What Causes Age Spots and Pigmentation? Facial pigmentation and pigmented lesions are common skin concerns that affect individuals of all ages and skin types. These conditions result from an overproduction or uneven distribution of melanin, the pigment responsible for skin colour, and can be triggered by a variety of factors.
Sun Exposure
UV rays trigger melanin production leading to sunspots, freckles and pigmentation.
Aging
Causes the appearance of age spots and along with the sun contributes to an uneven distribution of pigmentation.
Hormonal changes
Conditions like melasma can arise due to pregnancy or medications with hormonal effects.
Post-Inflammatory Hyperpigmentation (PIH)
Dark spots are left behind from acne, burns or irritation in predisposed individuals.
Genetics
Some individuals are more prone to freckles, age spots and pigmentation.
What is the difference between freckles, age spots and sunspots?
Melasma
Melasma is a form of hyperpigmentation due to increased production of melanin that predominantly affects the face of women and is more prominent in darker skin types. Excess melanin is produced in response to certain triggers including hormonal changes (e.g. pregnancy or contraceptive pill) or conditions that inflame or irritate the skin.
Melasma typically appears as irregularly shaped brown or greyish blue patches on the face, particularly on the cheeks, forehead, upper lip and jawline (less commonly the forearms, neck and decolletage).
The pigment may be located in the skins top layer, the epidermis (tan to brown) but may also drop down into the skin’s dermis or collagen layer (giving a greyish blue colour to the skin). UVB damage affecting the collagen layer including its blood vessels also contribute to the pigment production in this condition.
Solar Lentigines (Age Spots or Liver Spots)
Solar lentigines are generally larger than freckles and are caused by long term UV damage that builds up over time. This causes both an increase in melanin production and an increase in the number of melanocytes (the skin’s melanin producing cells) producing aged spots and an aged skin appearance.
They typically appear in adulthood and do not fade on their own. Solar lentigos commonly affect the face, hands, arms and chest.
Seborrhoiec Keratoses (Senile Keratoses)
Seborrhoeic keratoses are extremely common wart-like spots that occur as we age beginning in early adult years in the predisposed. They present as light brown through to dark black lesions that vary in size. They are distinguishable from lentigines by their raised smooth, waxy surface.
Melasma and post-inflammatory pigmentation (PIH) are among the more common causes of face pigmentation.
Freckles (Ephelides)
Freckles are small light to dark brown flat spots caused by an increase in melanin production due to genetic predisposition (common in individuals with fair skin) and UV exposure.
Freckles are more prominent in childhood and often fade with age or reduced sun exposure and tend to occur on the face, shoulders and arms
Why is melasma so hard to treat and control?
Effective melasma treatment requires a combination approach with sun protection key. Treatment options include topical depigmenting agents, and advanced therapies targeting pigmentation, repair of photodamaged skin, including targeting of underlying blood vessels.
Post-inflammatory Hyperpigmentation (PIH)
PIH is a form of hyperpigmentation that occurs particularly in those with darker skin types, due to inflammation or injury in the skin and occurs in conditions such as acne, dermatitis, skin infection, or burns. Inflammation triggers melanin production leaving behind a dark mark where the injury took place. Whilst PIH is not permanent, these dark marks can take months to years to fade and can contribute to overall uneven skin tone particularly in acne sufferers.
Best Age Spots, Freckles & Pigmentation Treatments – Achieve Even-Toned Skin
There are many treatments available. A dermatologist recommended laser, chemical peels and skincare program will only be optimal when guided by accurate assessment and diagnosis.
A consultation with our dermatology team includes skin analysis and imaging to assist us accurately diagnose your skin pigment, skin pigment lesions and associated skin changes allowing for tailored treatment recommendations which will also be influenced by your skin type, lifestyle and associated skin problems.
Laser Treatments for Pigmentation
- Fractional and Resurfacing Laser
- Both non-ablative and ablative fractional lasers are extremely effective in the treatment and removal of many causes of hyperpigmentation. Both types of fractional lasers resurface the skin by targeting portions of the skin surface or epidermis causing cellular destruction and removal. Through the skin’s natural healing process, the excessive accumulation of melanin and damaged skin cells are eliminated from the skin.
- Best for: Stubborn pigmentation, sun damage and age spots
(CANDELA NORDLYS 1940, LUTRONICS ULTRA 1927, ALMA HYBRID, ILODA FRAXIS DUO, ACCLARO ULTRACLEAR)
- PICO (Pigment & tattoo) Laser
- Pico Lasers target skin pigment using extremely short pulses (one millionth of a second) of sound or acoustic energy to shatter pigment particles.
- This precise, high-energy treatment targets pigmentation without damaging or heating surrounding tissue, effectively addressing pigmented lesions and improving overall skin tone
- Best for: Stubborn pigmentation, sun damage and age spots, freckles, Hori’s nevi, Nevus of Ota, Tattoo pigment, and PIH including in Asian and darker skin types.
