For our second round with Dr. Anna Palabyab-Rufino, we're tackling something every girl battles after a summer jaunt in the sun: pigmentation. This week she talks about what it is, what causes it, and a simple skincare product that can help prevent it.
1. What are the main causes of dark spots on the skin?
The main cause of dark spots on the skin is the increase in production of melanin, the pigment responsible for giving our skin its color. It is produced by specialized cells called melanocytes. It can also help protect us from the damaging UV rays of the sun which is why people with fair skin are more sensitive to the sun. We are mostly bothered by the conditions that cause patchy hyperpigmentation on our skin because our goal—light or dark skinned—would be to have an even complexion. Some of these conditions include, melasma, post-inflammatory hyperpigmentation, solar lentigenes or age spots and ephelides or freckles.
2. How can you prevent it from happening?
Most of these conditions are triggered by sun exposure. Melasma, however has a hormonal component that is why it is common among pregnant women and those who use oral contraceptive pills. Post-Inflammatory hyperpigmentation, can occur after a rash or irritation or any inflammation for that matter and some people may be genetically predisposed to developing freckles.
How to prevent hyperpigmentation brought about by sun exposure:
- Avoid the sun.- If you can't avoid it, protect your skin with a broad-spectrum sunblock with a good SPF (protection against UVB) and PA (protection against UVA) rating.
- If you will be out in the sun for long periods of time, reapply your sunblock every 2-3 hours.
- Make sure you apply the right amounts of sunblock on the exposed areas of your body.
- Use protective clothing or accessories such as clothes with UPF, hats and umbrellas. - Do not go to tanning salons!!!
3. What's the highest SPF we can use?
I would say the higher the better because we don't usually put enough! SPF actually multiplies the minimum amount of time it takes for our skin to get red under the sun. This is called the minimal erythema dose (MED). If it takes 5 minutes for my skin to turn red under the sun, then SPF 50 will protect me for 250 minutes. This is assuming that I applied the recommended amount, which is 2mg per square centimeter of skin or 1 shot glass of sunscreen for the whole body!
4. How often should you reapply your sunscreen?
I often advise my patients to reapply every 2-3 hours when they will be outdoors for long periods of time but this will also depend on the type of activity (will you be swimming or sweating?) and the type (cream, spray, gel or powder?) and amount of sunblock you are using (waterproof or not?)
5. Is it safe to reapply sunblock every hour?
For as long as you are not allergic to any components of the sunblock, it should be okay but hourly reapplication sounds a little tedious.
6. What can you do to treat any existing pigmentation? Are there any home remedies?
I wouldn't suggest home remedies. Let's stick to those that have sufficient evidence in terms of safety and efficacy.
7. What about procedures we can try at a clinic?
Chemical peels containing trichloroacetic acid (TCA) or glycolic acid (AHA) are popular amongst patients. Intense Pulsed Light (IPL) and some lasers such as a fractionated CO2 and the Q-switched Nd:YAG lasers have been proven to be effective specially in combination with topical treatments.
8. Are there any ingredients we should look out for while looking for over-the-counter products?
There are many topical treatments that can help improve and even out the skin tone. Lightening agents such as hydroquinone, azeleic acid, kojic acid, niacinamide, and arbutin in combination with retinoic acid, glycolic acid, and adapalene have all been proven effective. It is important to see a dermatologist so that the right potency may be prescribed.
9. Can dark spots only happen on your face?
No. Definitely not. It can occur on any part of the body, most specially sun exposed areas like the neck, chest, nape, arms, and hands. It can also be seen in unexposed areas specially those due to post inflammatory hyperpigmenation.
10. Can pigmentation be a cause for alarm? Like a sign of a serious skin disease?
Melasma can be a sign of a thyroid problem. Some spots that may look like age spots or freckles may actually be suspicious moles that need to be checked.
Our guest editor for the month of February is Dr. Anna Palabyab-Rufino. This porcelain-skinned beauty is a board-certified dermatologist and a member of the Philippine Dermatological Society. You can find her working her magic at the Palabyab Skin Clinic, helping her patients attain the complexion of their dreams.