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With the heated Summer sun now here, we wanted to understand the most common harmful effects from UVA/UVB rays, hyperpigmentation, so we sat down with Dr. Goldfaden to better understand hyperpigmentation, what causes it and how to treat it.

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Photo via Rodan & Fields 

Q: What is the cause of increased pigmentation and darkening of the skin, and what can I do for its prevention and management?

A: Dr. Goldfaden, MD: There are many possible causes of pigmentation disorders, which are marked by changes in melanin, the pigment in skin.

First, you should consult with your primary care physician or dermatologist to rule out the possibility of a systemic health disorder or a cancerous lesion that requires medical treatment. Your health care provider will conduct a physical examination, examining the location, distribution, color, and ap-pearance of the areas of increased pigmentation. Additionally, the practitioner will assess the history of the condition, which will help determine whether the disorder may be due to a developmentally programmed, congenital, or acquired cause.

Your practitioner will also evaluate whether external factors, such as medications, chemical exposure, or other environmental influences, could have contributed to the increased deposition of pigment in the skin. Furthermore, the practitioner will make note of any prior history of pigmentation disorder and its treatment.

The most common localized pigmentation disorder affecting the skin are ephelides, more commonly known as freckles. Ephelides appear as flat brown pigmentation in sun-exposed areas, usually on the face. They are much more common in fair-skinned individuals, and a propensity to have freckles is an inheritable condition. The degree of pigmentation in the skin changes according to the amount of ultraviolet light exposure, so that freckles usually darken in the summer and lighten in the winter.

Q: What are the causes? 

A: Dr. Goldfaden, MD

Pigmentation disorders such as melasma or chloasma arise from increased melanin in the lower layers of the skin and increased free melanin in the skin. The pigmentation is usually brown with a non-distinct border, and is usually found on the central facial areas such as the cheeks, moustache, and forehead areas. Melasma affects both men and women, though it is more frequent in women (up to 30% may be affected). Its incidence is much higher in Asian and darker-skinned individuals than in fair-skinned people. The causes are unknown, but probably include genetic predisposition, hormonal factors, pregnancy, and exposure to ultraviolet light.

Another very common skin disorder is known as post-inflammatory hyperpigmentation. The underlying mechanism is unclear, but may involve inflammatory mediators such as prostaglandins and leukotrienes. While the causes and clinical presentation of post-inflammatory hyperpigmentation can vary, they are usually secondary to a traumatic incident to the affected area of the skin. Sun exposure can worsen this condition.

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Q: What is the treatment protocol?

A: Dr. Goldfaden, MD

There is no true curative therapy for melasma. Affected individuals should avoid ultraviolet light exposure and drugs containing hormones, such as oral contraceptives and conventional hormone replacement therapy agents. Skin-bleaching agents are extremely helpful in lightening melasma and maintaining skin-lightening improvements.

Topical therapies in combination with sunscreens can be quite beneficial.

Exfoliation: For enhanced results, these products should be used in conjunction with exfoliation. Regular exfoliation (chemical or physical) removes the dead surface skin cells and allows the treatment ingredients to penetrate deeper and more effectively into the skin, providing enhanced overall results.

Treatment: Many all-natural, topical skin-lightening agents have been found to be quite beneficial in lightening hyperpigmented areas of the skin. These include alpha arbutin, as well as kojic acid, which comes from berries. Topical applications of natural, fruit-derived alpha-hydroxy acids, including glycolic acid, have been extremely beneficial in combination with the aforementioned naturally derived bleaching agents.

Sun Protection: Once your physician has ruled out conditions necessitating medical treatment, you may be able to minimize areas of hyperpigment-ation using a well-rounded approach that includes avoiding ultraviolet radiation from the sun, using an effective sunscreen throughout the day to stay protected and keep additional hyper pigmentation from forming.

Years of daily exposure to ultraviolet radiation from the sun take their toll on your skin. Sun-damaged skin becomes dry and rough, uneven patches and dark spots begin to appear, fine lines and wrinkles deepen, and your skin loses its firmness and elasticity. And, if you spent any part of your youth sunbathing you may find that your skin looks years older than you feel. Scientific research has led to the discovery of natural compounds that can help support the structure of skin as well as minimize signs of aging, such as crow’s feet, lines, sagging, and uneven tone. In addition to topical treatments and proper sun protection, many of these natural compounds come from the foods we eat.

Some examples are leafy green vegetables and cruciferous vegetables such as cabbage, kale, and broccoli, which provide many internal health benefits. What you may not know is that key phytonutrients in these vegetables can also visibly improve the health and appearance of your skin.

