Hypopigmentation

Hypopigmentation

What it is?

Hypopigmentation is the loss of skin colouring, it appears as pale white, pinkish blotches on the skin and can be known as skin depigmentation. Individuals with darker skin tones are more suseptible to suffer noticible affects of hyperpigmentation.

Hypopigmentation occurs when there is an imbalance of melanin in the body. Melanin is the chemical that gives skin its colouring.  

Symptoms

One or areas of skin are  white or lighter. The lighter patches can be any shape and size. The shape and size of the lighter skin patch depends upon what caused  the hypopigmentation. 

Causes

  • Hypopigmentation is most commonly caused by an injury to the skin such as burns or mistreaments.
  • Hyperpigmentation can also be caused by disorders such as albinism (colourless hair, skin and eyes due to skin cells that produce very little or no melanin), seborrheic dermatitis (an inflammatory skin disease in which the skin is covered with itchy, red, scaly patches where the skin tends to be oily), Vitiligo (patchy loss of skin colour due to melanin skin cells dying or stopping production due to an unknown causes), pityriasis alba (colourless, patchy skin that effects mainly children), and tinea versicolor (yeast infections with scaly, itchy patches of skin that is light or pink in color). 

Treatment

There are a variety of treatments for hypopigmentation. There are many topical creams that can be prescribed. These may include Hydroquinone or TriLuma. These will bleach the skin so the hypopigmentation is easily blended into the skin. If hypopigmentation effects over half the body, depigmentation of the entire body could be used effectively.

Some hypopigmentation is unresponsive to medications, so camouflaging the area with permanent makeup could be an option. Treatments that have been used by skin specialist successfully to treat hypopigmentation include IPL (intense pulsed light) and the Fraxel laser.

Microdermabrasion or chemical peels will treat hypopigmentation. Just look for a skin specialist that was trained properly to perform any procedure to reduce the risk of having a procedure administered improperly. At Advanced Dermatology medical clinic located in Sydney, we offer a range of treatments that can help with Hypopigmentation, for more information please contact us or call us directly on 1300 788 800.

– Hydroquinone
About Treatment
Hydroquinone is used to lighten the dark patches of skin (also called hyperpigmentation, melasma, “liver spots, “age spots” freckles) caused by pregnancy, birth control pills, hormone medicine, or injury to the skin.

This medicine works by blocking the process in the skin that leads to discoloration.

How to use Hydroquinone Skin Bleaching topical ?

  • Follow all directions on the product package, or use as directed by your doctor. Before using, apply a small amount of this medicine to an area of unbroken skin, and check the area within 24 hours for any serious side effects. If the test area is itching, red, puffy, or blistering, do not use this product and contact your doctor. If there is just mild redness, then treatment with this product may begin.
  • Apply this medication to the affected areas of skin, usually twice daily or as directed by your doctor. This medication is for use on the skin only. If it is used incorrectly, unwanted skin lightening may occur. Avoid getting this product in your eyes or on the inside of your nose or mouth. If you do get this medication in those areas, flush with plenty of water.
  • This medication may make the treated areas of skin more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use sunscreen and wear protective clothing on the treated areas of skin when outdoors.
  • Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. Inform your doctor if your condition persists or worsens after 2 months.

– TriLuma
About Treatment

  • Tri-Luma® is the only FDA-approved melasma treatment with 3 active ingredients, uniquely combined and more effective than treatments containing only two of the ingredients. 
  • Tri-Luma® Cream is a unique triple-combination topical therapy for the short-term (8-week ) treatment of the dark spots associated with moderate-to-severe facial melasma.
  1. Fluocinolone acetonide 0.01% is a mild corticosteroid that reduces inflammation.
  2. Hydroquinone 4% is a depigmenting agent that interrupts the formation and synthesis of melanin to help lighten the skin.
  3. Tretinoin 0.05% works by increasing the skin cell turnover rate, which helps exfoliate the skin.
  • Tri-Luma® Cream should always be used in conjunction with sun-avoidance measures, like using sunscreens and wearing protective clothing. Tri-Luma® may improve the appearance of melasma but is not a cure.

– Permanent Makeup
About Treatment
Permanent makeup: A form of tattooing (also known as micropigmentation). Some choose permanent makeup as a time saver or because they have physical difficulty applying regular, temporary makeup. For others, tattooing is an adjunct to reconstructive surgery, particularly of the face or breast, to simulate natural pigmentation. People who have lost their eyebrows due to alopecia (a form of hair loss) may choose to have “eyebrows” tattooed on, while people with vitiligo (a lack of pigmentation in areas of the skin) may try tattooing to help camouflage the condition.

