Theory of dark spots

Dark spots is the popular term that dermatologists refer to as "hyperpigmentation." As the name suggests, these are areas where the skin is darker – they appear where cells called "melanocytes" have produced more melanin (the pigment that determines skin color).

This is not a rare condition and can affect both men and women; people with light skin as well as those with darker skin.

Dr. Martina Yaneva helps us learn more about hyperpigmentation – in other words, to delve into the theory of dark spots!

What exactly causes their appearance?

Hyperpigmented spots can appear as a result of:

• Hormonal changes – the diagnosis "melasma" is most often made during pregnancy, when under the influence of hormones more pigment is produced and distributed unevenly in the skin. Such spots are most often noticed on the face – the so-called pregnancy mask.
• Sun exposure – this is the most common form of dark spots, also called "solar lentigo" (sun spots). The reason is clear – direct exposure to ultraviolet rays. Sun radiation stimulates melanocyte cells, and from the increased pigment production two things happen: the skin tans and melanin accumulates only in certain areas. Sun spots affect exposed parts of the body – face, hands, décolleté, mainly in people with light skin. They closely resemble freckles, but unlike them, they do not fade during winter.
• Inflammation – we talk about so-called "post-inflammatory hyperpigmentation" when spots appear in places where the skin has been injured or there has been an inflammatory process. Such spots occur after acne or burns.

Can we prevent the appearance of dark spots?

Since ultraviolet rays from the sun are the main factor in the appearance of hyperpigmentation, the first and foremost recommendation is to avoid prolonged sun exposure and possible sunburn.

Daily application of photoprotective cream with at least SPF 30 is another indispensable step both for prevention and treatment of dark spots.

What happens if we have already allowed spots to "decorate" our skin?

Let's admit it, we almost always reach this phase simply because prevention was neglected. And this is the moment when the dermatologist chooses one of the three main approaches to treat hyperpigmentation:

• Chemical peeling – involves the use of acids to exfoliate the upper skin layer and stimulate skin regeneration. Such peeling, combined with substances that suppress melanogenesis (increased melanin production), is the basis of dermatological depigmenting cosmetics like Melabel.
• Laser therapy – the principle of the therapeutic effect is the same as with the use of acids, with the difference that high-energy light beams are used, which penetrate to different depths in the skin.
• Hydroquinone – an organic compound, a derivative of benzene. Its use leads to skin lightening and reduction of melanin production. It is not suitable for prolonged use and treatment is carried out only under medical supervision.

In conclusion – what have we learned about dark spots:

The culprits for dark spots are known – the pigment melanin and ultraviolet rays from the sun.

Protection from direct exposure to sunlight is essential both for prevention and treatment of the spots.

Already appeared spots are treated with depigmenting products or device-based procedures – recommended after consultation with a dermatologist.

The effect occurs gradually and depends entirely on choosing the right approach and strict application of the selected products.

Dr. Martina Yaneva, dermatologist at EuroDerma Clinic.

Graduated from Medical University – Montpellier, France and Medical University – Sofia. Specialized in dermatology at the Clinic of Dermatology and Venereology at Acibadem City Clinic – Tokuda Hospital.

Member of the Bulgarian Medical Association, Bulgarian Dermatological Society, National Academy of Allergology and Clinical Immunology. Actively works in the field of dermoallergology and atopic dermatitis.