We are lucky in Auckland, New Zealand to enjoy beautiful landscapes and weather for much of the year. Unfortunately this can also mean that we experience more sun exposure and sun damage than in cooler climates. The New Zealand sun is relatively harsh, contributing to skin ageing and pigmentation. Below we discuss skin pigmentation causes, skin pigmentation removal, and skin pigmentation treatment.
Melanin is the brown pigment in our skin that makes it darker. Those with a darker skin tone have a higher amount of melanin than those with a fairer skin tone. And any skin tone experiences more melanin production when exposed to the sun (as we see when we get a tan).
Hormones (particularly oestrogen) and sun exposure promote melanin production which can cause freckles, sun spots, blotchy skin pigmentation and melasma (a hormonally driven skin pigmentation).
The benefit of having a darker skin type is that the skin tends to age very well. We can see the evidence of this when we look at older Maori, Pacific Island, Negro and Asian people. One downside though, is an increased likelihood of pigmentation issues.
The treatment of skin pigmentation is tailored to what type of skin pigmentation you have.
The most common pigmentation problems are brown sun spots (freckles), melasma, age spots, seborrhoeic keratosis and pigmented birthmarks. Pigmentation issues vary depending on your skin type. Treatments include medical grade skincare, medifacials or chemical peels, Elos Medical IPL, laser therapy like Fraxel Laser treatment and in some cases biopsy or skin excision is required to exclude skin cancer such as melanoma.
Brown Sun Spots (Freckles) Treatment
Treatment of Freckles
Freckles are small flat brown marks on sun exposed areas.
The tendency to form freckles is inherited and is often seen in redheads and younger people. Freckles usually fade in winter and reappear in summer. They can be treated with Elos Medical IPL, but may reappear with further sun exposure so it is very important to apply a good sunscreen following treatment to maximise and protect your results.
Post inflammatory hyperpigmentation (PIH) occurs after injury to the skin and is far more prevalent in darker skin types such as Maori, Indian, Asian and Pacific Islanders. PIH appears as a brown area over the site of previous injury and is due to excess melanin being produced by melanocytes as a result of inflammation from the injury.
Typically PIH resolves over several months but can persist for 1-2 years, and in some cases can be permanent. Treatment is often conservative as it will resolve over time and treatments can risk further inflammation and therefore further PIH. Our beauty therapists are skilled at using gentle topical treatments in the clinic and good skin care at home to help reduce PIH.
The mainstay is to use a good quality SPF to reduce UV exposure, a topical vitamin A and vitamin B to inhibit further pigment production, and a lightening cream, such as hydroquinone. Your Palm Clinic Auckland, NZ skin therapist will assess your skin and prescribe the appropriate skincare.
Age spots (liver spots) are larger flat skin spots on the face and hands that appear in middle age after years of sun damage. The medical term for age spots is ‘solar lentigines’. They are caused by an accumulation of the cells that make pigment. They fade but don’t fully disappear in winter.
If the brown marks are scaly, they may be solar keratoses (pre-cancerous sun damage) or seborrheic keratoses. It is also important to distinguish them from early malignant melanoma (lentigo maligna). If a dark spot has appeared or changed recently, has an irregular border, has more than one colour, or you have any concerns, see your dermatologist or GP for a skin check.
Skin pigmentation should always be protected from the sun. They can be faded with creams containing hydroquinone, alpha-hydroxy acids, retinoids and vitamin B. Stronger, quicker options to fade or remove spots are chemical peels (which may include glycolic acid, azelaic acid, vitamin A), Dermapen and many lasers.
Freckles on the decolletage area of the chest are easily removed with Elos Medical IPL laser treatment.
Palm Clinic’s most effective treatment option for treating age spots or freckles is Elos IPL. This medical grade IPL reduces the top layers of pigment, fading the brown spot without reducing the number of melanocytes. Good sun protection is essential after treatment to prevent brown spots darkening again. These lasers also reduce red veins and promote natural collagen formation.
Alternatively, the revolutionary Fraxel Laser treatment which partially resurfaces the skin can also be used to remove brown spots. Fine lines and skin texture are significantly smoothed at the same time improving the overall appearance of the skin.
Melasma is the blotchy appearance of brown skin pigmentation on the face.
