Women's Health - UK (2019-07)

SKIN

DEEP

I see lots of

clients in my

clinic troubled

by uneven

pigmentation.

Many have spent

a small fortune

on various

treatments and

products with little impact

because they don’t use them

correctly. The good news is that

there are effective treatments

for pigmentation, but they

require long-term commitment.

There are three main types

of pigmentation. Sun spots –

damage that occurs after years

of sun exposure – are the first.

The second is melasma, which

is the recurrent appearance

of patches of pigmentation

caused by hormonal changes

• such as pregnancy, use of
  the contraceptive pill or
  breastfeeding – coupled
  with sun damage. And, finally,
  there’s post-inflammatory
  hyperpigmentation (PIH),
  which is when the skin
  overproduces melanin as a
  response to injury or trauma,
  such as acne, chemical peels
  or aggressive use of laser
  treatments. It tends to affect
  darker skin types and follows
  the pattern of the trauma.
  Now, here’s what you can do...

THE EXPERT

Dr Johanna Ward,

founder of skincare

brand ZENii

HOW DO

I CORRECT

PIGMENTATION

Dark spots, discoloration

and scarring – pigmentation

is a common skin complaint,

but one that can be difficult

to treat. Here, WH’s resident

skin pro Dr Jo Ward reveals

her tried-and-tested strategies

for reducing its appearance

THE

PREVENTATIVE

TREATMENT

The reality is that

hyperpigmentation

is dynamic and often

recurs. Once you have

it, you’ll always be

prone to it, so you’ll

need to commit to a

maintenance skincare

regime and be cautious

in the sun to keep it

at bay. An SPF such as

Elemis Daily Defence

Shield SPF30, £46,

will ward off UV rays

and high-energy

visible light.

THE CLINICAL

TREATMENT

• Treatments for sun
  spots include light
  and laser therapy, but
  I wouldn’t recommend
  them for melasma or
  PIH because of the risk
  of making them worse.
  Sun spots respond
  well to most types of
  light therapy – laser
  works by shattering the
  pigment, which is then
  reabsorbed into the
  skin in an act of self-
  healing. The best lasers
  for photodamage are
  Nd:YAG or CO2 and
  can be found in most
  dermatology clinics.

THE OVER-

THE-COUNTER

TREATMENT

There are many

over-the-counter

serums and creams

for dark spots and

pigmentation, but

few are fully corrective

because they tend to

be better suited to

maintenance once

the pigmentation has

been clinically treated.

Over-the-counter

ingredients that can

help include arbutin,

bearberry, kojic acid,

glycolic acid, retinol

and L-ascorbic acid.

They all suppress or

inhibit (to varying

degrees) overactive

pigmentation cells in

the skin. Try IS Clinical

White Lightening

Serum, £57. Norwegian

kelp and acids make it

effective for all types

of pigmentation.

The most effective

treatment for excess

pigmentation is a

prescription cream

called hydroquinone.

It has a controversial

history because it’s

been used, abused and

counterfeited over the

years by people trying

to bleach their skin.

When used at the

appropriate doses,

under medical

supervision and in the

short term, it can be

very effective. It works

by inhibiting the

enzyme tyrosinase,

which inhibits melanin

and is generally used

at a 4% treatment

dose. It’s often

combined

with exfoliants

like glycolic and

salicylic acid, and

prescription-strength

vitamin A (tretinoin) to

help it perform better.

It needs to be used in

conjunction with

lifestyle measures

such as sun avoidance,

sun protection and

removal of hormonal

stimulants, otherwise

it won’t be possible to

successfully suppress

the skin’s pigment

cells. The Obagi

Nu-Derm range

contains hydroquinone

and is available on

prescription from

a dermatologist.

THE DERMATOLOGIST-

PRESCRIBED TREATMENT

Women’s Health JULY 2019 | 93

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