Post-traumatic facial pigmentation

Pigmentation unbalances, interferes with life, spoils the image and appearance. To remove age spots, it takes not a couple of weeks, but a couple of months, or even one or two years.

The main pigment of the skin is considered melanin, it is located in the epidermis and colors the skin a certain color. Color depends on the concentration and distribution of melanin. Epidermal cells are responsible for the synthesis of melanin - melanocytes. Moreover, in the skin of people of the white race and the black race, the number of melanocytes is the same, only the number and distribution of pigments changes.

Dermatologists identify a huge number of pigmentation disorders - they are called melanoses. Melanoses can be either hyper- (increased pigmentation) or hypo- (decreased).

In the practice of a cosmetologist, melanin pigment spots are most often encountered. They can be of different shades: from light to dark brown. In order to choose the right tactics for eliminating age spots, you need to determine the causes of their occurrence as accurately as possible.

Causes of pigmentation

1. Genetic (people of the first phototype, according to the classification of the American dermatologist Fitzpatrick, have hereditarily white skin with many freckles all over the face and body; exposure to ultraviolet radiation does not lead to tanning, but causes sunburn and an increase in the number of freckles). The genetic factor is the cause of the so-called primary hypermelanosis. These also include pigmented nevi (moles).
2. Ultraviolet irradiation (the sun's rays can give us not only a beautiful tan, but also multiple pigment spots on the face and body; this can happen if the rules of “communication” with the sun are violated - if you sunbathe in direct sunlight, even sunscreen will not help). Solar radiation leads not only to the activation of melanocytes, but also to the appearance of atypical (unhealthy) cells, which is more dangerous than any age spots.
3. Hormonal changes in the body, namely, pregnancy, menopause, disturbances in the functioning of the endocrine system - ovaries, adrenal glands, thyroid gland, taking hormonal contraceptives, a number of medications and dubious cosmetics. All this can contribute to the appearance of pigmentation.
4. Age – with age, the skin becomes more and more susceptible to external irritants and the sun, which provokes the appearance of foci of hyperpigmentation, which are called “senile lentigo.”
5. Skin damage and diseases (post-traumatic, post-inflammatory, post-infectious hyper- or hypopigmentation occurs).
6. Diseases of the liver, kidneys and other organs (for example, diseases of the biliary tract, thyroid gland, as well as mental disorders) can cause the formation of age spots on the skin.
7. Procedures that are accompanied by skin trauma - injection procedures, facial cleansing for acne, injection of fillers, plastic surgery, use of cauterizing agents, creams and ointments with a strong irritating effect.
8. Procedures that cause skin irritation - all types of hair removal, cosmetics that cause an allergic reaction or have a toxic effect on cells, contact with the skin of various substances - gunpowder, coal, graphite.
9. Procedures that cause thinning of the upper (stratum corneum) layer of skin — chemical peels, laser resurfacing, dermabrasion.
10. Vitamin C deficiency.
11. Work in chemical production or in areas with high temperatures.

Considering all of the above factors, to eliminate age spots, you may need the help of not only a dermatocosmetologist, but also a gynecologist-endocrinologist and gastroenterologist. These specialists will help eliminate “internal” problems with the body, and the cosmetologist will deal with external treatment.

To date, the best developed tactics for the management and correction of patients with Caucasian skin. Patients with Negroid and Mongoloid skin require a special approach to the problem and treatment tactics. But in both cases, the problem of pigmentation should be dealt with by professionals.

Sun protection

To prevent the development and formation of hyperpigmentation in people of any age and skin type, it is necessary to use sunscreen and avoid direct sunlight, especially during maximum solar activity - from 11 a.m. to 4 p.m. UVA rays should be avoided before and after peelings, laser hair removal, and plastic surgery; while taking hormonal contraceptives, antibacterial and other medications, as well as during pregnancy.

The skin's tendency to hyperpigmentation is increased by certain substances and cosmetics that increase the skin's sensitivity to UVR (ultraviolet radiation) - photosensitizers (substances that become an allergen under the influence of UV radiation). Before starting active sunny days and a course of procedures to remove age spots, you must consult with a specialist about all cosmetics and medications that you use in order to avoid complications.

