Your six-week guide to tackling pigmentation

Feeling good about one’s skin over the age of 45 lies in the middle ground between vanity and realism. To age well you must pick your battles carefully because if you intervene too fervently you rob your face of its character and its well-earned maturity.

Getty Images how to tackle pigmentation stop skin anti ageing tips skincare best beauty products 2022 - Getty Images

If I had to choose between a tight face or clear and vibrant skin – I’d take the latter. Sure, jowls can be firmed with ultrasound energy, wrinkles softened with Botox, cheekbones heightened with filler, but you can only fight gravity for so long. Perhaps the most profound way to feel good at any age is to improve the clarity and uniformity of our skin, as exemplified by the Queen, who in her Platinum Jubilee year, has a peachy, pearly complexion – without a blemish in view.

Maintaining a smooth, light-reflecting skin surface, free from pigmentation, takes diligence and dedication. Pigmentation affects women of all ages and ethnicities for a number of reasons, says aesthetic practitioner Dr Uma Jeyanathan from GetHarley.

A main cause of pigmentation is the sun. When skin is exposed to UV light, the skin cells known as melanocytes are prompted to dish out melanin, a protective pigment that helps to block UV radiation from damaging DNA and potentially causing skin cancer. 

In its mildest manifestation melanin is dispersed evenly, resulting in an eye-pleasing tan (though, technically this is a sign of sun damage). At worst, melanin is over-produced in uneven patches, known as pigmentation or age spots that, unlike a tan, don’t fade so easily without intervention.

The sun isn’t the only culprit. Pollution has been shown to be a major factor, too. “Studies have found that pollution particles actually penetrate the surface of the skin causing premature ageing, particularly pigmentation,” explains dermatologist Dr Uliana Gout. 

Dr Gout explains there are two main types of pigmentation: deeper dermal pigmentation and epidermal, which is surface-deep. The former is harder to treat. The best way to know which one is which is by doing the stretch test, says Dr Gout. “Take a pigment spot and push down on it, stretching the skin. If the brown patch gets lighter then it’s epidermal, if it doesn’t, then it’s deeper dermal pigmentation and you’ll need a six-week protocol of lasers and/or peels and medical-grade skincare to improve its appearance and plateau its progression.”

Another common pigmentation concern is melasma, a hormone-induced pigmentation also known as the pregnancy mask, due to a hormone imbalance. This can trigger an overproduction of melanin, which tends to settle in patches on the forehead, chin, nose and cheeks. Melasma isn’t just reserved for pregnant women, however – it can strike when taking the Pill and during perimenopause, says Dr Jeyanathan. 

“Fluctuating hormones during the menopause transition mimics what’s happening during pregnancy and can impact how our melanoctyes behave,” she explains. “During any period of hormone turbulence, it’s important to be vigilant about your skincare regime, wearing sunscreen and antioxidant protection to prevent melasma from sneaking up on you at a vulnerable time.”

Provided by The Telegraph If a brown patch on the skin gets lighter then it’s epidermal, if it doesn’t, then it’s deeper dermal pigmentation and you’ll need a six-week protocol of lasers - Getty Images

Ingredients that dermatologists recommend for pigmentation include a good antioxidant serum to mop up free radical damage and a daily SPF to prevent sun damage. Dr Gout recommends an oil-free serum with up to 30 per cent L-ascorbic acid (vitamin C) and, if it doesn’t tingle it’s not active enough. “You want to create a good reaction in the skin, so if it’s red at first and feels slightly tingly, it is working properly to exfoliate the top layers of the skin,” she explains. 

As for sunscreen, Dr Gout says to choose SPF30 or above with UVA, UVB and infrared protection. But, more importantly, make sure you apply enough. “Most people don’t know that you need two fingers-worth for the face and more to cover the neck and decolletage to provide adequate protection,” she says. 

At night, a retinoid product is what both Dr Gout and Dr Jeyanathan recommend, as it is most proven to resurface and fade pigment spots. Though, to avoid over-sensitising skin, especially in summer, Dr Gout suggests going for a gentler, new generation retinaldehyde, such as retinyl palmitate or a retinol 0.3 per cent, two to three times a week. And, avoid oils at all costs, says Gout. “Oil-based products clog the pores and can make pigmentation worse.”

For those who wish to avoid retinols, kojic acid is a powerful de-pigmentor shown to be a gentler and safer alternative to prescription hydroquinone, which has a skin lightening effect, and cleansers with salicylic acid or PHAs will help to slough away dead skin cells and pollution. 

“The most effective approach is to utilise all methods to control pigmentation as they all have different pathways; some block melanin production, others fade existing pigment, some resurface or boost clarity. A 360-degree approach works best, not forgetting diet,” says Dr Jeyanathan. “A diet high in antioxidants will help to fight free radicals from within the skin, even if it’s just a handful of blueberries and a portion of dark leafy greens a day,” she says.

A typical anti-pigmentation skincare protocol includes an exfoliating cleanser, followed by an antioxidant (vitamin C) or specific anti-pigment serum in the morning, which has a high sun protection factor, even on cloudy days. At night, alternate between retinol two or three times a week, depending on your tolerance, and a kojic acid serum on the others.

If your pigmentation is already advanced then skincare will only get you so far. In this case the most thorough approach is a medical grade treatment. The LAM Pigmentation Ultimate Programme (£1,350; london-aesthetic-medicine.com) includes two wavelengths of IPL to fade brown and red pigmentation, LED red-light therapy to curb inflammation along with a signature peel and medical grade skincare, which is administered over two sessions three weeks apart.

Dr Gout explains, “Since the pandemic, all my patients want is to feel good. They’ve been spending more time outside, enjoying life. Along with the psychological stress from the past couple of years, consistent skincare routines have gone by the wayside. On the one hand, it’s been a positive to let go, on the other, there’s been a rise in pigmentation complaints as a result.” On the bright side (no pun intended), Gout says six weeks is all you need to curb the onslaught of overactive melanin production.