Skin Lightening refers to the evening out of skin colour or tone, similar to the effect that is achieved when foundation is used to cover up age spots, redness, or uneven pigmentation.
Uneven skin tone can be the result of several different mechanical, U.V. or hormonal causes. There are two main categories of uneven colour. One is vascularity leading to rosacea, red spots and blotches. The other is overactive melanocytes leading to brown spots or brown masking. Pregnancy mask is the result of hormonal imbalances and may or may not completely resolve on its own. Ethnic background can also guide a predisposition that will increase the odds that uneven pigmentation will occur at some point over a life time. For example, English, Irish, Welsh, German, Scandinavian people with very little pigment in their skin will often appear flushed with reds (often blotchy red), or freckles. People with more pronounced colour like Asian, African, Middle Eastern ethnic backgrounds will often have darkness under their eyes, and/or small dark spots or larger dark areas on their cheeks and forehead (often in areas of constant sun exposure).
As you can imagine, diagnosing and treating uneven pigmentation requires a diverse set of approaches in order to be successful. For example, treating melasma (hormonal browns) with a heat source such as laser may reduce the colour for a short period of time but usually it will return in time more pronounced than before the treatment. Generally the treatment must reduce the offending colour without inadvertently stimulating the source of that colour.
To begin, melanin rises in cells from the dermis eventually becoming a stained epithelial cell. When we remove the outer layers of the epithelium the stained cells formerly causing the majority of the intensity of pigment are no longer visible leaving the complexion more even and better able to reflect light. Skin now looks brighter. We call this first step Skin Polishing Systems. It is a combination of treatments such as microdermabrasion or chemical peels along with topical products such as Retinol (a vitamin A derivative) or AHA’s. Vitamin C-20 moisturizer has proven to be invaluable in calming melanocytes and repairing the lipid bi-layer of the epithelium. With regular use, skin looks brighter and feels like silk. This look and feel is a great indication that the skin’s metabolism is functioning correctly.
Treatments such as Micro-Needling with Oxy-Nutrient Infusion followed by daily use of C-20 moisturizer is effective at treating browns without stimulating melanocytes. In some cases where laser heat would make the condition worse in time. This procedure, aside from harsh chemicals like hydroquinone, may be the only treatment option. For more stubborn cases, Lumixyl will be added to the regimen to block the cytokines responsible for stimulating melanocytes.
Photo facials have a long standing history of excellence when dealing with uneven tone. The variable spectrum laser is adjusted with precision to deal with each specific chromaphore. Reds and browns can be dealt with in a single session, with the added benefit of increased collagen production. We have clients with China Doll skin that come for Photo Facials on a monthly basis.
Micro-Pulse laser treatments target reds, the visibly overgrown micro-vessels and arterioles. The session is painless and has no down-time. 10,000 micro pulses in a single session will target the vascularity that is visible on the surface. It will also stimulate collagen genesis and in time create thicker more opaque skin to help cover healthy skin vascularity.
MiXto CO2 Fractional Resurfacing (FS4&5) is used when pigment is combined with fine lines and wrinkles and a generally grey or sallow complexion. This treatment is variable in intensity and does come with social down-time relative to the intensity of the treatment.
As you can see evening out skin tone is not a one size fits all procedure. Each client that walks in the door will come with very specific needs. Multiple laser platforms and treatment modalities along with extensive experience are required to effectively treat dischromia. At EA, our extensive tool box of procedures, oral and topical nutrition combined with effective topical treatments and years of investment and focus means that we are not going to try to squeeze your round problem into our square hole.