Intense pulse light (IPL)
Treatment used for
How does laser / IPL hair removal work?

  • The laser / light energy is selectively absorbed by the melanin in hair follicles and converted to heat, diffusing to and injuring stem cells in the bulb and bulge.
  • Effective hair reduction can only be achieved during the active growth phase, only 25 % of hairs are in this phase at a time. Hence multiple treatments are required.
  • Hair reduction is considered permanent when a significant amount of hair does not return for a period of time longer than the complete growth cycle.
  • After a series of treatments, 80-85% of hair should be removed. However, if hair does regrow it will be finer and lighter than before.

How many hair removal treatments will I need?
6-12 would be typical. Some areas don’t respond as well as others eg female facial hair

How far apart should treatments be?
6-7 weeks

Fraxel laser
About Treatment

Fraxel is the original fractional laser treatment that works below the skin’s surface from the top down, addressing imperfections like fine lines, visible photo aging, wrinkles, scarring and age spots. Fraxel light energy stimulates your skin’s natural collagen, rejuvenating skin cells below the surface to help smooth the creases and pockets that cause wrinkles and scars. Fraxel only treats targeted problem areas – so the results are focused and effective.

The Fraxel laser is a form of facial rejuvenation treatment using new age Fractional technology. The Fraxel laser is an aesthetic treatment laser device used to treat a variety of skin textural problems, ranging from sun damage to acne scars, fine lines around the mouth and eyes and even stretch marks and Fraxel Sydney has become a highly popular treatment. Whilst there are now many different forms of Fractional Laser Treatments and the technology has evolved a fair bit since the first Fraxel treatment was performed, the first version was created by Solta Medical – a company involved in the research and development of skin care and aesthetic laser devices utlising the core principle of selective photothermolysis. Selecting a Fraxel Sydney treatment: the options.

Anyone considering treatment with the Fraxel treatment is strongly advised to have a thorough conversation with their skin care professional, as advertising claims for these treatments can sometimes mislead people into believing that the results will compare to real face lift surgery, they will not. At a bare minimum, laser skin resurfacing is as invasive as a chemical peel; at its worst, a laser facial can have some side effects that include burning and blistering, albeit very rare. As you consider whether laser skin resurfacing is right for you, also keep in mind that this Solta Medical brand includes three devices:

  • Fraxel Repair: an aggressive treatment for wrinkles and scar damage;
  • Fraxel Refine: to reduce the appearance of fine lines and improve poor skin texture; and
  • Fraxel Restore: a non-ablative treatment for Melasma and sun spots on skin.

In order to treat a greater variety of conditions, Solta Medical developed several devices under the Fraxel brand, with each having unique treatment options. One of the most useful ways to look at these models is to understand what they were designed to do, and how much skin damage they cause in the process.

Fraxel Repair
Fraxel Repair is a powerful laser that delivers the most intense treatment by removing microscopic amounts of skin from various skin layers. The micro wounds closer to the surface are meant to remove cells with pigmentation issues, whilst the deeper wounds help stimulate collagen production and tighten skin over time. Solta Medical suggests that the results from Fraxel Repair take approximately three to six months to reach their full potential. Although, because this treatment is so intense, only one procedure may be needed to show improvement, especially in patients with mild skin problems.

Fraxel Restore
The Fraxel Restore technology focuses on treating sun damaged skin by stimulating collagen production in the dermis. The laser delivers powerful bursts of light to these layers but is considered a non-ablative laser, because it doesn’t completely destroy skin cells. This, however, may not be a viable solution for everyone because Fraxel Restore is not meant for deep wrinkles and sagging skin.

Unlike the Fraxel Repair procedure, the Restore treatment will need to be repeated at least three times to show significant results. It is simply not aggressive enough and is meant for patients who cannot take time off work to recover and properly care for their skin. Usually, the best results from Fraxel Restore will be visible within two to three months after treatment, and will likely need to be repeated every six to twelve months.

After undergoing the Fraxel Restore treatment, it is common to experience dry flaky skin on face, as the damaged skin layers begin to peel away. It is advisable to use copious amounts of sunscreen during this time to prevent further damage while the body’s natural UV radiation defenses are weak. This should be continued for at least three months after undergoing Fraxel Restore, which can be simplified by purchasing a facial moisturizer with sunscreen built in.

