The colouring of our skin is referred to as pigmentation. Melanocytes are special cells in our skin that produce melanin which happens to be the pigment responsible for the skin’s natural hue. Skin hyperpigmentation occurs when the skin cells are unhealthy or damaged due to a myriad of reasons resulting in the colour of your skin changing. 

Appearing as random dark patches or spots, hyperpigmentation can occur due to genetics, sun or environmental damage, and hormones. Hyperpigmentation can also stem from acne and there is a chance of skin discolouration occurring after your acne has healed. What many find vexing is while the darkened skin eventually fades, some realise that the status is near-permanent and no amount of exfoliation or skin brightening creams seem to help.

Nonetheless, one slightly comforting factor is that there are no harmful side effects. Hyperpigmentation usually appears in appearance such as birthmarks, freckles and is just another part of your skin. The marks are usually tan, brown, or dark brown in colour. These dark spots may darken with increased sun exposure, especially without sunscreen.

Hyperpigmentation can be further classified into three subgroups: Melasma, Sun Spots, and Post-Inflammatory Hyperpigmentation (PIH). 

Melasma causes dark discoloured patches on the skin to appear and is common among women between the ages of 20-40 years old. Sometimes known as the ‘mask of pregnancy, it is believed that melasma can flair up due to the hormonal changes during pregnancy as a result of taking birth control or stress.

Sun Spots are known by many names such as liver spots, solar lentigos, and age spots produce the formation of light to dark brown spots on the skin. The damage caused is mostly due to the ultraviolet rays (UV) from the sun leading to the production of melanin in the skin to speed up at an irregular pace. This prompts certain parts of the skin to darken while other parts remain the same ruining the even-toned complexion. Individuals with fairer skin tend to find themselves in this category. 

Post-Inflammatory Hyperpigmentation (PIH) tends to occur after the skin has gone through an episode of inflammation such as acne, chemical peels, or eczema. Individuals with darker skin tend to find themselves in this category and can appear as small to large patches of pink, light, or dark brown coloured skin. 

Regardless of skin colour, many of us find ourselves facing some kind of hyperpigmentation and despite our efforts to lighten them with exfoliation and creams, some hyperpigmentation marks can be quite stubborn and persistent. We have two aesthetic and laser treatments that have seen success in the fight against hyperpigmentation. 

At Cambridge Medical, we offer the benefits of Neogen Plasma and Pico 450 Laser as we believe in the most advanced technology to best suit your skincare needs.

Neogen™ Plasma Skin Regeneration Treatment

Neogen Plasma is a highly advanced skin regeneration technology that applies heat to the targeted area of treatment without causing damage or harm to the surrounding tissue of the skin. This treatment is highly sought after in Japan, the USA, and Europe. 

In Japan, it is mostly used to treat acne problems, fine lines, and wrinkles. However, it improves skin tone and rejuvenates skin damaged by the sun and other weather conditions. Engaging in Neogen Plasma treatment refreshes your face and gives it a more youthful touch, which other treatments may be unable to.

Essentially, it targets the root cause of pigmentation: Acne scars. Through the removal of acne scars and suppression of sebum secretion, it provides more effective results as compared to other conventional acne and pore-tightening treatments.

Benefits of Neogen Plasma include:

• Treating different skin conditions at the same time. Some of these skin conditions include wrinkles, acne, and psoriasis, etc.
• All areas are treated safely. This includes the upper and lower eyelids where the most improvement is seen in droopy eyelids
• Clinically proven to regenerate skin
• Does not react with melanin which widens its scope of potential patients
• Safe and effective with minimal downtime
• Pain-free and requires no anaesthetic.

Some of the Expected Results are:

• Dramatic improvement within the first few months
• Fresher, firmer, and more youthful appearing skin
• Upper and lower eyelids are tightened
• Dark eye circles are lightened
• Pigmentation, brown spots, and melasma are lightened
• Acne and acne scars are effectively treated

An oily, waxy substance, sebum is produced by the body’s sebaceous glands to keep the skin sufficiently protected and moisturised. Blocked pores cause sebum to accumulate and this forms comedones (blackheads and whiteheads). This happens when excess debris or pollutants from dirt, bacteria, and/or makeup are mixed with sebum and trapped in the skin’s pores.

During the treatment, plasma is generated through inert nitrogen gas being converted into activated ionised gas. At high energy levels, Nitrogen Plasma effectively tightens and contours skin. At low energy levels, Nitrogen Plasma treats premature signs of ageing such as fine lines, wrinkles, and age spots. Regardless of the level of thermal energy used during treatment, Neogen Plasma successfully regenerates new skin and replaces old damaged collagen and elastin with controlled precision.

Some Key Advantages of Neogen Plasma:

• Deep dermis healing: Promotes healing and cell regeneration from the deep layers of the dermis
• Strong anti-bacterial effect: The energy of plasma has a high sterilising power known as a bactericidal effect which eliminates bacteria and prevents growth.
• Skin peeling effect: Sheds the extra layer of dead skin which is partially responsible for acne breakouts
• Increases skin absorption efficiency: Neogen Plasma treatment makes the application of topical medication more effective as the skin’s absorption rate significantly increases. 

Treatments usually last for 10-20 minutes. However, this varies on the area of treatment and condition of your skin. Neogen Plasma mainly targets patients with active acne, enlarged pores, age spots, skin discolouration (hyperpigmentation), melasma, early sagging skin, and wrinkles.

