Dark spots on the skin, such as preventing and treating

To the 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 several types of stains and it is essential to differentiate them before starting treatment to eliminate them. Most stains are melanic origin, that is, they are caused by a 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 Lentigines

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)

These are small, flat spots that appear on fair-skinned people after sun exposure. They are caused by genetic predisposition and sun exposure.

3. Melasma

These are dark, irregular and symmetrical spots that appear on the face, especially on the forehead, cheeks and upper lip. They are caused by sun exposure, genetic predisposition and hormones (pregnancy, contraceptives).

It is the most difficult type of stain to treat due to its multiple causes and “chronic” nature, with a tendency 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 the 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.

THE solar radiation is the main cause of the appearance of spots, since melanocytes, the cells specialized in the production of melanin (brown pigment responsible for skin color) produce this protein that has the function of protecting DNA against damage caused by sunlight, which is why its quantity increases with sun exposure, resulting in a tan.

Melanin is produced by the action of the enzyme tyrosinase, which is why 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 quantity produced depend on genetic factors, which explains the different skin colors.

There are disorders that can affect melanocytes, causing diseases such as melasma, vitiligo, and melanoma. Therefore, it is essential to have a medical diagnosis to identify the stain and decide on the type of treatment, since only melanin stains can be treated with depigmentation methods.

They exist 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, due 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 skin pigmentation abnormalities, 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 when exposed to the sun and can cause melasma. This can occur 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 lead to hyperpigmentation.

HOW TO PREVENT THE APPEARANCE OF SPOTS?

Prevention is the most important step to avoid the appearance of spots, 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 a high or very high SPF (at least SPF30) every day, even if it is cloudy. Reapply frequently.

There are numerous options for reapplying sunscreen, such as powders, sticks and compacts with SPF that can be easily applied anywhere, even over makeup.

2.Apply a vitamin C serum or cream, ferulic acid, vitamin E or other antioxidants before sunscreen to help prevent oxidative damage and dark spots and enhance its protective effect.

3.Wear Sun Protective 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 sun hours (usually between 10 am and 4 pm). Stay 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 make blemishes worse. Use gentle exfoliants in moderation.

7. Avoid tanning beds and photoepilation: tanning beds and the heat from photoepilation can worsen existing blemishes.

8. Moisturize your skin: Keeping your skin moisturized helps prevent flaking, irritation and blemishes.

9. Consult a Dermatologist: If you have spots or are predisposed to having them, consult a dermatologist and follow their instructions strictly.

WHAT CAN I DO TO ELIMINATE OR IMPROVE THE APPEARANCE OF STAINS?

Multiple assets can be used depigmenting agents and lighteners 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 long-lasting results.

As the pigment is already present 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 on each other, since many of them are not very effective when used individually.

The active ingredients used in stains belong to several families:

  • Chemical Exfoliants: They help remove cells from the surface of the skin and accelerate cell turnover to eliminate pigment more quickly. They are usually used at night. Examples include alpha hydroxy acids (glycolic, malic and lactic acid), polyhydroxy acids, retinol and retinoids, and salicylic acid.
  • Melanin Production Inhibitors: prevent or reduce the production of melanin. They normally act by inhibiting tyrosinase. Examples include resorcinol, thiamidol, tranexamic acid, arbutin, and kojic acid.
  • Others: There are also other active ingredients with different mechanisms, such as preventing the “spreading” of pigment or anti-inflammatory action, as is the case with 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 medication 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 inhibit melanin production and increase the effectiveness of sunscreen, in addition to 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

It 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 effect.

10.Tranexamic Acid

Inhibits skin inflammation and reduces melanin production, particularly useful for post-inflammatory dark spots.

11.Azelaic Acid

It works by inhibiting tyrosinase and reducing inflammation, being useful in the treatment of blemishes caused by acne.

Choosing the right cosmetic for dark spots depends on several factors, such as the type of spot (melasma, lentigo), its location (face, groin, armpits, hands) and skin type (more or less fair, more or less sensitive, dry, normal or oily). You can always consult a professional to help you choose the best solutions for your particular case.

You should also adopt simple routines to avoid, for example, the sunscreen from crumbling, which would leave the area unprotected.

Remember that more severe cases of blemishes may require more aggressive procedures such as chemical peels, microneedling or laser and should be performed by a dermatologist or 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 and even skin.

Consult a healthcare professional for the most personalized care and to maintain radiant, bright and even skin, WITHOUT SPOTS!

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