Melasma, (also known as chloasma ‘pregnancy mask’), appears as blotchy pale brownish pigmentation on the face, especially forehead, cheek and upper lip. It is more common on darker skin types. It is especially common in women aged 30 and over, in pregnant women, and in those taking the oral contraceptive pill or hormone replacement therapy.
Sun exposure following some cosmetics can cause a phototoxic reaction where the chemical substance absorbs UV light. The resulting pigmentation extends where sun and cosmetic use have coincided, for example down the neck.
Melasma is more stubborn and unpredictable to treat than freckles or age spots because the melanocytes have become sensitized and continue to produce extra pigment with even the slightest hint of sun. Sun protection is an essential part of treatment.
Hormonal changes can aggravate melasma, so after discussion with your GP, you may consider switching your form of contraception.
Our skin therapists will assess your skin and advise on the best medical grade skincare suited to your skin type. These topical creams include a quality SPF, vitamin A, vitamin B, vitamin C and a lightening cream. These all play a different role in helping to reduce pigmentation. They will also prescribe a series of medifacials or chemical peels, which are a gentle way to reduce pigmentation.
Laser therapy is best avoided for melasma as it will often provide an initial improvement followed by a recurrence.
Seborrhoeic keratosis is often referred to as a senile wart. These benign skin growths can appear anywhere on the body but are most common on the trunk and in areas where there is skin friction such as under the breasts and in the armpits.
Seborrhoeic keratosis is easy to treat as although they are generally raised above the skin surface they do not penetrate deep into the skin. At Palm Clinic we use a procedure called Surgitron which uses radiofrequency to shave the growth off the skin leaving a grazed area which typically heals without a scar.
View our gallery of before and after treatment images.
There is a genetic predisposition to melasma but triggers may include:
Melasma usually affects women; only 1 in 20 affected are male. It generally starts from the age of 30. Melasma is more common in people that tan easily or have naturally darker skin.
Melasma affects the forehead, cheeks and upper lips resulting in macules (freckle like spots) and may then spread causing larger more confluent patches. Occasionally it spreads to involve the sides of the neck and a similar condition may affect the shoulders and upper arms. Melasma can affect either the superficial skin surface or the deeper layer of the skin (dermis) or both.
We recommend an initial consultation with one of the clinicians at Palm Clinic who will diagnose your condition and exclude the possibility of a skin cancer or suspicious mole within the area to be treated. We will try and determine the cause although this is often not possible. Once exacerbating factors are eliminated we will recommend complete sun avoidance, home products, vitamin A peels and possibly Dermapen.
Melasma is an extremely difficult condition to treat and we cannot guarantee a specific outcome. We have many patients with excellent results but there have been a few in which the melasma has worsened after treatment due to post inflammatory hyperpigmentation (PIH). If this occurs the PIH typically resolves over a few months.
IPL (intense pulsed light) treatments are rarely recommended. In our experience over many years, IPL will often worsen melasma due to the melonocytes being irritated by the scattered light from IPL.
Botox® is a prescription medicine for the treatment of frown lines, horizontal forehead lines and crow’s feet round the eyes. Botox® has risks and benefits. Ask your doctor if Botox® is right for you. If you have side effects, see your doctor. You will need to pay for Botox® and clinic fees will apply. For details on precautions & side effects consult your healthcare professional or the Consumer Medicine Information (CMI) at www.medsafe.govt.nz. Botox® treatment lasts about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals.(Contains botulinum toxin A 50,100 & 200 units). Allergan (NZ) Limited, Auckland.
Juvederm Ultra™ & Juvederm Ultra Plus™ are medical devices Class III for the filling of medium size and deep facial wrinkles by injection into the skin and for creating definition and volume in the lips. Contains 24mg/mL. cross-linked hyaluronic acid. Juvederm has risks and benefits. Cautions: Use in an area that has been treated with another dermal filler, people with autoimmune disease, or who are pregnant, breastfeeding, under 18 years of age or have an increased susceptibility to keloid formation and hypertrophic scarring. People on blood thinning medicines. Possible side effects: injection site inflammatory reactions (redness/swelling, itching/pain on pressure) induration or nodules; discolouration; weak filling effect. If you have side effects or concerns speak to your doctor. Product and treatment costs will apply. Note: Juvederm treatment lasts about 12-24 months. For product information check with your doctor or product information at Allergan (NZ) Limited, Auckland.
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Please note that individual results may vary from patient to patient, and the information provided on our website is only a guidance to the possible results.