(CANDELA PICOWAY, ILODA CURAS)
- Laser Toning
- Laser toning (pico toning) differs from treating pigment lesions with a pico laser in that it focuses on evening overall skin tone and texture by targeting widespread pigmentation and improving skin quality rather than specifically treating individual lesions such as age spots. This uses lower energy to gently even out pigment, remodel collagen and to skin rejuvenate without causing significant downtime.
- Best for: Melasma, PIH, diffuse or uneven pigmentation, Darker Skin Types, Maintenance Treatments
(CANDELA PICOWAY, ILODA CURAS)
- Laser Peel
- Laser peels using the ACCLARO ULTRACLEAR 3DMIRACL and ALMA HYBRID devices deliver precise, fractionated laser energy to target and break down pigmentation in the skin’s surface layers. Cross talk between the skin layers also leads to the stimulation of new collagen production for overall skin rejuvenation. This treatment is used to target problem pigment lesions plus uneven pigment, improves skin tone, texture, and clarity with limited downtime.
- ALMA HYBRID is best in those with significant sun-damage and ACCLARO ULTRACLEAR 3DMIRACL is a safe option in darker skin types.
(ACCLARO ULTRACLEAR 3DMIRACL and ALMA HYBRID laser peel)
What’s the difference between IPL and laser for pigmentation?
INTENSE PULSE LIGHT (IPL) / PHOTOREJUVENATION (CANDELA NORDLYS IPL)
- IPL emits a range of wavelengths of light while lasers emit only a single wavelength of light.
- The wavelengths of light utilized by IPL are highly absorbed by both melanin along with the skin’s blood and blood vessels. IPL is an effective way to remove mild to moderate forms of hyperpigmentation, photo rejuvenation (improves fine lines and skin tone) and target skin redness and broken capillaries.
- Best for: People with a mix of skin pigment and redness or as an all-rounder for aged skin and prejuvenation including ageing, photodamage, melasma and PIH.
Other Pigmentation Treatments
CHEMICAL PEELS for Dark Spots & Uneven Tone
- Chemical peels are an effective treatment for mild to moderate cases of hyperpigmentation and uneven skin tone and are suitable for most skin types. They can range from superficial to deep depending on the layer of skin to be targeted and can help improve hyperpigmentation through exfoliation of damaged skin cells. This in turn encourages cellular turnover, revealing healthier, clearer and brighter skin. Choice of peel is based on the cause of face pigment, other changes present and skin type
Age spot removal treatment: CRYOTHERAPY and ELECTROSURGERY
- Cryotherapy can be used to freeze individual seborrhoeic keratoses and lentigines or age spots with the application of liquid nitrogen. This causes the abnormal cells to die and slough off. This method is quick and effective for isolated lesions. Electrosurgery can be similarly utilized to treat individual age spots and skin lesions.
- Best for: Treating individual pigmented age spots
RADIOFREQUENCY (RF) MICRONEEDLING AND SUBLATIVE RF (CANDELA MATRIX) for melasma, aging and photodamage
- RF works to stimulate collagen and skin repair and improves skin pigment and skin pigment lesions.
- Boosted by: REJURAN and integrated skin actives (including CE Ferulic Acid, Tranexamic acid).
- Improves: Sun damage, acne scars and acne, and hyperpigmentation.
- Best for: Pigmentation with skin texture concerns.
Intregrative Skin Actives
- To enhance pigment response and speed recovery after laser, specific skin actives are applied immediately after laser for additional benefits. This is called laser assisted delivery which helps target their synergistic benefits.
The best SKINCARE for dark spots and pigmentation and daily maintenance starts with an accurate diagnosis
- Corrective and consistent skincare plays a key and central part in the effective management of skin pigmentation problems. Integrated skin care can also help, improve your results, speed recovery and reduce risks with professional treatments. Use of a broad-spectrum UV protective product both before and after treatments is essential. Protection against high energy blue light may also benefit some with melasma.
Best ingredients: Vary with condition being treated but include:
- Vitamin C: brightens and reduces pigmentation.
- Retinol: Enhances skin renewal and reduces dark spots.
- Niacinamide and Tranexamic acid: Inhibits melanin production.
- Citric Acid and Glycolic Acid: Fruit acids that helps target pigment.
While all these treatments can have benefits, for personalized expert dermatology recommendations this should be based on your individual assessment (including pigment and pigment lesion imaging and skin analysis). Consideration is also given to a holistic approach that takes into account potential risks and rare complications along with your tolerance of downtime. A consultation with a dermatologist or dermatology nurse practitioner at KDAA is required to assess your suitability for many of these treatments and to discuss expected outcomes.