Fraxel Refine
The third device in the product line was designed as an upkeep option. The Fraxel Refine is most commonly used to create a smoother skin texture, get rid of fine under eye wrinkles, and remove brown spots on face. This treatment will need to be completed up to six times for best results, and the most significant improvements will not be visible for at least two months, as the dermis replenishes collagen fibres to tighten skin. Fraxel Refine is considered to be the least invasive of the three lasers, and delivers results slower than the aggressive Fraxel Repair treatment.

During the Fraxel Laser Treatment
If you choose to get a Fraxel laser treatment, set aside at least an hour to spend at your dermatologist’s office. First, your face will have to be cleansed, and treated with a topical numbing agent about an hour and a half before the procedure. The procedure itself should last about half an hour, depending on the skin area being treated.

The painfulness of the treatment often differs based on the person, but patients have reported discomfort, stinging and burning sensations during Fraxel laser treatments. Afterwards, you will need to follow special care instructions as your face heals for several days. In the case of Fraxel Repair, you may need to stay out of sunlight for the first day or two, as this is the most dangerous time for the skin to sustain damage.

How Laser Skin Resurfacing Works
At first, the details of how a laser works may seem confusing, but the concept behind the various Fraxel technologies is rather simple. Our skin cells contain quite a bit of water, which can quickly heat up by absorbing certain wavelengths of light. If you shine a focused light beam onto a skin cell, such as that of the Fraxel laser, the absorption of the light by the water causes the cells to either vaporise (this is called an ablative laser), or heat up just enough to cause cell damage and stimulate the body to replace it with healthy skin (the non-ablative laser). The ablative laser is the more intensive form of treatment, and causes damage not just by vaporising cells, but by dissipating excessive heat to surrounding tissue, exacerbating the side effects, and contributing to the need for significant after care.

If you wanted to really simplify it, you could think of getting a Fraxel laser treatment like taking a magnifying loupe and focusing the sunlight on a patch of skin. You would quickly feel the heat, and could easily burn yourself if you leave the focused beam on the skin for too long. Of course the Fraxel treatment is more complicated than that, and uses precise light wave lengths, but the basic idea is similar. Whatever you do, please don’t spend your next weekend in the back yard, pointing a magnifying glass at your face – nothing good will come of it.

Ablative vs. Non-Ablative Lasers
Whether you are considering Fraxel or some other laser treatment, the distinction behind the ablative and non-ablative options is an important one. The ablative devices, like CO2 laser models, cause significant amounts of damage to the skin. They are very intense and the early models removed entire layers of upper skin cells, creating large surface wounds that made recovery time a major drawback. Before Fraxel and other fractional laser technologies, the after care for ablative skin resurfacing could take several weeks, and even required patients to take time off work.

The aggressiveness of ablative laser treatments makes them more suitable for the treatment of surface skin problems like scars, pigmentation issues, low-to-medium wrinkles, and sunspot on skin. By removing the entire upper skin layer, these Fraxel predecessors significantly accelerated the natural skin rejuvenation process, and after several treatments were able to cycle all the damaged cells from the surface. The Fraxel Repair laser, for example, is an ablative approach, but uses fractional technology to somewhat reduce recovery time (discussed later).

Non-ablative laser treatments work mostly on the deeper layers of the skin, like the dermis, and deliver heat for the purposes of stimulating collagen growth, rather than completely vaporising damaged cells. Fraxel Restore and Fraxel Refine are considered to be non-ablative models, and because they cause less damage, they also require more follow up treatments.

The Fractional Approach
The various Fraxel devices are CO2 lasers, and use a series of reflective technologies to amplify the energy of the beam to the point where it can be used to treat skin. But what makes Fraxel different from earlier CO2 models the way in which light energy is delivered. With the idea of minimising skin damage, the laser beam is separated into shorter bursts, or “packets,” of energy that only damage some parts of the treatment area, leaving more tissue untouched. This pattern of micro damage dots directly helps remove old skin cells, and shortens healing time.

The other aspect of the Fraxel laser is its believed ability to stimulate collagen production. The device does so by sending some of the energy “packets” deeper into the skin, where the heat and coagulation of tissues can stimulate collagen rejuvenation in the dermis. Solta Medical built this ability into the Fraxel lasers to improve wrinkle treatment results, as the strengthened collagen fibres tighten skin from beneath, to complement the resurfacing effect in the epidermis.

Serious Side Effects of Fraxel Laser Resurfacing
Like any medical treatment, Fraxel laser resurfacing technologies carries a risk of side effects and it’s important that we inform our patients about this. In addition to the usual symptoms of redness and swelling, Fraxel Repair can cause oozing and crusting of the skin in rare circumstances. Whilst very unlikely, this can lead to permanent scarring if proper protocol adherence is not followed (like staying out of the sun). In some cases, the micro damage caused by the Fraxel Repair laser can lead to infection, which would likely require a course of antibiotics to address.