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Concentrated extracts from cruciferous vegetables like broccoli contain bioactive phytonutrients that can help to reverse and repair a lifetime of skin damage—revealing smoother, clearer, and more radiant skin.

Sun Exposure Accelerates Aging – What you need to know:

Time, gravity, heredity, and other environmental exposures all affect how skin ages, but the overwhelming majority of visible signs of aging are caused by exposure to ultraviolet radiation. Because the complex outer layer of our skin, the epidermis, is fully exposed to the external environment, it’s always under attack through dehydration, abrasion and most especially, ionizing damage from high-energy ultraviolet (UV) radiation.

Photoaged skin is prematurely lined, wrinkled and frequently has broken capillaries and irregular pigmentation. It loses its elasticity earlier than healthy aging skin.

Although precisely how ultraviolet radiation causes skin aging is not yet known, we do know that cumulative UV radiation increases production of free radicals, damaging DNA and the enzymes involved in DNA repair. UV radiation increases inflammation and damages collagen and elastin, the proteins that give skin its resilience. It also acts to suppress immune function in the skin.

Antioxidants join forces to combat aging:

Screen Shot 2015-04-01 at 11.05.06 AMAntioxidant rich green and red tea adds to the anti-aging and anti-inflammatory effects of sulforaphane and beta-carotene. Epigallocatechin-3-gallate is the principal antioxidant polyphenol in green and red tea and in addition to its antioxidant activity, it also demonstrates photoprotective, anti-inflammatory, and anti-angiogenic (inhibits the growth of new blood vessels) properties, which may help to reduce the appearance of small, dilated blood vessels around the nose, cheek, and chin. The polyphenols in green tea have also been shown to increase the tensile strength of skin and enhance wound healing. In combination, these potent antioxidants can not only improve skin health and reverse the signs of aging in photodamaged skin but also help to prevent future damage from free radicals and ultraviolet radiation.

“Using a daily anti-oxidant rich topical treatment is a must-have in any regimen as will help prevent against long term sun damage.” Dermatologist Dr. Gary Goldfaden MD

Proper Sun Protection:

With Spring just around the corner, practicing safe and proper sun protection is essential for keeping your skin burn free this coming Spring. While applying an SPF in the morning – whether it be in your foundation, moisturizer, or as a solid base, is just not enough to keep you protected throughout the day, especially for women who wear makeup and reapplication tends to get tricky.

Try our goto and favorite sun spray on the market, Sun Visor. oh, did we mention that the formula is oil-free, fragrance-free and can even be applied on top of makeup? Yes, you heard that right!

 

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Everyone regardless of skin tone needs to protect their skin against the sun. Although fair skinned individuals will burn quicker, darker/olive skin tones need to be aware too. It is important to keep in mind that sunscreen does not prevent tanning, it does however help protect against damaging UVA and UVB rays. This is important for darker/olive tones to remember, just because the skin is tanning does not mean it is not being damaged.  A tan in reality is the body’s reaction to sun damage. That gorgeous glow you’re hoping for is essentially your skin reacting to being attacked by damaging rays. When the skin is exposed to sun light the melanocytes in the body become activated and produce dark pigment to protect the skin from absorbing more rays. While SPF is a must it is only 1 of 3 lines of defense against the sun.

Glorious summer days can be spent at the beach or the pool without paying the hefty price of sun damage. Be careful not to overdo with your skincare regimen before your vacation or time spent at the beach. Do not over exfoliate or use acid based wipes or peels on the morning of a day when you know you’ll be in the sun. This is extremely important right after sun exposure. When considering how to protect yourself from the sun keep in mind that SPF is not enough. There are three crucial steps to protecting your skin. The best way is to avoid the sun altogether. Just being outdoors 4 times a month for 30 minute each can cause sun damage. While it is not feasible to always avoid the sun(and some may actually enjoy it), protective clothing and hats can help. Wearing a hat everyday along with the use of an SPF can cut down on sun exposure and damage not to mention keep your face looking young. If you are going to be outside in direct sun choose SPF protective clothing in addition to reapplying SPF every 30 minutes.

If you happen get sun burned there are many ways to treat this at home. Products that contain Organic Red Tea can be soothing and reduce inflammation and redness caused by the sun. To soothe hot itchy red skin add oatmeal or baking soda to a cool bath. Topical application of aloe or a cool compress always helps. If you are really sore or swollen you can try taking Ibuprofen for inflammation. And because the sun dries the skin out, moisturizing is a must! Body lotions with avocado oil, Shea butter, coconut oil are the best for this.

Enjoy the outdoors, just be smart about covering up! Happy Summer!