Dreaded pigmentation again - confused

Hi

I have posted previously about pigmentation, I know the topic has been covered a hell of a lot

I’m just after some opinions

I stopped electrolysis on my upper lip but will be starting again, now I know once trauma to the area stops the pigmentation can heal, however I have done nothing in terms of hair removal and still the area darkens, obviously by sun exposure but I’m not in a position where I can completely avoid sun exposure

I religiously use a physical suncream, burnout but this doesn’t help, it still gets darker

Is there Anything else I can do to prevent it getting darker

I am also concerned that once I do finish treatment I’ll be in battle forever trying to deal with the pigmentation, it’s currently at its worst and people look there when they talk to me so I know it’s got worse

For Many avoiding the sun is not an option so how will it ever go

I heard of one ladies story, hers has nearly completely gone but she wears a plaster with vinyl underneath it to avoid the sun on her upper lip, her derm said it was the safest option, this is definitely not an option for me

I’m at a loss, any opinions? Thank you

Well I wont be able to tell you much you probably dont know already.
Hyperpigmentation can take a year and a half or more to diminish. Sun, while perhaps unavoidable for you, wont help decrease that time frame but could serve to lengthen it especially if you get burnt.Wide brimmed hats help:)

Seana

Hi

Thanks Seana for your response

I guess time will tell how it heals

Look at the following ingredients - decide which you want to use.
Many warn against some of the ingredients that prevent melanin from being produced as skin cancer is a concern. Natural or synthetic, there are potential risks from either.

Keep in mind that new skin cells are being produced - replacing the older skin cells at the surface of your skin - these newer skin cells will most likely be your lighter pigment. So, if you only use a physical sunblock, repeat every few hours if you are out in the sun, you won’t need any of the following:

Melanogenesis Inhibitors Appropriate for Darker-Skinned Clients
Arbutin—A potent antioxidant that is found naturally in cranberries, wheat, pears, and blueberry and bearberry leaves, arbutin is thought to be less cytotoxic than hydroquinone. It inhibits the activity of tyrosinase, inhibits melanosome maturation and converts to hydroquinone in the skin, allowing for a controlled release, resulting in less irritation than hydroquinone.

Azelaic acid—Naturally sourced from cultures of Pityrosporum ovale, grain products, castor beans or by the oxygenation of oleic acid, found in milk, azelaic acid has an antiproliferative and cytotoxic effect on melanocytes while sparing surrounding healthy cells. It also inhibits tyrosinase activity, DNA synthesis and mitochondrial activity.

Hydroquinone—Hydroquinone is typically engineered in a lab, but can be found naturally in wheat, berries, coffee and tea. It works by inhibiting DNA and RNA synthesis, suppressing the binding of copper and tyrosinase, decreasing the formation of melanosomes, increasing the degradation of melanosomes and inducing melanocyte-specific cytotoxicity.

Kojic acid—Derived from rice, soy and mushrooms, kojic acid may cause irritation in some skin types, although less frequently than with hydroquinone. It inhibits melanogenesis by chelating the copper bound to tyrosinase, rendering it useless. It also decreases the number of melanosomes and dendrites, and is useful in treating hyperpigmentation due to its ability to inhibit nuclear factor-kappa B (NF-kB) activation in keratinocytes, mitigating inflammatory response.

L-ascorbic acid (vitamin C)—Derived from many botanical sources such as citrus fruit and corn, L-ascorbic acid is an anti-inflammatory and antioxidant agent that stimulates collagen production and converts dopaquinone back to L-DOPA, preventing melanin formation.

Lactic acid—Derived from sour milk and sugars, lactic acid works as a moisturizer and antimicrobial agent. It increases the exfoliation of melanin-filled keratinocytes and suppresses the formation of tyrosinase.

Licorice extract—Licorice extract can be naturally derived or engineered. It inhibits tyrosinase activity of melanocytes without cytotoxicity, UV-B–induced hyperpigmentation and erythema, and has strong anti-inflammatory properties.

Morus bombycis root extract (mulberry)—A potent antioxidant and anti-inflammatory agent that inhibits the L-DOPA oxidase activity of tyrosinase, studies show a 50% reduction in tyrosinase activity following an application of Morus bombycis root extract.3

Phenylethyl resorcinol—An engineered resorcinol derivative, phenylethyl resorcinol is an antioxidant that has demonstrated results comparable to kojic acid and hydroquinone without any potential for topical irritation. It works by inhibiting the conversion of tyrosinase to L-DOPA.

