Pigmentation

Skin pigmentation disorders can range from simple to complex. Sometimes, more complex pigmentation conditions occur on darker skin types, which many doctors prefer not to treat or don’t have the experience to manage.  

Excess pigmentation may be superficial and may be easily treated with topical creams or can be deep, requiring a combination of topical creams and/or systemic medications often in conjunction with laser and light treatments. At the Skin Specialist Centre, we treat loss of pigment or excess pigmentation for all types of skin, from the very fair to very dark.

Our comprehensive approach takes into account your condition, any prior treatments, lifestyle choices and we identify specific treatments to help you regain your skin to the level of pigmentation you want. We will match your skin to the shade you want it to be.

Hyperpigmentation

Skin discoloration is a most distressing issue for many patients, most frequently as a result of sun exposure and/or hormones. These brown patches and darkened areas can be an ongoing problem for someone of any age. Pigmentation is usually mixed, consisting of age spots, sun-damage and melasma. It is essential that the type of pigmentation is identified for the patient to receive optimal treatment. A specialist dermatologist can differentiate between melasma, sun-induced pigmentation and potential skin cancer pigmentation. Each form of pigmentation has a specific approach for an optimal outcome.

Hyperpigmentation From Sun Exposure

The skin gets its colour (whether light or dark) from melanin. Melanin is a pigment that your body produces which determines the colour of your eyes, hair and skin. An over-production of melanin shows up as brown patches and spots, and an under-production of melanin shows up as white, flat patches. Due to the high amounts of UV exposure in the upper part of the North Island, Asian and dark-skinned persons residing in this area will often develop uneven and patchy pigmentation. 

Hyperpigmentation From Melasma

This is a condition characterised by dark patches of pigment, usually on the face. Melasma can be caused by hormones such as the oral contraceptive pill or pregnancy, as well as the sun, or a combination of factors. Melasma is not a harmful condition but it can have a dramatic effect on one’s appearance.

Post-Inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation is a direct result of some type of injury to the skin. Where topical treatment to remove excess skin pigment is found to be less than adequate, or should a patient desire more aggressive treatment we offer numerous options for laser and light removal of brown spots. These may include using some of our Range of Newest Lasers, sometimes in combination with the latest medicines.

Hypopigmentation

Some people suffer from loss of pigment. This presents as hypopigmentation (either partial loss of pigment such as due to trauma or total loss of pigment – vitiligo). Alteration in skin pigmentation can be of great concern from either a cosmetic or medical perspective, or both. Several medical conditions of the skin can cause changes to the skin pigment. These may be treated with topical applications alone or in combination with our Excimer laser therapy. This is a unique device and is only available in Auckland, New Zealand. It offers new hope in Vitiligo and our results will please you. If you are interested in treatment for your skin pigmentation disorder, the Skin Specialist Centre welcomes you to make an appointment with us to provide a diagnosis and formulate a treatment plan for your specific pigmentation concern. No more need to disguise it.

Post-Inflammatory Hypopigmentation

Inflammation such as eczema or dandruff and trauma to the skin such as post-liquid nitrogen application, superficial abrasions and laser or heat burns may cause a temporary or permanent lightening of the skin and decrease in pigmentation by affecting the way the melanocytes (pigment cells) work. It appears as flat, non-scaly and lighter than normal areas of skin. The condition is diagnosed by means of clinical examination carried out by your specialist dermatologist. It may be necessary for a skin biopsy to be performed to distinguish this condition from other skin conditions that may have a similar appearance.

Cosmetic camouflage techniques such as cosmetic foundations and concealers can be used to blend the normal and affected skin until the condition resolves. Depending on the cause of pigment loss, we can usually achieve partial re-pigmentation with appropriate choice of one of our many lasers. It is also important to sun-protect as tanning may increase the visibility of the affected areas.

Hypopigmentation From Vitiligo

Vitiligo is a very specific type of pigment loss and needs specialised treatment. It is a chronic dermatologic disorder that causes de-pigmentation of patches of skin. It occurs when the melanocytes (the cells responsible for skin pigmentation) are destroyed. The vitiligo lesions may appear nearly anywhere, but are more common in areas where the skin is exposed to the sun. Common areas to be affected include the armpits, navel, groin, mouth, eyelids, and nostrils.

Men and women are equally affected and it usually presents before the age of thirty. The cause of vitiligo is not known but the most common form of vitiligo is thought to be an “autoimmune” disease, meaning that the person’s own immune system accidentally attacks the skin pigment cells (melanocytes). When attacked, they can no longer make pigment in normal amounts, which causes the skin to turn white (de-pigmentation).

Some people with vitiligo also have autoimmune conditions such as thyroid disease, pernicious anaemia, diabetes mellitus and alopecia areata. Vitiligo looks white, flat and does not have scaly spots. The disease usually occurs in childhood or early adulthood. The de-pigmented patches are often sharply defined, surrounded by normal or darker skin and are usually symmetrical. Vitiligo often follows trauma, with the disease common on the hands, elbows and knees. Another pattern is orofacial, with de-pigmented areas surrounding orifices (nostrils, mouth, vagina and anus).

The recent introduction of our Excimer laser in combination with topical creams has resulted in significant re-pigmentation, particularly in such areas as the face and neck. Treatment options will be aimed at restoring pigment to the white patches of skin, and the choice of treatment will depend on how widespread the patches are, the number of white patches, how long the condition has been present, and what treatment is most preferable to the patient.