Ironically, I started getting pigmentation a few years when I started taking pills to help treat my acne, and sadly, no cream or amount of sunscreen has helped with the brown patchiness. As if recurring acne in my 30s wasn’t enough for my skin, I had to face up to pigmentation, and the fact that I was I was never comfortable without makeup, and even when I had on enough base to coat my face and cover up, I mostly always felt self-conscious and “naked”.
So what can one really do about pigmentation? Well, according to some dermatologists, there’s not just one pill or cream that can fix it. This is because many times it lies deep in the skin (sob, like mine), or superficially in the top layers of the skin. And there’s not just one type, according to Dr Natasha Chapman of Laserderm.
“Sun spots (solar lentigines) tend to lie nearer the surface of your skin and are caused by previous sun damage, most likely from time spent in the sun as a child. It has been estimated that 90% of long term sun damage occurs before the age of 7! With the passing years, this sun damage rises to the surface as presents as sun spots which certainly age us. In darker skins, it appears as irregular dark patches.
Hormonal pigmentation lies much deeper and is caused by a darkening of your melanin-producing cells called melanocytes, under the influence of hormones. Estrogen is the main culprit, and for this reason we usually find hormonal pigmentation in women, although men are not completely immune. Hormonal pigmentation tends to worsen with the contraceptive pill and pregnancy and is exacerbated by sun and heat exposure. The usual distribution is symmetrically over the cheeks, upper lip, and forehead.
Post-inflammatory hyperpigmentation is a darkening of areas of the skin where inflammation has occurred. Typically this occurs in darker skins and may occur after a pimple, an ingrown hair, trauma to the skin, a reaction to a skin product, or a deep chemical peel, or due to repetitive friction on an area (such as elbows), knuckles of the fingers, and heels of the feet.
Exposure to the sun causes melanocytes to produce more melanin (dark pigment) as a protective measure. Regular sun exposure without the use of sun block and a hat, will lead to a gradual darkening of the skin, which results in a tan in light skins, and often a patchy, uneven appearance in darker skins. Over the long term, sun exposure also causes a breakdown of collagen, causing more fine lines and wrinkles to appear.”
According to Natasha, treatment of pigmentation involves a multi- level approach and differs according to the level where the pigmentation lies. For best results, a patient needs to do a combination of home and in-salon treatments, and should expect results over the course of a few weeks to months, rather than an instant fix.
One of these treatments is Fraxel laser, which I had heard about a few years ago as a “wonder” laser treatment, but which I’d avoided owing to the cost – it can cost from R2 000 for a treatment at Laserderm, depending on how much of your face you have lasered, and while one treatment might be enough, you could need up to five treatments over six months.
But, in the quest to have a forehead that doesn’t look dirty all the time (thanks, pigmentation), I decided to give it a try (and yes, I paid for it).
Fraxel is considered one of the best treatments in the world for removing pigmentation. It involves non-invasive minute laser beams penetrating the skin, to stimulate the production of younger, smoother and healthier-looking skin to replace damaged tissue. It’s said to be good for treating fine lines and wrinkles, surface scarring, pigmentation (including the hormonal type) and sun damage.
It takes around two hours, which involves one hour of sitting with anaesthetic cream on your face, about 15 minutes of the actual laser, and then sitting under a light to heal the skin. When I asked the doctor how sore the treatment is, she said “very very painful”. I’m glad I was warned, because it is really painful, and I would have hated to expect anything else. It went fairly quickly, and afterwards it was quite stinging – I felt like I either had extreme sunburn, or had been tattoo’ed all over my face.
Recovery time isn’t needed, and you can go back to work, though you might be a little red – it’s fine to cover up with make-up right after the treatment.
The next day I was hardly in pain, and as explained to me, my face felt dry like sandpaper. After a few days the old skin cells started coming off, and my skin felt smoother, and then felt like new’ish after a complimentary microdermabrasion facial at Laserderm, where all the dead skin cells were removed.
The verdict? I’m moderately happy. I know that I will need a few more treatments to see the full effects, but there’s always hope that one thing will be the one fix that I need forever.
Am I feeling a bit more confident without makeup? Absolutely. Am I prepared to go to work without foundation? Not a chance.
While I do have some forehead patchiness, and some acne scar patchiness on my chin still, I feel a bit “fresher”, and “cleaner looking”. The dark patches on the sides of my eyebrows and eyes have disappeared, which is brilliant. My bf, who can’t really describe why my skin is better, says it’s “more even”, which I actually think is spot on. It’s way less patchy.
I’ve been prescribed Eucerin Even Brighter Day Cream and Even Brighter Night Cream, so perhaps that will add to the clearing-up process.
Another thing I will do, since pigmentation often comes back, and is often caused by sun, is re-apply sunscreen throughout the day, especially when I’m running.
To sum up, Fraxel really was the light fantastic, even though I suspect I’ll need more to really get the full benefits.