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Pigmentation & Melasma
Understanding Pigmentation and Melasma
Pigmentation concerns can develop for a number of reasons and may present as localised spots, patches or more diffuse changes in skin colour.
Melasma is a chronic pigmentary disorder that commonly presents as symmetrical areas of brown or grey-brown pigmentation, most often on the face. Accurate assessment is important, as different types of pigmentation can respond differently to treatment.
Pathogenesis
01
Melanocyte Hyperactivity
Increased activity of melanocytes, the cells responsible for producing melanin.
02
Increased Melanin Production
Overproduction of melanin, leading to the development of darker areas on the skin.
03
Dermal Pigment Deposition
Melanin becomes deposited deeper within the skin, contributing to persistent pigmentation.
04
Vascular Changes
Changes in the skin’s blood vessels that may contribute to pigmentation, particularly in some cases of melasma.
01
Melanocyte Hyperactivity
02
Increased Melanin Production
03
Dermal Pigment Deposition
04
Vascular Changes
The depth and location of pigmentation within the skin can influence how it responds to treatment.
Types of Pigmentation
Common types of pigmentation include:
Epidermal pigmentation
Excess pigment located primarily in the outer layer of the skin (epidermis), often appearing as brown or darker discolouration.
Dermal pigmentation
Pigment located deeper within the skin (dermis), which can give the skin a blue-grey or ashy appearance and may be more persistent.
Mixed pigmentation
Solar lentigines
Flat, well-defined brown patches that develop as a result of cumulative sun exposure. They are commonly referred to as sun spots or age spots.
Post-inflammatory hyperpigmentation (PIH)
Darkening of the skin that develops after inflammation or injury, such as acne, eczema, irritation or certain skin treatments.
Melasma
Symmetrical brown or grey-brown patches, commonly appearing on the cheeks, forehead and upper lip. It can be influenced by sun exposure, hormones and heat.
Melasma Subtypes
- Epidermal
- Dermal
- Mixed
Vascular changes may also contribute to melasma in some patients.
Contributing Factors
A number of factors can contribute to pigmentation and melasma, including:
- Ultraviolet exposure
- Visible light
- Heat
- Hormonal influences
- Genetics
- Inflammation
- Certain medications
- Lifestyle and environmental factors
Melasma Prevention
- Heat avoidance
- Daily tinted SPF
- Combination therapy
- Avoid over-treatment
- Long-term maintenance
How We Can Help
Pigmentation can develop for many different reasons, and understanding the type and cause of pigmentation is an important first step before considering treatment.
At Fremantle Skin Cancer Clinic, we assess factors such as the pattern and distribution of pigmentation, potential triggers, previous treatments and how your skin has responded in the past.
This is particularly important for melasma, which is a chronic condition that can be influenced by sun exposure, visible light, heat and hormonal factors.
Your management plan may include a combination of skin protection, medical or topical treatments where appropriate and professional treatment options selected based on your individual skin and pigmentation concerns.
The focus is not simply on lightening visible pigmentation, but on helping to manage contributing factors and reduce the risk of recurrence.