Skin Explained: Pigmentation and Dark Spots Dark marks and pigmentation, known dermatologically as hyper-pigmentation, can affect all of us. It tends to occur more in those of us who are older, have naturally darker skin tones or have suffered skin lesions and abrasions (such as acne). This is due to a lifetime of sun damage in ageing and/or the fact that the more pigment producing cells you have working, the more chance there is for them to go a bit wonky in those with darker skin tones. What is it Dark spots / dark marks / hyper=pigmentation aren’t freckles or moles, nor do they really look like them. They’re sort of blotchy, patchy and uneven. The photo below shows an example of pretty common hyper-pigmentation of someone who is older (image source): A word of warning If the dark spot looks particularly dark or the texture of the skin has slightly changed, don’t even take a beat before contacting your GP for an appointment. Melanomas and skin cancers are one of the most violent types of cancer so if there’s any doubt, you can make a big difference by getting things checked out earlier. It’s better to be safe than sorry. Why it happens When our skin is damaged by the sun, cells in the base of our skin called melanocytes activate. These cells produce a gooey brown substance called melanin. Melanin acts as an umbrella, in an attempt to shield the skin from any further UV damage – this reaction is what is being referred by tanning; you’re skin is desperately trying to protect itself. This reaction can also occur when the skin is left vulnerable through cuts, grazes and scars, which is why a many people who recover from cystic acne are often left with dark marks in their resulting scars. Sometimes however, once these cells are activated, they don’t fully shut off and certain areas of them can keep producing melanin. This could be because they’ve been re-written due to damage (often UVA sun damage) or simply a genetic abnormality. As mentioned, certain races and skin colours are more prone to these abnormalities. How to treat it Skin Care vs. The Dermatologist Once these cells have decided they’re not shutting down and are continuing to produce melanin, presently, there is no way to prevent them. Whatever anyone tells you, you can’t. I promise you. Skin lightening creams and Hydroquinone There are highly potent prescription products such as hydroquinone that can be prescribed by your doctor or dermatologist. These essentially break down the melanin colour in the skin by preventing them forming (inhibiting the melanin producing enzymes). These treatments can and often do cause a lot of trauma to the skin and can be more detrimental in the long run. Also bear in mind that after discontinuing use, the discolouration will return; only on rare occasions will the results be permanent. Many illegally available skin lightening creams use hydroquinone as a base – this is unregulated and most often untested so steer clear. Skin care alternatives Skin care products that by definition (and legislation) can’t reach the basal cell layers, work by exfoliating the top layers of the skin away. As melanin gets further and further to the top of the skin and becomes more exposed to oxygen, it gets darker and darker. Therefore if the top layers are safely removed, the discolouration appears lighter. The colour purple Skin care products often also use light reflectors and colour correctors (usually purple) to temporarily brighten and mask the colour of dark spots. Even though their effects are temporary, they can often be very effective. Exfoliation I’ve touched on exfoliation above, but by using regular gentle chemical and or manual exfoliation (beaded and grained) you can make a real difference to the appearance of dark marks / dark spots / hyper-pigmentation. This is only a temporary solution and if you discontinue it, you’ll notice the marks will come back. However, by removing those oxidised layers of melanin containing surface skin cells, the darkest form of melanin, you’ll not only reduce their appearance, but smooth out the skin’s texture allowing light to reflect more evenly and give the appearance of a brighter, fresher, lifted and more radiant complexion. Fake Don’t Bake As I’ve already mentioned, the majority of dark marks / dark spots / hyper-pigmentation on the skin are the direct result of sun damage, either from a lifetime of sun exposure or a few cases or very acute over-exposure. Wherever you can see without the use of artificial lights, there’s skin damaging solar radiation (UVA and UVB), even when it’s cloudy. Therefore always be sure to wear at least an SPF15 all year round, but at least an SPF30 on days with stronger sun. Solariums and Sun Beds Why these aren’t illegal, I have no idea. Constant, acute UV radiation exposure has a strong and direct link to skin melanomas. Skin cancer is one of the hardest cancers to treat as the cancerous cells can spread so easily throughout your entire body. If you use sun beds, even if only infrequently, you are dramatically increasing your risk of dark marks / dark spots / hyper-pigmentation as well as cancer. The frighteningly real risks of something worse Skin cancer rates in the UK have increased seven-fold since 1975 and its prevalence is increasing. 37 people are diagnosed with skin cancer in the UK every single day yet 86% of cases were preventable. It could and very much can happen to you; no one is immune. Wear an SPF.