Sunscreens are cosmetic products that contain substances that absorb or reflect UV radiation. The SPF value shows how much the biodose of protected skin exceeds the biodose of unprotected skin. This indicator only indicates the effectiveness of protection against UV radiation. The SPF indicator is relative. For people with different skin phototypes, it makes it possible to stay in the sun for a certain time, which is subtracted according to the formula, without harm to health.

If your skin is prone to the formation of freckles, then it is necessary to carefully protect your skin from ultraviolet radiation, because freckles cannot be eliminated once and for all; their appearance is due to the genetic characteristics of melanogenesis. And sun protection (applying creams with UV filters, wide-brimmed hats) is one of the effective methods of combating the appearance of freckles.

Pigmentation during pregnancy

If pigment spots appeared during pregnancy, then you should not correct them yourself at the moment, since at this time a certain hormonal background is maintained in the body and has its own characteristics. Pigment spots should be removed only after childbirth. And it is also very important to remember that pigmentation often goes away on its own after pregnancy. Therefore, you should not rush and, especially, self-medicate.

Fight against pigmentation

All procedures in the fight against pigmentation can be divided into 2 groups:

1. Procedures aimed at skin renewal (exfoliating) – these are chemical peels, resurfacing, ultrasonic peeling.
2. Chemical peels. To remove age spots, peelings based on AHA acids (glycolic, mandelic, lactic acid), salicylic or trichloroacetic (TCA) acid, and retinoids are suitable. Different depths of impact and penetration allow for a variety of courses of procedures with different rehabilitation periods. In this case, specialists always focus on the individual characteristics of the patient. Superficial peelings are carried out in sets of 6-10 times, once every 7-10 days. Medium peeling is a course of 2-3 procedures, once every 1-1.5 months. Recommendations from a specialist are required before, during and after the course of procedures.
3. Microdermabrasion – a procedure for removing age spots by mechanical exfoliation using a stream of crystals or microcrystals. Thanks to this manipulation, the surface layer of the skin is delicately removed and at the same time the renewal of its deep layers, as well as the dermis (middle layer of the skin), is stimulated. Microdermabrasion uses microcrystals of aluminum oxide, which mechanically grind or remove the top layer of skin under pressure. Microdermabrasion is used to remove age spots on aging skin prone to hyperkeratosis. The technique is also effective for post-inflammatory pigmentation after acne, where, as a rule, there is an altered skin texture.
4. Laser skin resurfacing* – a procedure for removing age spots by destroying epidermal cells with excess pigments due to their heating. When hyperpigmentation is combined with signs of photo- and chronoaging, laser resurfacing of the facial skin (CO2 laser, erbium laser) with or without ablation is used. As practice shows, the best clinical results are observed after using fractional erbium (1550 nm) laser and CO2 (10,600 nm), using low energy and high coating density.
   In modern medicine, the method of fractional photothermolysis has gained wide popularity, in which laser radiation is supplied to tissue by fractionating (distributing) into hundreds of microbeams that penetrate to a fairly large depth (up to 2000 microns). This effect allows you to reduce the energy load on tissue, which in turn promotes rapid regeneration and avoids complications.
5. Phototherapy* – removal of age spots by stimulating the production of collagen and elastin.
6. ELOS therapy* - a combination of exposure to light energy and electric current. By combining IPL and RF radiation, it is possible to achieve selective coagulation of dilated superficial vessels, removal of epidermal hyperpigmentation with minimal risk of damage to surrounding tissues. In this case, the thermal effect develops at a depth of up to 4 mm. Improvements in skin texture and lifting are achieved through additional synthesis of collagen fibers caused by exposure to radio waves. This effect is cumulative (cumulative) in nature and increases from procedure to procedure. The achieved result should be consolidated with supporting courses of procedures.
7. Ozone therapy* – a procedure for removing age spots (post-traumatic or inflammatory pigmentation), which has an anti-inflammatory and resolving effect on the spots.

* All of the above procedures can be carried out in a course of 2 to 5 procedures, depending on the severity of the pigment spot, with an interval of once every month or two. The course and its duration, time intervals are varied by the doctor.

