acid : derived from rice fermentation, it has natural brightening and antioxidant properties, acting gently on spots.
• Vitamin C : known for its antioxidant effects, it brightens spots while boosting collagen production and giving a more radiant complexion.
• Retinoids (vitamin A derivatives) : promote cell renewal, exfoliate the skin’s surface and reduce pigmentation spots.
• Azelaic acid : a gentle ingredient suitable for sensitive skin, it reduces hyperpigmentation and has anti-inflammatory properties.
• Tranexamic acid : an effective depigmenting agent ideal for melasma-prone skin, acting on pigmentation and inflammation.
• Phytic acid : found in cereal grain husks.
• Citric acid : derived from lemon.
• Niacinamide or vitamin B3 : found in plant roots and mushrooms.
These ingredients are often combined to maximize efficacy, providing personalized solutions for a more even and radiant complexion.
To determine appropriate treatments, it is essential to distinguish the different types of pigment spots.
Aesthetic treatments for spots are effective solutions for reducing them and evening out the complexion. Depending on the type of blemish (sun spots, melasma, ephelides or post-inflammatory blemishes) and skin type.
Laser and chemical peels are the most effective methods.
It is important to understand that treatments eliminate the pigment but do not correct the abnormal functioning of the melanocytes. The results are therefore transitory, and the pigmentation will reappear one or more years later depending on the patient's lifestyle, particularly exposure to the sun.
A depigmenting peel is an effective, non-invasive method for treating pigmentation spots and evening out skin tone. Suitable for pigmentation problems such as melasma, solar lentigo and post-inflammatory pigmentation, this treatment involves the application of powerful exfoliating agents such as glycolic acid, trichloroacetic acid or kojic acid. These substances act by eliminating the superficial layers of the skin, encouraging cell renewal and visibly reducing the appearance of spots.
The combination of these active ingredients produces visible results, including a marked improvement in skin evenness in 84% of cases after 2 treatments, a significant reduction (72%) in melasma, and smoother skin and less pronounced fine lines after several sessions for 83% of patients.
Sun exposure is contraindicated for two months. The peel cannot be performed on tanned skin.
The choice of laser will depend on the type of stain and the depth of pigmentation.
Two types of laser can be used:
- Laser depigmentation.
- The ablative laser.
The mechanism of action of depigmenting lasers is the use of a beam of light with a very short firing time, of the order of a nonosecond, which enables the pigment to be fragmented.
Depending on the depth of the pigment, a KTP Qswitched (epidermal pigment) or Nd:YagQswitched (dermal pigment) laser is used.
A small crust may appear on the treated area, and the patient should take care to grease it daily. One or more sessions may be necessary.
Dr Romano prefers to use the ablative laser. The mechanism of action of this laser is the vaporisation of the pigment. This treatment is more complicated to perform, but can be used to treat all types of pigmentation (the depigmenting laser is not indicated, for example, for the treatment of melasma).
Treatment with ablative laser treatmentIf carried out correctly, depigmenting lasers do not cause post-inflammatory pigmentation. In fact, even if used to remove spots, depigmenting lasers can cause local inflammation that worsens pigmentation.
It is possible to effectively prevent the appearance of pigmentation spots and preserve the skin's natural radiance by taking certain steps on a daily basis.
- Use daily sun protection: applying a broad-spectrum sunscreen (SPF 30 minimum) every day is essential, even on cloudy days. This protects the skin from the effects of UV rays, which are the main cause of pigmentation spots.
- Choose antioxidant-rich skin care products: creams and serums containing vitamin C, vitamin E or ferulic acid help to neutralise the free radicals that damage the skin and stimulate melanin production.
- Moisturise the skin regularly: good moisturisation is essential to keep the skin barrier healthy, thereby limiting inflammation and the risk of post-inflammatory pigmentation.<Limit sun exposure: reduce the amount of time you spend in the sun, particularly between 10am and 4pm, and wear hats or protective clothing to reduce the risk of dark spots appearing.
- Use skin care products that are gentle on the skin: avoid aggressive products or treatments, as repeated inflammation or irritation can lead to the appearance of post-inflammatory pigmentation.
- Use lightening active ingredients as a preventive measure: active ingredients such as vitamin C or azelaic acid help prevent melanin imbalances, evening out skin tone and reducing the appearance of incipient pigmentation.
| Type of consultation | Generally practiced rates |
|---|---|
|
Peel
|
Starting at 200 CHF per session |
|
Laser |
Starting at 200 CHF per session |
The services described on this website apply to Swiss territory; there are differences between countries.
Contact
Dr Valeria Romano
Pl. du Molard 5, 1204 Geneva, Switzerland
Monday to Friday, 9.30am to 6pm
Dr Valeria Romano - All rights reserved.
