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Différents types d'hyperpigmentation.

How to recognise the different types of pigmentation spots?

Due to hyperpigmentation or hypopigmentation, pigmented spots can appear on the skin of the face, hands, or other parts of the body. Although they are unsightly and difficult to conceal, they are mostly harmless. To identify them, a thorough diagnosis may be necessary.

What are pigmentation spots?

Melanin is a natural pigment found within the body. It determines the colour of our eyes, hair, and skin. In instances of melanin overproduction, brown, red, or pink spots may appear, impacting the uniformity of the skin tone. There are also instances where the amount of melanin produced by the body is insufficient. In such cases, this results in hypopigmentation, leading to the emergence of white spots. Pigmentation spots are thus the result of alterations to the normal colour of the skin. They can affect all skin types, but are frequently more visible in individuals with darker skin.

What are the different types of pigmented spots?

Depending on their origins, pigmented spots are classified into several categories:

  • Sun spots (lentigo or age spots), caused by prolonged and repeated exposure to the sun's UV rays.

    As a reminder, the production of melanin by melanocytes increases under the influence of UV rays and pigmentary anomalies can occur. They primarily appear on the most frequently exposed parts of the body (face but also the backs of hands, décolletage, back...). Be aware, the use of certain photosensitising medications can promote the occurrence of lentigines. Moreover, lentigo can also be caused byskin ageing. With age, the skin fails to fully protect itself from external aggressions and deteriorates. A dysfunction of the melanocytes is observed, associated with the exhaustion of their pigmentary potential at the level of the hair follicles. This phenomenon is attributed to the consequences of repeated attacks of reactive oxygen species (or free radicals) on the nuclei of the melanocytes and the mitochondria. When this happens, the skin becomes vulnerable to UV rays, which are responsible for pigment spots often referred to as "age spots". To prevent this, at any age, it is therefore essential to apply asun protection suited to one's skin tone before exposure to the sun.

  • Melasma, pigmentation spots caused by hormonal fluctuations.

    Also known as chloasma or melasma, these hyperpigmentation marks are caused by hormonal changes. They occur during pregnancy but also following the use of contraceptive pills or hormone replacement therapy. Indeed, hormones stimulate melanocytes, thus causing an overproduction of melanin. It's worth noting, pregnancy mask usually disappears after childbirth, although this can take some time. Moreover, this type of hyperpigmentation is not exclusive to women. According to the American Academy of Dermatology, 10% of melasma cases affect men.

  • Thepost-inflammatory hyperpigmentation.

    This refers toflat brown to black spots, depending on skin colour, that occur following a skin lesion or inflammation (acne flare-ups, burns, injuries, insect bites...). This post-inflammatory hyperpigmentation is due to an excessive production of melanin, a pigment present in the skin whose main function is to protect skin cells from UV rays. Indeed, during inflammation, pro-inflammatory cytokines will stimulate the activity of melanocytes (cells that produce melanin). This type of mark is more common in mixed to dark phototypes. To reduce them, it is recommended to apply daily treatments containing the following active ingredients: azelaic acid, arbutin acid, niacinamide, vitamin C, chemical exfoliants (AHA, BHA and PHA), retinoids. If this is not effective, certain procedures can be performed by a dermatologist: chemical peels, laser treatment, prescription of hydroquinone or even use of pulsed light.

Note : Pigment spots can also be ofgenetic origin like freckles,which appear at the time of birth. This phenomenon, usually associated with fair skin, poses no danger to the body.

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