Prevention of pigmentation

It is almost impossible to prevent the appearance of secondary hyperpigmentation (those caused by metabolic disorders or diseases of internal organs). At the same time, you can significantly reduce the likelihood of relapses after treatment if:

1. strictly follow all doctor’s recommendations (when preparing the skin for the procedure and after it), use preparations with UV filters during the procedure and for another month after the procedure;
2. avoid tanning in direct sunlight and in a solarium (especially during a course of procedures);
3. protect exposed areas of the body with reflective powder;
4. cover sun-sensitive skin with wardrobe items (thin capes over the shoulders, sunglasses, brimmed hats, etc.);
5. when taking medications, it is advisable to first consult with a doctor to see if they increase skin sensitivity to the sun;
6. do not use St. John's wort extract (it is a photosensitizer), do not get carried away with herbs containing a significant amount of psoralens (celery, dill), do not use photosensitizing essential oils (bergamot oil, all citrus oils) before going outside.

Currently, the development of technology and aesthetic medicine makes it possible to competently and comprehensively approach the removal of age spots and completely eliminate them. However, you should not fight stains on your own; such self-medication can worsen the problem. To get rid of age spots forever, consult a doctor (dermatologist, cosmetologist) who will develop an individual treatment regimen and plan for you, and be patient - the fight against pigmentation takes time.

It’s a shame when, after the procedure for treating age spots, another misfortune appears on the face - post-traumatic pigmentation, which, unfortunately, is very difficult to get rid of. What type of pigmentation is this, why does it occur and are there any recipes to eliminate it?

Post-traumatic pigmentation. What is it and why does it happen?

The occurrence of such pigmentation is the body’s reaction to certain procedures or complications after acne, as a result of which the skin is injured, the stratum corneum of the epidermis becomes thinner, and various skin irritations appear. Cosmetologists know that getting rid of this type of pigmentation is much more difficult than the one for which this or that procedure was performed. This is due to the fact that the melanin cell, in response to stress, becomes more active and moves to the injury area, where it begins to produce coloring pigment in large quantities. And, as a result, a new pigment spot forms in that place.

The occurrence of post-traumatic pigmentation can result from:

1. any types of peeling using various acids;
2. dermabrasion;
3. skin resurfacing using laser;
4. mesotherapy, which is carried out using subcutaneous injections;
5. procedures using Botox;
6. cleansing the skin for acne;
7. plastic surgeries of all types;
8. epilation;
9. introduction of implants;
10. cosmetics that cause allergic reactions or have a toxic effect on skin cells;
11. substances that can increase the sensitivity of the skin to ultraviolet radiation - photosensitizers.

Preventive measures for post-traumatic pigmentation

To minimize the risk of developing this type of skin pigmentation, you should adhere to the following recommendations:

1. before carrying out any of the procedures that injure the skin, it is necessary to prepare for this: take antioxidant complexes, use ultraviolet filters and substances that suppress the synthesis of the coloring pigment melanin;

1. after the procedure, be sure to use broad-spectrum protective equipment for the period prescribed by the doctor and under no circumstances sunbathe, this is excluded;

1. of the proposed procedures, the least traumatic one should be chosen;

1. before starting the procedure, it is necessary to notify the doctor about the medications that are being taken, because among them there may be those that increase the skin’s sensitivity to sunlight;

1. refuse to take: St. John's wort extract, dill, celery due to the fact that they contain a high content of psoralens;

1. Before going outside, do not use essential photosensitizing oils, because post-traumatic pigmentation reacts very sensitively to such components;

1. After completing procedures that lead to a decrease in the thickness of the skin layer, be sure to use drugs that help restore the skin.

How to remove post-traumatic pigmentation

It happens that pigmentation in the local area of ​​the inflammatory process goes away on its own, although this happens extremely rarely. Knowing that post-traumatic pigmentation is caused by the excessive sensitivity of melanocytes to stress, it is necessary to use treatment methods that can eliminate repeated manifestations of stress. There are such options and they include:

1. alpha hydro acids;
2. derivatives derived from ascorbic acid;
3. retinoids;
4. preparations made from bearberry and other herbs;
5. ozone therapy;
6. various anti-inflammatory, immune-modulating agents and antioxidants.

