Hyperpigmentation

Sun exposure causes complex chemical changes in the skin, and these chemical changes are responsible for the various forms of damage that are externally visible as hyperpigmentation. Damage to melanocytes, or pigment cells that produce melanin and give our skin color, causes cells to be distributed skin unevenly to the surface of the skin and this produces the various forms of discoloration. For this reason, we stress the importance of sun block. Individuals who are prone to developing pigmented areas of the skin must be absolutely consistent in their use of sun block for even the most casual exposure. Unless they are consistent in this regard, even the most advanced therapies will prove to be ineffective. Birth control pills and many other medications can also play a role in the promotion of hyperpigmentation. However, it is sun exposure that provides the trigger resulting in skin discoloration.

There are three important points to look for in selecting a good sunblock: 1) It should provide “broad spectrum” coverage, i.e., it should be both UVA and UVB protective. 2) It should have an SPF of 15-30, anything greater than 30 typically has more chemicals and may cause skin irritation, and a higher SPF does not provide significantly greater coverage. 3) It should be highly water resistant or waterproof; this is more likely to provide longer lasting protection. Recent FDA recommendations have resulted in changes to the sun protection industry.  Products with an SPF over 50 are no longer available.  In addition, they have recommended the term “waterproof” no longer be used on product labels, only “water resistant” or “highly water resistant”, if applicable. Finally, they have recommended the term “sunblock” no longer be used, rather, “sunscreen”.  The problem with the latter recommendation is that some sun protection products are actual physical “sunblocks”, i.e., they contain zinc oxide, micro-ionized zinc oxide and/or titanium dioxide…these ingredients physically act to block the suns rays and work immediately when applied to the skin.  In distinction, “sunscreens” contain chemicals which produce a reaction in the pigment cells of the skin to prevent sun damage, and as such, these products must be applied at least 20 to 30 minutes before sun exposure.  Dr. Rasmussen offers two uniquely “cosmetically elegant” sun blocks that not only provide broad spectrum coverage, but are also highly water resistant.

Topicals referred to as “bleaching agents” don’t really “bleach” the skin…they make dormant the pigment cells. These products take approximately one month before effects are visible, and if the products are stopped, the effects are generally reversed. Bleaching agent preparations can be extremely beneficial in “lightening” pigmented areas of the skin. The use of these topicals are extremely compatible with a glycolic acid skin care program. The effectiveness of bleaching agents is partly dependent on their ability to penetrate. Glycolic acid skin care products appears to aid in the penetration of bleaching agents, probably due to the action of glycolic acid in enhancing the exfoliation rate of the dry thickened top layer of skin (stratum corneum). Much of the color change we perceive is located in the stratum corneum: when topical bleaching agents and glycolic acid are used regularly and consistently, the pigmentation will gradually diminish and the dry aged thickened skin will significantly improve. Other treatments which enhance the exfoliation rate such as micropeels, microdermabrasion, or deeper treatments such as the VI Peel™ and FRAXEL™ may be recommended for better results.

Remember, in addition to topical bleaching agents, glycolic acid skin care products, and adjunct treatments, individuals must use a full broad spectrum sun block daily in order to prevent a recurrence of this condition!

Hydroquinone is a well known topical bleaching agent and is available in prescription strength by Dr. Rasmussen. HYDRO-Q™  skin bleaching gel is 4% hydroquinone in a cosmetically elegant water-based gel formulation to help lighten hyperpigmentation and skin discoloration. As opposed to many other hydroquinone products that oxidize, turn brown, and tend to smell (and that Dr. Rasmussen has not found to be consistently effective), HYDRO-Q™’s unique water based gel is greaseless, applies on the skin easily, and allows the medication to penetrate the skin readily without irritation to prevent further discoloration.

Dr. Rasmussen also offers non-prescription strength skin care products which include a blend of natural lightening ingredients, including glycolic acid, retinol, and extracts from licorice root, mulberry fruit, grape, fennel seed, olive leaf, and tomato – ingredients that when used together, are helpful in diminishing hyperpigmentation and uneven skin tones.  In addition, Dr. Rasmussen offers two uniquely “cosmetically elegant” sun blocks that not only provide broad spectrum coverage, but are also highly water resistant.