The Fraxel Restore laser also has a set of serious side effects, like blistering of the skin and the development of scars after treatment. In some cases, this laser can lead to herpes reactivation in people who are carriers of the disease. This would develop as a herpes breakout, with the accompanying blistering and need for topical antiviral medication. With the Fraxel Refine, the side effects are similar, with the development of acne, permanent scars, and infection all being potential dangers. For this reason extra diligence must be taken when choosing a Fraxel Sydney provider.

Treatment used for
Fraxel is effective on:

  • Fine lines and wrinkles – like crow’s feet and brow lines
  • Surface scarring – erasing effects of acne and other scarring
  • Pigmentation – minimizing the appearance of age spots
  • Sun damage – helping heal dangerous skin damage
  • Actinic Keratosis (AK) – a common pre-cancerous skin condition

Microdermabrasion
About Treatment

  • Microdermabrasion sounds vaguely painful, but it’s actually one of the gentlest, fastest, non-invasive anti-aging treatments around today.
  • Microdermabrasion is a non-surgical facial resurfacing technique performed in a series of about 6 to 10 treatments. It mechanically exfoliates the outermost layer of dead skin cells (the stratum corneum) and vacuums them away, leaving your skin feeling softer and smoother — and if done well, looking younger and more vibrant.
  • The way it works is that when you remove the stratum corneum, the body has a minor freakout, interpreting it as an injury. It quickly replaces the lost skin cells with new, healthy ones. 
  • Microdermabrasion machines are rather expensive contraptions that use either crystals or diamonds to abrade the skin.
  • Crystal microdermabrasion machines consists of a compressor that draws in air through a hand-held stainless steel or glass wand. When the wand touches the skin, a vacuum is created.
  • The most common crystals used are aluminium oxide crystals, also known as corundum. They are second only to diamonds in hardness but are a lot cheaper.
  • Some studies have suggested there may be health risks associated with aluminium oxide-based microdermabrasion machines, with fears the small particles could enter the lungs if breathed in, or scratch the eyes (most microdermabrasion clinics now use eye protection for this reason).
  • Other crystals used in microdermabrasion are sodium chloride, sodium bicarbonate (baking soda) and magnesium oxide.
  • Other commonly used microdermabrasion machines use a diamond-tipped hand piece that mechanically abrades the skin and a suction system to vacuum the exfoliated particles away. 
  • Microdermabrasion is non-invasive and recovery time is as little as one or two days.
  • Best of all, you can have it done during your lunch hour and go straight back to work looking pretty good for someone who has just had their skin cells vacuumed off their face (take your foundation along as your skin may be a little pink afterwards).

20 FACTS ABOUT MICRODERMABRASION TO WOW YOUR FRIENDS WITH
1. Microdermabrasion was first developed in Italy in 1985 — pasta, pizza and microdermabrasion — thanks guys!
2. There are over 100 microdermabrasion machines on the market but they all have the same basic design — exfoliate and suck up those dead skin cells!
3. Microdermabrasion has been shown to diminish fine lines, wrinkles, shallow acne scars, though results may vary from person to person.
4. Those who suffer from enlarged pores will be pleased to know microdermabrasion can help minimise pores and is great for unclogging them.
5. Microdermabrasion may decrease the appearance of superficial hyperpigmentation, age spots and other superficial skin damage caused by the sun.
6. Removing dead skin through microdermabrasion can aid in the penetration of skincare products by up to 50% and with a more even surface to work with, it allows makeup to go on more smoothly.
7. In 2009, the American Society of Plastic Surgeons reported there were 910,168 microdermabrasion procedures done in the US alone (176,541 of those men). It’s obviously big business, and not just in the States either.
8. Many people choose microdermabrasion over chemical peels and laser treatment because it is generally safer and more cost-effective.
9. The procedure may be a little uncomfortable but shouldn’t hurt (though skin can feel a little tender afterwards).
10. Microdermabrasion stimulates blood flow, which increases the nutrition delivered to skin cells. This improves cell production, which improves skin’s elasticity and texture.
11. Microdermabrasion temporarily removes moisture so it should always be followed by application of a rich moisturiser.
12. The best results are usually seen by people in the early stages of ageing, between 35 and 50.
13. It’s not recommended if you have skin conditions such as rosacea, eczema, dermatitis, active sunburn, herpes, lupus, open sores, psoriasis, fragile capillaries or widespread acne. Seek medical advice first.
14. While home dermabrasion kits are available, they act more like a scrub and can be quite harsh. Beware!
15. A series of 6–10 treatments is usually recommended for optimum results, with 2 weeks in between for skin to recover.
16. The entire procedure usually takes about 30 minutes for the face, longer if you want your neck and other body parts such as hands and feet done.
17. Skin will be more sensitive to sunlight afterwards so stay out of the sun or use a good sunscreen.
18. Your aesthetician should be checking in with you about your comfort level during the treatment. Don’t be afraid to speak up if you feel like your face feels like it’s being sucked into a black hole.
19. If an aesthetician uses an unskillful technique it can lead to abrasions and pin-point bleeding, which means the treatment was done too aggressively.
20.  Always go to a qualified aesthetician for microdermabrasion and ask them about their training, as the results you get will largely depend on their expertise.

