Skin pigmentation is a natural process determined by melanin, a pigment produced by cells called melanocytes. Melanin production is influenced by various factors, and malfunctions in this process can lead to the appearance of pigmentation spots, which can be aesthetically embarrassing.
In fact, luminous, even skin without spots is a frequent request.
In most cases, skin pigmentation is of no consequence.
However, when brown spots appear, it is essential to consult a doctor for a precise diagnosis.
Apart from naevi (moles), pigmented lesions can be :
- Senile lentigos.
- Melasma.
- Freckles.
- Hyperpigmentation spots: due to increased activity of melanocytes, the cells responsible for synthesising melanin, following stimulation (trauma, pimple, medical procedure, application of chemical agents, etc.).
- Spots secondary to a fungal infection.
The skin spotsSkin blemishes, whether brown spots, melasma, solar lentigos or hyperpigmentation, are a common aesthetic problem that affects the clarity and uniformity of the complexion. In aesthetic medicine, there are several treatments available to correct these imperfections
and restore smooth, radiant skin. Visit pigment laserthe chemical peels and depigmenting treatmentsThese products effectively reduce pigmentation spots for an even complexion.
The spot is the result of increased or anarchic production of melanin by the melanocytes.
Melanin is the pigment that gives colour to the skin, and melanocytes are the cells responsible for its synthesis.
Pigmentation problems are caused by factors that influence melanin production.
- Exposure to the sun: UV rays stimulate the production of melanin, which is why we tan, but excessive production of this pigment causes persistent spots.
- Hormones: hormonal changes, particularly during pregnancy or when taking contraceptives, play an important role in the appearance of melasma.
- Ageing: with age, cell renewal slows down and melanocyte activity deteriorates.
- Genetic factors.
- Inflammation of the skin: infections, acne, skin aggressions and even certain beauty treatments can cause local inflammation, leading to pigmentation, known as post-inflammatory pigmentation.
The main depigmenting active ingredients used in beauty treatments and creams include :
- Hydroquinone: a powerful inhibitor of melanin production, it is highly effective but its use is restricted to avoid the risk of irritation. It is found in onions, fruit, seeds, tea, coffee, beer and wine. It may only be used in magistral preparations such as the Kligmann trio, and is currently banned from over-the-counter cosmetics.
- Arbutin: this is a hydroquinone derivative found in cranberry and blueberry leaves.
- Kojic acid: derived from rice fermentation, it has natural lightening and antioxidant properties, acting gently on spots.
- Vitamin C: known for its antioxidant effects, this active ingredient lightens dark spots while boosting collagen production for a more radiant complexion.
- Retinoids (vitamin A derivatives): promote cell renewal, exfoliate the skin's surface and reduce pigmentation spots.
- Azelaic acid: a gentle active ingredient, suitable for sensitive skin, which reduces hyperpigmentation and has anti-inflammatory properties.
- Tranexamic acid: an effective depigmenting agent, ideal for melasma-prone skin thanks to its action on pigmentation and inflammation.
- Phytic acid: found in the bark of cereal seeds.
- Citric acid: derived from lemons.
- Niacinamide or vitamin B3: found in plant roots and mushrooms.
These active ingredients are often combined to maximise their effectiveness, providing personalised solutions for a more even, luminous complexion.
To understand the right solutions, it is essential to distinguish between the different types of pigmentation 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 of 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 work 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 clear improvement in skin homogeneity in 84% of cases after 2 treatments, a significant reduction (72%) in melasma, and smoother skin and less fine lines after several sessions for 83% of patients.
Sun exposure is not recommended 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 laserIf 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 skin care products rich in antioxidants: creams and serums containing vitamin C, vitamin E or ferulic acid help neutralise the free radicals that damage the skin and stimulate melanin production.
- Moisturise the skin regularly: good hydration is essential for maintaining the skin barrier in good health, limiting inflammation and the risk of post-inflammatory pigmentation.
- Limit exposure to the sun: 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 pigmentation.
Le cost of a superficial peel depends on the problem being treated, the product used and the patient's skin.
Several sessions are held.
| Type of consultation | General rates |
|---|---|
Peeling |
From CHF 200 per session |
Laser |
From CHF 300 per session |
The services described on this site are applicable to Switzerland; there are differences between countries.
Contact details
Dr Valeria Romano
Pl. du Molard 5, 1204 Geneva, Switzerland
Monday to Friday, 9.30am to 6pm
Dr Valeria Romano - All rights reserved.
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