I. Understanding various kinds of pigmentation
In fact, the facial blemishes we usually mention are not simply one disease, but many different diseases, and the treatment methods for these different blemishes are also different, and not all blemishes can rely on blemish removal products to help solve the problem. Only after recognizing what kind of spots you have on your face, you can take a more appropriate way to get rid of them. So, what are the most common pigmentation spots?
Melasma
Also commonly known as butterfly spot and liver spot, it is generally a large irregularly shaped yellowish spot in the cheekbone area. The appearance of chloasma is mostly related to endocrine, especially to female estrogen level, so menstrual disorders, pregnancy, taking birth control pills or poor liver function and chronic kidney disease are all prone to this disease. In addition, sun exposure and psychological factors can aggravate the disease. Chloasma often appears in pregnant women after the third month of pregnancy, and most of them fade away when their menstruation returns to normal after the birth of their children. If it does not subside for a long time, it needs to be treated. The disease is also occasionally seen in men.
Freckles
It is usually hereditary and is often present since childhood, and people with fair skin are prone to freckles. Basically 100% of the Caucasian population has freckles. Most freckles are located on the bridge of the nose and the sides of the nose, and are often brown spots the size of a grain of rice to a bean. The color becomes more pronounced in adolescence and deepens in summer after sun exposure, and decreases in winter when the color becomes lighter.
Age spots
Generally, for people around 40 years old, some brown spots appear on the exposed parts, and the surface is smooth at the beginning, but it will become rough after a long time. Long-term sun exposure will accelerate the formation of age spots, so if you pay attention to sun protection from the young age, you can prevent and delay the appearance of age spots in the future.
Pigmented mole
Many women have small black spots or black papules on their faces. These are pigmented nevi, which are benign proliferations of nevus cells and often occur in children or adolescence.
Melanosis
This kind of facial pigmentation is mainly related to the application of unsuitable cosmetics containing photosensitive substances and further exposure to sunlight. This, combined with some massage stimulation can lead to aggravation.
Cheekbone nevus
Zygomatic nevus is a pigmented disease that occurs on the face because melanocytes do not pass through the epidermis and dermis normally during the transfer from the neural ridge to the epidermis during embryonic development, and remain in the dermis. The main feature is the symmetrical distribution of dark gray spots on the zygomatic and temporal areas with a diameter of about 1-5 mm. There is no damage to the eye or oral mucosa, and patients do not have any conscious symptoms. It occurs mostly in women, and the age of onset is 16-40 years old, and some patients have family history. It should be distinguished from chloasma because oral medication and topical medication for spot removal are ineffective.
Nevus of Ota, Mongolian spot
Also known as black birthmark, the cause of this disease is due to some melanocytes dropping out and staying in the dermis during embryonic development, which has certain genetic factors. The brown spots of nevus of Ota are located on one side of the face and can involve the sclera on the same side. Generally, they cannot disappear naturally and can expand in size with age, and basically stabilize after puberty. Mongolian spots, on the other hand, are mainly found on the lumbosacral region or buttocks of children and are present at birth and may fade away after a few years.
Post-inflammatory hyperpigmentation
Pigmentation can also occur after acute and chronic inflammation of the skin, for example, some patients with facial acne or psoriasis will have spots or patches of pigmentation on their face after healing. In dark-skinned people, hyperpigmentation is heavier and lasts longer. The severity of skin hyperpigmentation appears to be less related to the degree of inflammation and more dependent on the nature of the skin disease itself. Pigmentation is common and obvious in some skin diseases, while it is mild in others.
II. Factors related to pigmentation
Different pigmentation spots have different factors for their development. It is generally believed that it is related to the abnormal secretion of estrogen and progesterone. Pregnancy will increase the level of these hormones in the body, and the ingredients of birth control pills are mainly these hormones, so many pregnant women and those who take oral contraceptives will have butterfly spots. Many young women can also develop butterfly spots during their adolescence due to higher estrogen levels in their bodies than the average person.
In addition to some pathological factors, endocrine abnormalities, lack of vitamins and certain trace elements, or cosmetic injuries such as chemical peeling, or contact with certain productive harmful substances such as heavy metal nickel and arsenic, cold and dry climate, strong sunlight exposure, etc. can cause chloasma; irregular life, improper diet, lack of sleep, mental stress and other psycho-neurological factors can also cause chloasma. Chloasma can also occur when some women suffer from chronic diseases, such as tuberculosis, tumor, chronic liver disease, etc. Patients who take phenytoin sodium can also sometimes develop this change.
In addition to melasma, many other pigmentation spots including freckles and age spots have a clear relationship with sunlight, which can aggravate them.
Common whitening and spot removal products
Whitening ingredients that have been commercialized, including vitamin C and its derivatives, vitamin E, B3, and natural plant extracts such as mulberry extract, licorice brassica, arbutin, etc., all have whitening effects and are relatively safe, but their effects often need long-term use to be seen.
