What Is Pigmentation - Video

Maureen, what is pigmentation? Pigmentation is one of the most common skin conditions patients come in for, and it's a very important problem because you have to distinguish between the different kinds of pigmentation. So, when patients come in, if they are older than 40, then you could be getting age spots or wisdom spots, as we call them, you know, which are from chronic sun damage, UV, UVA exposure, where that part of the skin gets lab refusions, and they actually start increasing lateral different spots on the face, but very often in the body. Of course, people with extensive sun damage and tanning get these dark spots, and they can also get the lab spots, which are also due to sun damage. So, we have to distinguish to see which is which, and I tell my doctors that if a patient comes in over 40, then you can look to see whether it's hormonal pigmentation or whether it's pigmentation, you know, like sun spots, because there's a big difference in how you treat that. And you know, lots of these patients go to clinics where they think that pigmentation is pigmentation, and they don't understand the underlying causes of pigmentation. So, they usually start with the IPLs, which can treat pigmentation, but we find that with hormonal pigmentation, you cannot keep hammering with the IPL because then you get something called rebound pigmentation because the IPL, too many IPL treatments, can cause inflammation in the skin, and then once you get the inflammation, you start getting post-inflammatory pigmentation, and you can make your melasma worse. So that is the kind of melasma that's very difficult to treat. I'd say it's one of our most difficult, you know, skin conditions to treat because you have to know what's happening with melasma, which we'll discuss later, and then you get the age spots, and then you also get the post-inflammatory pigmentation, which can happen in anybody, but you'll find that our people of colour actually have it much worse because they have got increased melasma activity, which means they make more pigment. As soon as they get trauma to the skin, if you cut your skin or if you get some kind of skin condition like acne, dermatitis, eczema, you will find that you will start developing post-inflammatory pigmentation down the line, hyperpigmentation. So it's important to treat the causes, because it's pointless to treat only what you see on the skin. You have to make sure you're not getting more and more acne lesions, because that will perpetuate the cycle. So, that's why it's so important to differentiate between those three main causes of pigmentation.