Retinoids (vitamin A)—Retinoids stimulate collagen, elastin and glycosaminoglycan production and inhibit tyrosinase activity, decrease the amount of melanosomes produced, inhibit the transfer of melanin from melanocytes to keratinocytes, and enhance the penetration of actives through the stratum corneum.

Undecylenoyl phenylalanine—Another engineered ingredient, undecylenoyl phenylalanine prevents the synthesis the melanocyte-stimulating hormone (MSH).

Curious Arlene, you’ve mentined Castor beans as a source of Azelaic acid. How do they mange to filter out the ricin, which is a deadly toxin?

Seana

If you want to go into depth to do the research regarding how ricin is removed, that would be interesting, you can let us know.

Even still, many ingredients and products are not without risk. Too bad most of us only know the obvious ones - tobacco and alcohol - yet so many still smoke and drink.

In any event, my clients who are concerned about hyperpigmentation use ice immediately after treatment. They use a physical sunblock, wear wide brimmed hats, use lactic acid in their cleansers and exfoliants. This is my suggestion. If this is not suitable, there are many choices, some with more or less risk.

All the best.

Hi Arlene

Thanks very much for your response

I am currently using rosehip oil at night, i am nervous about other products but may venture there

I’ve made my own vit c serum but didn’t try it long enough, will persevere with it

If anyone has success stories in ridding pih I would love to hear them, just need a boost right now

Thank you all again :slight_smile:

A couple of your sentences indicate that you don’t have a reasonable understanding of PIH. These are:

“ … [I know that] once trauma to the area stops, the pigmentation can HEAL.” (PIH is not a matter of “healing.” PIH itself if not an injury.)

“ … [I fear that] once I do finish treatment I’ll be in the battle FOREVER trying to deal with the pigmentation.” (This statement got my attention.)

Flowers, take a bit more time and read through the many explanations of pigmentation caused by electrolysis located on this site.

My next question is this: When you put something on your skin, what mechanism do you think the product is using to “heal” the pigmentation? If the product does reduce the PIH, by what means is this happening? (In your understanding.)

Example: I went to a seminar for “Nerium” (rip-off new skin cream). The presenter said, “The cream removes deep wrinkles.” I asked, “What’s the bio-chemical mechanism that accomplishes this?”

The presenter said (I kid you not): “Oh, the bio-chemical mechanism is … you rub it on your face, and the wrinkles disappear!”

I want to know what’s happening BETWEEN the “rub it on” and the “wrinkles disappears” part … and, that’s my question. (If you understand what the product is doing, you can use it more effectively and have realistic expectations?)

Actually, there are (serious) medications that will stop the PIH cold … you don’t want to use these because they will stop the healing process too.

Yep, there are enough questions about this subject that a definitive “paper” needs to be written for the public … including a list of good products and how to use them! A full explanation is long overdue. (I’ll start talking to Dr. C next week? Gotta get the facts right.)

My PIH is still around at a little over 4 months.

I’ve seen some improvement, but taken as a whole, it doesn’t look much different.

There’s a lot of snake-oil salesmen out there who advertise hyperpigmentation products.

If there’s some miracle cream out there, we’d all know about it. It would sell itself.

The gold standard is Retin-A. Hydroquinone works too but you can’t use it for longer than X amount of months (I forget how many). It can actually cause more pigmentation problems if used in excess (and I believe in darker skin tones there’s a darkening-condition associated with excessive use).

If you can get some Retin-A, that’s what I would recommend. It’s safe to use. I’d check how long people recommend using it before taking a break.

I can’t tell if it’s working for me, but I think you have to invest in the long-term recovery.

So it’s difficult for me to say, but for example on me the mosquito bites took about 7 months to completely disappear on my legs (and i’m unsure of this vs the face in terms of recovery time) but i invested in a good, gentle skin care routine.

I have dry, dehydrated skin and the thing i’ve consistently used is rose hip oil, every day for the past year. (it is good source of a different form of vitamin A).
I also use, very gentle exfoliating acids (i stayed away from manual or chemical exfoliation when doing electrolysis) eg. lactic acid, glycolic acid, tartaric acid etc and a very hydrating moisturiser (the oil helps in this regard as well).

Retin-A is very, VERY strong stuff. A general physician/hospital doctor cannot prescribe this - only a dermatologist can in the UK as they have to personally assess the level of damage and degree of reversibility against the very substantial and dangerous side-effects. The healthcare system in the USA is very different and I can only (grossly generalising of course) assume private medical practitioners make it easier to access such drugs, but please I would ask for two things before anyone decided to do this- patience and a very clear understanding of what it is you are about to do to your entire body with something like Retin-A.
Retin-A works, that is a fact, but the risk of suicide, foetal abnormalities, liver dysfunction etc are also very real.