Summary

And remember that if you are afraid of wolves, then you should not go into the forest. Procedures exist, which means someone needs it. And what may appear after them post-traumatic pigmentation, this doesn't happen often. If you believe in good things, then so it will be.

Dermatologist-cosmetologist Gintovt Elizaveta Alekseevna:

Occurs after prolonged inflammation as a result of injuries, plastic surgery (if the surgeon’s recommendations are not followed), laser resurfacing, acne, or due to a reaction to cosmetics.

For some, every injury leads to pigmentation - all it takes is a cut and a dark spot will remain. This tendency often manifests itself with age, when vascular regulation is disrupted. Also, patients with dark hair and dark skin are more prone to developing congestion spots.

Melasma can be triggered by UV radiation, pregnancy, menopause, taking hormonal and photosensitizing drugs, hereditary factors, and some gastrointestinal diseases.

— epidermal, clearer and darker: when it begins to get dark, the spots clearly appear even under a good layer of cosmetics;

- dermal pigmentation is lighter, but it lies in a deeper layer of the skin;

- mixed pigmentation is formed due to the accumulation of pigment cells in the dermal and epidermal layers.

Precautions against pigmentation:

1. Use sunscreen. Guaranteed protection is only a completely UV-blocking cream with zinc, factor 100. There are no guarantees when applying sunscreen with factor 50. People prone to pigmentation should use sunscreens from the beginning of March. Even in Moscow there is already a danger during this period, so in the spring we do not carry out photosensitizing procedures (laser resurfacing, etc.).

Some patients complain that in sunny times they do not take off their hat and only tan their bodies, but the pigment appears. Yes, this is possible, since melagenesis starts in the body as a whole.

2. Do not abuse the solarium. Covering your face and sunbathing only with your body will not protect you from pigmentation, since melanin production is a general process.

3. Do not sunbathe when using drugs that provoke photosensitivity. A group of tetracycline antibiotics increases photosensitivity. Hormonal drugs and oral contraceptives often act as photosensitizers. Therefore, you need to carefully study the instructions: as a rule, similar properties are indicated. If you take such drugs and then go to a sunny country or sunbathe even in the middle zone, pigmentation will appear if there is a tendency, and if pigmentation already existed, then it will intensify several times. You also need to be careful with aggressive cosmetics: peelings, retinol-based products.

Remedies to combat pigmentation at home

To combat pigmentation, retinoids, preparations based on azelaic acid (for example, Skinoren), professional creams with glycolic acids (for example, creams from SkinCeuticals, Dermaceuticals) are used. These drugs help with any type of pigmentation with proper and long-term use.

Hydroquinone is currently not approved for sale because it is very toxic, although it is effective even in the fight against dermal melasma.

Anti-pigmentation products from a cosmetologist

For post-inflammatory pigmentation you need to choose a course of procedures so as not to get new post-inflammatory pigmentation: already because of attempts to get rid of it. Sometimes it is necessary to first carry out mesotherapy, plasma therapy, improving the quality of the skin and relieving inflammation, and only then remove the pigment.

Dealing with post-traumatic pigmentation is difficult. Therefore, if you notice that redness persists for a long time after an injury, go to a cosmetologist.

With dermal pigmentation You may need a course of procedures that will have to be repeated next year, or maybe within 2-3 years.

Different lasers may be needed to combat different age spots. Only the doctor can make the choice. You can use V-Beam when the pigment spot is also based on a vascular component. Sometimes we use a CO2 laser, sometimes a thulium laser. I like the Fraxel thulium laser - it is non-aggressive and effective.

Epidermal spots go away quite quickly, sometimes one Fraxel procedure (using a thulium laser) is enough. Dermal melasma is more difficult to deal with: we can make the spot paler, but in spring and summer the pigment may return and the course of procedures will have to be repeated.

Phototherapy can also be used, but, unfortunately, the effectiveness of this technique is much lower than that of laser.

Peels based on retinol and glycolic acids are also used. At the same time, biorevitalization will be useful for strengthening and moisturizing the skin.

This is not a public offer! There are contraindications. Before use, consultation with a specialist is required.