Cosmetic Surgery and Beauty Magazine #68

feature
pis for Pigmentation
Hyperpigmentation, or the darkening of
the skin in localised areas such as the
cheeks, forehead and around the eyes,
can be triggered by several factors
and can spoil an otherwise clear complexion. The
appearance of dark, often brown spots is caused
by the overproduction of melanin by melanocytes
in the basal layer of the epidermis. This can occur
in response to hormonal changes, pregnancy,
inflammation and sun damage.
The most avoidable form of pigmentation,
particularly common in Australia, is caused by sun
exposure, when melanin is produced to protect skin
cells from harmful UV rays. Acting like an umbrella,
melanocytes release pigment into the skin cells to
surround and protect the cell’s nucleus. This causes
skin darkening and concentrated spots of melanin,
often termed ‘sun spots’.
Certain products such as perfumes, soaps or
cosmetics contain ‘phototoxic’ ingredients, which
induce a sensitised reaction to sun exposure can
also trigger excessive melanin secretion.
Presenting in a more ordered, symmetrical
pattern, hormonal melasma is caused by
overstimulation of melanocytes in response to
increased levels of oestrogen and progesterone.
Most common in women, hormonal melasma
can arise after pregnancy, in women with a
history of taking the oral contraceptive pill or in
those undergoing hormonal therapy. Finally, postinflammatory
pigmentation occurs as a result of
injury to the epidermal/dermal junction. This can
appear in skin conditions like eczema, acne or
chronic dermatitis, or in some cases after harsh
cosmetic treatments.
Pigmentation of all forms can lie unnoticed in
the lower layers of the epidermis for years before
appearing on the face. Because of this, and the fact
it is so sensitive to inflammation, treating visible signs
of pigmentation can be difficult with no guarantee of
complete eradication.
Regardless of the cause, all pigmentation is
treated with a similar approach. Topical treatments
are the first step, with a skincare range incorporating
vitamin A to normalise cell function, vitamin C to
protect DNA and niacinamide (the active form of
vitamin B) to inhibit the synthesis of melanin and
lighten existing pigmentation. This treatment can
be combined with collagen induction therapy (skin
needling), light-emitting diode (LED) therapy and
chemical peels. It is best to work with a dermatologist
when fighting the appearance of pigmentation, as it
is often a long process involving multiple aspects.
ris for rosacea
Evident as redness, pimples, flushing and
pustules, rosacea is a vascular disorder that
can arise in the centre plane of the face, across
the cheeks, neck, chest and around the eyes.
A flushed appearance occurs on account of mildly inflamed
superficial vasculature, and the redness can be dotted
with small bumps called papules or, in more severe cases,
inflamed pustules.
Rosacea symptoms can flare up in response to various
triggers, including sun exposure, heat, alcohol, spicy foods
and certain cosmetics. Treatment for rosacea will usually
begin with a patient journal to identify the triggers most
troublesome to the individual so that lifestyle adjustments
can be made to avoid these irritants.
Skincare with anti-inflammatory ingredients can be
effective in combating the appearance of rosacea, with aloe
vera, provitamin B5, green tea, red algae, and zinc just some
of the ingredients shown to sooth skin irritation. Salicylic
acid can help with rosacea, and retinaldehyde, the milder
version of retinoid, is usually appropriate to promote skin
integrity in rosacea patients, though progressive adoption is
recommended. Alongside topical treatments, oral antibiotics
can be used to reduce inflammation and eradicate the
papules and pustules that can sometimes arise.
Though steroid treatment will succeed in promoting
short-term relief of rosacea symptoms, it will usually
increase capillary formation and result in amplified redness
and flushing in the long term. While some cosmetic
treatments like chemical peels and microdermabrasion will
inflame rosacea symptoms, other procedures like vascular
laser therapy or intense pulsed light (IPL) treatment can
successfully relieve redness and flushing. By targeting
the capillaries in the dermis, these treatments use light to
destroy the tiny blood vessels and reduce flushing. csbm
www.cosbeauty.com.au 67