Pico 450 Laser Pigmentation Removal

Widely considered as the standard of care for pigmentation removal and the treatment of hyperpigmentation is the Q Switch Laser. Technology evolved and Q Switch laser evolved to Nanosecond Pulse lasers that are faster. Today, Nanosecond pulse lasers have given way to picosecond pulse lasers and have been vital in pigmentation treatments. 

The Pico 450 Laser targets laser energy into the skin’s layers which are absorbed by pigments. They break apart the pigments into smaller forms. The damage caused to the pigmentation layer triggers the body’s immune response and starts to remove the fragmented pigments. 

The Pico Laser incorporates PicoCare 450 to speed up its treatment. It emits light pulses at a rate faster than a nanosecond and allows the treatment session to be completed at a faster rate making the process more effective.

With a reduced number of shots, there would be less thermal heat generated as well as reduced pain. Patients would experience fewer side effects and little to no skin irritation after the treatment is completed.

Pico Laser Pigmentation Removal Benefits Patients with:

• Freckles
• Melasma
• PIH (Post-Inflammatory Hyperpigmentation)
• Age spots (Senile lentigos)
• Sunspots (Solar lentigos)
• Café au Lait
• Seborrheic Keratosis
•  Acne redness
• Flushed skin
• Becker’s Nevus
• Acne scars: Box, Ice Pick, Rolling, Hypertrophic

Advantages of Pico Laser Pigmentation Removal:

• High speed with 4 picoseconds of wavelength power
• Reduces the size of pigments into fragmented pieces at a higher speed
• Effective and safe pigmentation treatment
• Treats a variety of pigment types
• Beam quality is highly accurate to minimise damage caused to healthy tissues
• The treatment has little to no pain and is relatively comfortable

How To Prevent Pigmentation At Home

Though there are many medically approved treatments for hyperpigmentation available, it requires a regular, consistent routine to treat hyperpigmentation at home and that itself is not always successful. For individuals who would like to manage their pigmentation at home, we have compiled a few of our favourite at-home treatments to help prevent and manage pigmentation. We would like to note that these treatments will also have to be administered regularly to see results. 

Vitamin C

Vitamin C has been deemed as one of the “holy grail” products in anyone’s skincare routine. It is packed with antioxidants and ingredients that brighten and even out the skin tone. It also reduces the appearance of scarring through the increase in collagen production. [1]

A 2019 scientific report found that Vitamin C at levels from 3 to 10% is one of the quickest long-term solutions for managing hyperpigmentation. [2]

Vitamin C can be applied mostly through serums. It is also included in some brightening creams and sunscreens. Ideally, it should be applied once daily after cleansing and moisturising.

Retinoids

Retinoids are also known as Vitamin A and they are just as powerful (if not, more) as Vitamin C. Mainly used to treat signs of ageing, they also double up as solutions to treat acne and hyperpigmentation.

A 2016 study that took place for 24 weeks was able to learn that a combination of 4% hydroquinone and 1% retinol treatment significantly improved the photodamage and melasma of the participants. [3]

Retinol products of up to 2% can be purchased over the counter at most pharmacies. However, you should consult a doctor if you would like to use retinol products of a higher concentration.

For retinol to work without any harmful side effects, incorporate it once or twice weekly into your skincare routine.

Glycolic Acid

Known as the most popular and strongest AHA (alpha hydroxy acid), the sugar cane derived acid is pretty much an all-in-one with the ability to exfoliate, prevent acne, and fade dark spots.  It also adds in another strong barrier in the skin layers which enables the skin to be thickened.

Though found mostly in professional chemical peels, it is also an active ingredient in many face washes, moisturisers, and serums.

Most products usually contain about 8-30% of glycolic acid. While some may find this concentration mild, it is not typically recommended to use more than 30% once or twice a week to avoid irritation or harmful side effects.

Similar to the application of retinol, it is vital to apply glycolic acid gradually by working your way upwards. Regardless of skin type, glycolic acid is guaranteed to make your skin more sensitive to the sun. We would recommend applying sunscreen and moisturiser everyday religiously if you are using retinol or glycolic acid, and it is important to mention how integral patience and perseverance to a good skincare routine is. It is also advisable to not use both products at the same time as it can damage your skin.

It is always best to opt for simple treatments rather than a plethora of ‘recommended’ products. Retinol and Glycolic Acid are often good starting points. Neogen™ Plasma Skin Regeneration and Pico 450 Laser Pigmentation are recommended treatments by Cambridge Medical for deeper pigmentation in the skin. Make sure to consult your doctor prior to any treatments or cosmetic procedures for a better gauge if the treatment is suitable for you.

1. https://www.webmd.com/diet/features/the-benefits-of-vitamin-c#1
2. De Dormael, R., Bastien, P., Sextius, P., Gueniche, A., Ye, D., Tran, C., Chevalier, V., Gomes, C., Souverain, L., & Tricaud, C. (2019). Vitamin C Prevents Ultraviolet-induced Pigmentation in Healthy Volunteers: Bayesian Meta-analysis Results from 31 Randomized Controlled versus Vehicle Clinical Studies. The Journal of clinical and aesthetic dermatology, 12(2), E53–E59.
3. FAAD, M. I. R. M. (2016). Clinical evaluation of a 4% hydroquinone+ 1% retinol treatment regimen for improving melasma and photodamage in Fitzpatrick skin types III-VI. Journal of Drugs in Dermatology, 15(11), 1435-1441.