In addition, UV rays play a role in aggravating and causing various pigmentation, so sun protection is also one of the effective ways to get rid of spots. There are many commercially available whitening products, each with different active ingredients and different production processes. When choosing cosmetics, it is best to choose regular products from well-known brands, as these are relatively safe after professional identification.
At the same time, we should be wary of cosmetics that overemphasize the short time of spot removal, which probably contain chemical decolorizing ingredients with high concentration, including hydrogen kun, azelaic acid and vitamin A acid, which are pharmaceutical-grade whitening ingredients, and these drugs can only be applied after a doctor’s prescription.
As for hydrogen kun, it is prohibited to be used in cosmetics abroad, because its long-term application can cause permanent skin depigmentation, and it is easy to cause skin allergy, so it should be used with caution. Mercury preparations have been banned from regular cosmetics and drugs due to their toxicity. Retinoic acid also has certain side effects, it can lead to peeling, local irritation, some people can have allergies to retinoic acid, the skin appears more serious redness, swelling, itching, etc.. The application of these products should be stopped immediately once allergies occur, and should be used from a low concentration, only at night, preferably under the guidance of a medical professional. Similar to retinoic acid, fruit acids also have these reactions.
IV. Treatment of pigmentation
If the pigmentation is caused by disease, it is necessary to go to a specialized hospital to listen to the dermatologist’s opinion with the treatment of drugs and laser, etc. It is difficult to be effective with cosmetics.
Treatment of melasma
Laser treatment, including various gemstone lasers and YAQ lasers, is not ideal, and often requires a combination of internal medication and external medication.
Common oral medications include anti-aging drugs such as vitamin C and E, or traditional Chinese medicines such as Liu Wei Di Huang Wan and Jia Wei Yi Yao Wan. Topical medications include 2%-4% hydroquinone cream, 0.025%-0.1% retinoic acid cream, 10%-20% azelaic acid cream, 0.1% SOD (superoxide dismutase) cream, etc. In addition, sunscreen is essential. The selection and use of drugs should be carried out under the guidance of doctors, and generally adhere to the treatment for a period of time before there will be certain effect.
All in all, melasma treatment is difficult and requires patience and slow adjustment.
Treatment of freckles
First of all, sunscreen should be used throughout the year, and the SPF value of sunscreen in summer should be more than 25. You can choose sunscreen that is whiter after application, such as pure physical sunscreen, because it also has a certain covering effect, which makes the color of freckles less obvious.
If the freckles are lighter in color, the pure application of spot removal products can have certain effect. For example, products containing hydroquinone and retinoic acid should be used under the guidance of a doctor. And long-term use is needed to show the effect.
At present, the best method is ruby laser to remove existing freckles, some people will have shallow traces left after laser, and the effect is better for people with white skin. After the laser, you need to protect yourself from the sun, otherwise new freckles will appear in other areas.
Treatment of other pigmentation spots
Age spots can be treated by freezing or laser in regular hospitals. Early age spots can also be cured by topical application of retinoic acid cream once a night for several months.
Pigmented nevus can be removed by laser or surgery if any spot removal products are ineffective.
Nevus of Ota is mainly treated with gemstone laser, which has good effect.
Brown nevus of cheek: high energy laser (wavelength: 755-1064) is the only effective means to treat brown nevus of cheek, which usually needs to be done 3-5 times and treated once every 3 months – 6 months, with external sunscreen during treatment.
V. Diet to remove spots
When it comes to difficult to treat pigmentation spots like melasma, many people who come to the clinic may ask whether they can improve these pigments through diet. Indeed, a reasonable diet can have certain effect on the prevention and treatment of pigmentation. As long as we pay attention to our diet in our daily life, we can sometimes receive better results than taking medicine.
Eat foods containing vitamin C often: foods rich in vitamin C include citrus fruits, tomatoes, peppers, baby radish, melons, fresh green leafy vegetables, dates, kiwi, prickly pears and so on. They can always melanin formation, thus reducing the facial pigmentation, to achieve the purpose of treatment.
Regularly eat foods rich in vitamin A: for example, spinach, carrots, poultry eggs, dairy products, and also consume foods rich in niacin such as peanuts, beans, liver, etc. It helps to lighten hyperpigmentation.
Eat foods rich in vitamin E: the increase of lipid peroxide is related to the occurrence of hyperpigmentation. Long-term consumption of foods rich in vitamin E, such as soybeans, green cabbage, fresh lettuce, malt, egg yolk, sesame and other foods, is beneficial to hypopigmentation.
Often eat foods high in protein and iron: such as eggs, milk, lean meat, soy products, etc. Foods containing more iron include animal liver, kidney, walnuts, raisins, beans, etc.
Eat less tyrosine-rich food: because tyrosine is the material basis of melanin, if tyrosine intake is less, then the synthesis of melanin is less basic material, so should eat less tyrosine-rich food such as potatoes, sweet potatoes, etc.