Treatment used for
Patients with fine facial lines or wrinkles, age spots, sun damage, uneven pigmentation, clogged pores, skin texture problems, or minor scars are good candidates for microdermabrasion. Patients with rosacea or acne may also benefit from microdermabrasion treatments.

Procedure

  • Brighter, smoother, softer
  • Microdermabrasion treatments are used to improve the texture and quality of your skin.
  • This treatment is fantastic at tackling dull, dry or rough skin, treating acne and reducing superficial pigmentation and fine lines.
  • Microdermabrasion treatments are commonly used in combination with other treatments, including peels, wrinkle reduction and prevention and volume enhancement. It is perfect to polish and deeply exfoliate your skin, while also promoting lymphatic draining.
  • The small microdermabrasion hand piece is then passed over the face to loosen and remove the upper layer of dead skin cells.
  • Following treatment, your skin will be brighter, smoother and softer to touch. We recommend six sessions at fortnightly or monthly intervals for ultimate improvement.

– Chemical Peels
About Treatment
Chemical peels can improve the skin’s appearance. In this treatment, a chemical solution is applied to the skin, which makes it “blister” and eventually peel off. The new skin is usually smoother and less wrinkled than the old skin. Chemical peels can be done on the face, neck, or hands. They can be used to:

– Reduce fine lines under the eyes and around the mouth
– Treat wrinkles caused by sun damage and aging
– Improve the appearance of mild scars
– Treat certain types of acne
– Reduce age spots, freckles, and dark patches (melasma) due to pregnancy or taking birth control pills
– Improve the look and feel of skin
– Areas of sun damage may improve after chemical peeling.

After a chemical peel, skin is temporarily more sensitive to the sun, so wear sunscreen every day. It should say “broad-spectrum” on the label, meaning it protects against the sun’s UVA and UVB rays. Also, it should be a physical sunscreen and be above SPF 30. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m., and wear a wide-brimmed hat.

Treatment used for
Who Is a Good Candidate For a Chemical Peel?

Generally, fair-skinned and light-haired patients are better candidates for chemical peels. If you have darker skin, you may also have good results, depending upon the type of problem being treated. But you also may be more likely to have an uneven skin tone after the procedure.

Skin sags, bulges, and more severe wrinkles do not respond well to chemical peels. They may need other kinds of cosmetic surgical procedures, such as laser resurfacing, a facelift, brow lift, eyelid lift, or soft tissue filler (collagen or fat). A dermatologic surgeon can help determine the most appropriate type of treatment for you.

Procedure
You can get a chemical peel in a doctor’s office or in a surgery centre. It’s an outpatient procedure, meaning there’s no overnight stay.

The professional who does your peel will first clean your skin thoroughly. Then he or she will apply one or more chemical solutions — such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol) — to small areas of your skin. That creates a controlled wound, letting new skin take its place.

During a chemical peel, most people feel a burning sensation that lasts about five to ten minutes, followed by a stinging sensation. Putting cool compresses on the skin may ease that stinging. You may need pain medication during or after a deeper peel.

Recovery

  • Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until you get the look you’re after.
  • Medium-depth and deep peeling may result in swelling as well as blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to 12 months, if necessary.
  • After treatment, you may need bandages for several days on part or all of the skin that was treated.
  • You’ll need to avoid the sun for several months after a chemical peel since your new skin will be fragile.

– Home Remedies
About Treatment
There are some at-home remedies that may assist with easing the symptoms of hypopigmentation include the use of fresh ginger. Simply take a small piece of fresh ginger and dab it on the area of skin that has hypopigmentation. Do not rinse this off. Do this twice a day. It will take time to work but within a few months, scars will have faded away completely. This has not been tested by our skin specialists and we recommend other treatments for hypopigmentation.

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