According to my electrologist, who thought I had very bad pitting and pigmentation on my face when she first saw me, things have healed remarkably well in the past year and I have no reason to suspect it won’t continue to do so in the next year. I used to have to use foundation on my face to even it out but have been able to go without for the past 3-4 months as it has improved so well. wishes she had a better camera for better pictures.

I think you may be confusing Retin-A with Accutane?

“Retin-A works, that is a fact, but the risk of suicide, foetal abnormalities, liver dysfunction etc are also very real.”

Sounds more like “Accutane?”

Yes, you are right, Mike.

They have similar generic names and can be easily confused. Retin A is a topical that you put on your skin and Accutane is a more powerful retinoid, that you take internally with a pill. Both are related to Vitamin A, but it is the Accutane that can cause the serious side effects, so one has to weigh the benefits and risks of taking Accutane.

One or two short term courses with Accutane and acne can be cured.

With the topical Retin A, it can be used long term.

I just asked a family physician that I know well if he prescribes it and he said he doesn’t like to do that anymore - he leaves that to the dermatologists, but he could prescribe it as long as he registers with the company that makes it and registers the patient taking the drug, as well.

Hi Michael

Thanks for your email

Yes I am confused about pigmentation

Let me explain a bit more how this all started, last year after returning from holiday I noticed my upper lip was darker, I was on the pill so put it down to this and threading

I saw a derm who believed that it was from hair removal and that when I stopped removing hair the pigmentation would fade, over a long period though

I started electrolysis however I noticed a lot of prolonged swelling so I stopped, I then bleached the hair but believe this burnt my skin resulting in more darkness, so now I am going back to electrolysis to hopefully finish what I started

As many have done I read a lot of peoples experiences on the net, some who got terrible pigmentation and it is there years later, the only way to get rid of it is complete sun avoidance, this is fine in the winter but obviously not I the summer where the skin gets darker again, this is where I refer to my constant battle, if I don’t avoid sun how will this pigmentation go

I’m hoping the products will help to lighten the pigmentation, whether they help shed the skin so new skin appears, I don know really how they work, I wanted to use kojic acid but then read that this has side effects even though it is suppose to be natural so I’m not sure what to use if anything, I’m not expecting quick results but you read so many reviews which state pigmentation starts to fade in weeks and even days

I won’t use harsh products on my face

I would love to hear what your doctor says Michael, please please please

Hi Summercrush

Thanks for your response

Do you use rh oil at night only? I’ve read not to use in the day because of the vit a content? I too have very dehydrated skin, especially round the mouth where I am constantly applying zinc suncream, I have been searching for a decent moisturiser for ages, currently trying vit e cream but I’m sure this has made some areas darker

What do you use in the day and what mild exfoliant do you use please?

Addressing the dehydrated skin is so key, I’ve used countless products that either don’t moisturise enough or break me out, I’m at a loss on what to use

Thanks

Yes, of course it’s the oral version of retin a I was referring to, silly me forgot to make the distinction. It’s just that often people seem to want to jump from the topical to oral equivalent and that would be (as Michael in his wisdom has pointed out) accutane (or roaccutane as it’s known in the uk).
I’m glad that the dermatologist only prescribing might not be limited to the uk. General physicians really cannot know (as they haven’t received appropriate training or real life clinical experience) to assess whether the acne and skin damage have left scarring levels appropriate enough to warrant the risk of taking the drug.

Again, just to re-iterate, I am not against it (at all), friends of mine have used and it has unequivocally done the job. It just needs to be administered and monitored appropriately.

Side note: please don’t consume large oral doses of vitamin a either in an attempt to get the same effect (some young teen did this a few years back). it eventually will have the same effect as the pro-form and isomer e.g. hepatitis etc.

Flowers, I again stupidly forgot to mention the other main product (I don’t consider it skincare for some bizarre reason) was SPF. good quality, photostable, UVA included. I live in the UK and wear some everyday. It’s my ‘splurge’ product I suppose. It will do more than anything to prevent and help damaged skin heal.
I work indoors so that helps too. i will PM you some products I use as i don’t want to start sounding like an advert on here.

Thanks Summercrush

I’m in the uk too, yes please let me know what products you use and ur rosehip routine

I even find rh is not moisturising enough

Retin-A route alone would be a long process: many months to see results. I’ve read couple of sources from MDs describing combination of Pulsed Dye Lasers and glycolic peels for red mark PIH or Q switched ND:Yag laser treatments for brown mark PIH. My aunt had PIH on her neck and was treated in two sessions with TCA peels successfully.