Pigmentation and brightening

Pigmentation is an umbrella term for a large number of disorders.

Probably the most common pigmentation concerns which we see in day to day events include:

1. Melasma or blemishes
2. Periorbital pigmentation or dark circles
3. Pigmentation around the mouth and dark lips
4. Pigmentation post acne
5. Pigmentation of the underarms and / or intimate areas

1. Melasma – Also known as the “mask of pregnancy” as it occurs commonly after pregnancy or otherwise, typically induced by UV light under a hormonal undercurrent. A long standing, pigmentation usually present on the cheeks, brownish in color and seen commonly in women. It is symmetrical on both sides of the face and at times also covering the nose and the center of the face along with skin next to the eyebrows.
   Melasma requires strict photoprotection with a barrier restoring, broad spectrum sunscreen with an SPF of at least 50. A tinted sunscreen further helps. Skin lightening agents such as topical hydroquinone, tretinoin, kojic acid, silymarin, glycolic acid help. Consult a certified dermatologist for treating melasma. 
2. Dark circles – do you look tired ? sad ? not fresh ? These are common complaints of anyone suffering from dark undereye circles. Dark circles may or may not be associated with structural defects such as a deep eye socket, a tight ligament around the eye, thin skin and / or eye bags or puffiness.
   Things which can help are certain home remedies such as cold tea bags, cold cucumber and / or sliced potato applied to the area, which provided a soothing benefit to the area. Improved habits such as decreased smoking and decreased alcohol intake, better hydration and good sleep help to enhance circulation and nourishment of nutrients to the periorbital area.  are retinol based eye creams albeit applied cautiously under supervision and certain non-retinol based formulations with peptides, caffeine, silymarin etc. Moreover, since many are associated with structural defects, procedural intervention in the form of fillers, microneedling, chemical peels, lasers and / or surgery in the form of a blepharoplasty after consult with your dermatologist can help.
3. Pigmentation around the mouth and dark lips – pigmentation around the mouth maybe associated with:

• Sun exposure: The skin produces melanin to protect itself from UV rays, but this can lead to tanning.
• Hormonal changes: Hormonal imbalances can cause hyperpigmentation.
• Genetics: Pigmentation is more common in darker skin types.
• Medications: Some medications can cause hyperpigmentation.
• Nutritional deficiencies: Vitamin deficiencies can cause hyperpigmentation.
• Skin injuries: Skin injuries can cause hyperpigmentation.
• Medical conditions: Addison's disease and other metabolic disorders can cause hyperpigmentation.

While this sort of pigmentation is typically not harmful, it can be frustrating for the individual and can cause self-consciousness. 

Treatments include: 

• While not standardized, some home remedies one can try include applying aloe vera gel, lemon juice, or face masks made from gram flour, tomato juice, or citric acid. 

• Over-the-counter creams: There are many skin lightening creams that can help reduce hyperpigmentation

• Medically prescribed ointments: Medcial therapy can help improve peri-oral pigmentation Typical ones which may help include the use of hydroquinone, kojic acid, silymarin etc under your dermatologists supervision.

• Procedural intervention in the form of mild chemical peels, laser toning and microneedling may help in. enhancing the appearance of these areas and providing them a more even tone.