Dear Doctor
I have a problem on my face side and neck which is very black. How to remove? What cream and soap to use daily for face. My weight is 90 kg and height is 175 cm.
Dear Patient
Uneven Skin Tone Causes
Uneven skin tone, which is also known as uneven skin pigmentation, is a condition in which the skin has different colors.
Melanin is the natural pigment that is responsible for the skin’s color. It is produced by cells in the skin known as melanocytes. In most circumstances, unevenness in skin color is the result of excessive production of melanin.
This excessive production of melanin can be caused by:
UV Exposure
Ultraviolet (UV) light from the sun results in an increased production of melanocytes and thus melanin in an attempt to protect the skin from damage by the sun.
Skin Injury
Injury to the skin by burns or diseases like acne can result in an exaggerated response by the melanocytes which leads to increased melanin in the skin. This causes what is known as post inflammatory hyperpigmentation.
Hormonal Fluctuations
Hormonal fluctuations can cause melanocytes to increase their production of melanin. These hormonal fluctuations can be caused by pregnancy or using oral contraceptives (birth control pills). Melasma, which is also known as the mask of pregnancy, is an example of uneven skin tone or pigmentation caused by hormonal fluctuations.
Uneven Skin Tone Treatments
The at home treatment for uneven skin tone which uses over the counter products includes using:
Sunscreen
Broad spectrum sunscreens which offer protection against UVA and UVB and that have a sun protection factor (SPF) of at least 30 should be applied every day.
Wide brimmed sun hats should be worn when out in the sun preferably with large UV 400 sunglasses.
Skin Brighteners
The dark patches can be lightened by using skin brighteners or skin lighteners. Examples of skin brighteners include:
a. Vitamin C or ascorbic acid which is found in products like Olay Total Effects tone correcting night moisturizer and LumiEssence Organic Brightening Treatment. It is also found in Palmer’s Skin Success Fade Cream which also contains the skin bleach hydroquinone.
b. Vitamin B3 or niacinamide is another skin brightener used to reduce hyperpigmentation. It is found in products like Olay Total Effects tone correcting night moisturizer.
c. Kojic acid which is derived from fungi and is found in products like LumiEssence Organic Brightening Treatment. It may however act as a skin irritant.
d. Arbutin which is derived from bearberry and is found in products like LumiEssence Organic Brightening Treatment.
e. Vitamin E It is found in products like Olay Total Effects tone correcting night moisturizer.
f. N-acetyl glucosamine is another skin brightener used to reduce hyperpigmentation. It is found in products like Olay Total Effects tone correcting night moisturizer.
Retinols
Retinols have a lower concentration of retinoic acid and thus can be purchased over the counter without a prescription. Retinols are found in products like the Dark Spot Corrector Kit and Neutrogena dark spot corrector. Retinols should be used together with broad spectrum sunscreens. Pregnant and breastfeeding women should avoid using retinols.
Hydroquinone
Hydroquinone is a skin bleach which reduces melanin formation by interfering with the activity of the enzyme known as tyrosinase. Its use must be combined with the daily application of a broad spectrum sunscreen on top of it since exposure to the sun reverses its effects and causes repigmentation.
Hydroquinone is available over the counter at concentrations of 1% and 2% in products like Ambi Fade Cream with 2% hydroquinone. 2% Hydroquinone is also found in the Alpha Hydrox Spot Light Targeted Skin Lightener which also contains 10% Glycolic acid. 2% Hydroquinone is also found in Palmer’s Skin Success Fade Cream which also contains vitamin C.
Mild Chemical Peels
Chemical peels help to remove the superficial darkened layer of the skin. They also stimulate the production of new skin cells with a more even tone and youthful appearance. Mild or superficial peels can be done at home. These include alpha hydroxy acids (AHAs) like 30% Glycolic acid peels and lactic acid as well as the beta hydroxyl acid (BHA) salicylic acid. For example a person can begin with a 10% Salicylic Acid peel like the one from ASDM Beverly Hills and gradually move onto to stronger ones like the 20% Salicylic Acid gel peel.
Camouflage Cosmetics
Camouflage cosmetics can be used to cover up the discolored patches of skin. Cover-up makeup usually comes as sets which include concealing creams and setting powder. Examples include the Smart Cover-up Starter Kit and Dermablend Cover Cream.
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