Pigmentation
At Shine MD, we understand that pigmentary conditions of the skin can cause a heavy burden for patients. Pigmentary conditions such as sun spots, melasma and post inflammatory hyperpigmentation can be intensely impactful of a patient’s quality of life and significantly affect day to day decisions.
Pigmentation is one of the most common conditions treated at Shine MD. Pigmentary conditions affect all skin types and are definitely more common in skin of color patients. Pigmentation can affect the face and body and lead to significant emotional distress.
Patients with ongoing pigmentary issues are likely to make social and work-related decisions that can impact their life trajectory. Based on this awareness, Dr. Khurana and the team at Shine MD have aimed to become a center of excellence for treating pigmentary conditions.
Our exemplary results and high patient satisfaction are attributed to the strategic integration of medical management and skin care protocols with the application of first in class technology.
Shine MD offers skin care treatments such as facials and chemical peels and a variety of laser treatments that can safely address different types of pigmentation, inclusive of even the darkest skin tones.
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What Causes Pigmentation?
Our skin gets its hue by a molecule called melanin. Melanin is produced and stored in specialized cells called melanocytes. Melanocytes can overproduce melanin, leading to splotches or patches of darker skin, called hyperpigmentation. While having pigmentation is completely normal, undesired or uneven pigmentation can be devastating for patients and lead to anxiety, depression and in extreme cases, social isolation.
Sun Spots and Sun Damage
Sunspots are one of the most common forms of uneven skin pigmentation that usually worsen as we get older due to the lifelong accumulation of sun exposure. Melanin protects our skin from the harmful UV rays of the sun, but prolonged sun exposure can still lead to sunburns and skin damage. As a result, our bodies accelerate the production of melanin, which may be highly concentrated in a specific area, forming sunspots. Sometimes, the sun damage can be broader and lead to more widespread pigmentation.
At Shine MD, there are various approaches to treatment of sun related pigmentation. In lighter skin types and patients without melasma, the Forever Young Broad Band Light (BBL) Laser is our first line treatment. Combination treatments of Forever Young BBL with either Halo or Moxi can augment pigment clearance and provide resurfacing of the skin, improving fine lines, wrinkles and acne scars. The PicoSure Pro is a powerful and highly effective technology that can target general pigmentation and improve sunspots while being safe for darker skin types and for patients with melasma and mixed hyperpigmentation.
With all patients, prevention of the recurrence requires judicious sun avoidance and sun protection and follow up maintenance treatments.
Post Inflammatory Hyperpigmentation
Post inflammatory hyperpigmentation (PIH) is caused by injury to the skin that can leave behind residual dark spots. Dark skin spots occur after the skin has experienced trauma, like acne lesions, injuries, or inflammatory skin conditions. The melanocytes in the skin are triggered by the trauma and produce melanin as a protective measure, leading to excess pigment. One of the most common causes of post-inflammatory pigmentation of the face and back is from acne. Sometimes skin rashes such as allergic reactions, dermatitis or eczema can cause pigmentation over large body areas. Injuries such as thermal burns or cuts and scrapes can cause increased pigmentation. Post inflammatory hyperpigmentation can also be an expected side effect of some skin lesion removals and laser treatments in skin of color patients. Patients with richly pigmented skin are more likely to be affected by PIH. Fortunately, PIH is a very treatable condition. Once the original causative factor is treated, ie, acne or dermatitis, the pigmentation can be treated with success. Depending on the cause of the post-inflammatory hyperpigmentation and other skin goals, your treatment plan can be tailored to include lasers such as Halo, Moxi, PicoSure Pro and Aerolase. At Shine MD, there are various approaches to treatment of sun related pigmentation. In lighter skin types and patients without melasma, the Forever Young Broad Band Light (BBL) Laser is our first line treatment. Combination treatments of Forever Young BBL with either Halo or Moxi can augment pigment clearance and provide resurfacing of the skin, improving fine lines, wrinkles and acne scars. The PicoSure Pro is a powerful and highly effective technology that can target general pigmentation and improve sunspots while being safe for darker skin types and for patients with melasma and mixed hyperpigmentation.
With all patients, prevention of the recurrence requires judicious sun avoidance and sun protection and follow up maintenance treatments.
Melasma
MelasmaThe inception of The Melasma Clinic at Shine MD demonstrates Dr. Khurana’s dedicated commitment to advocating for the treatment of this common, chronic and high impactful skin condition.
Melasma is a common skin condition that leads to patches of dark pigmentation on the skin. It affects women more commonly than men. It is often worsened by the birth control pill, during pregnancy and with sun exposure. Mixed hyperpigmentation describes a clinical scenario where there are a few causes of pigmentation and one of those can be caused by melasma. Sunscreen, sun protection, skin care, medical management and laser treatments are the cornerstones of treating melasma. The PicoSure Pro is our first line laser for treating melasma and is the only laser that has an official FDA indication for treating melasma. Aerolase and Moxi are also effective at treating certain types of melasma. Microneedling with platelet rich plasma, more commonly known as the Vampire Facial is also effective at treating pigmentation and comes with very little risk. Laser treatments and settings must be carefully chosen to maximize your outcomes and minimize the chance of making melasma worse.
It is important to note that melasma is a challenging condition to treat. There is no single cure for melasma. The goal of treating melasma is to minimize your pigmentation and improve your quality of life. Treatments are aimed at reducing pigmentation.
With all patients, prevention of the recurrence requires judicious sun avoidance and sun protection and follow up maintenance treatments.
Pigmented Skin Lesions
Pigmented Skin Lesions such as skin tags, dermatosis papulosa nigra and seborrheic keratoses can be very bothersome and highly impactful on a patient’s quality of life. The physicians at Shine MD can effectively remove pigmented lesions with electrocautery. This low intensity treatment gently removes the surface lesions with very little heat delivery to the tissue beneath, leaving behind smooth skin. In skin of color patients, the skin may develop some post inflammatory pigmentation that is then treated with skin care protocols and laser treatments based on your preference and the extent of the pigmentation.
Pigmented Skin Lesions For Face and Body
Uneven skin tone can be caused by many factors, which may determine what treatment option is best for you. During your consultation at Shine MD, one of our treatment providers will assess your skin and diagnose any underlying skin conditions. Depending on your skin type and the factors contributing to your concern, a treatment plan will be developed to optimize your results.
Pigmentation Treatment at Shine MD
Skin Care
Skin care products are particularly effective at lightening the skin and must be incorporated into all treatment plans aimed to target pigmentation. For sun spots, post inflammatory hyperpigmentation and melasma, the two most effective ingredients in skin care are hydroquinone and cysteamine (Sente). These products work as powerful inhibitors of pigment production and can be found in many lightening skin care products. The team will usually recommend a pre and post care routine containing hydroquinone or cysteamine (Sente) to ensure you have the best results possible from your laser treatment. Other products that improve pigment and suppress pigment formation are Kojic Acid, Retinol, Vitamin C, Azelaic Acid and Arbutin.
Sunscreen is a must for anyone undergoing treatments for pigment reduction. We carry a wide variety of sunscreens and carefully selected products that are suitable for darker skin types.
Laser
Shine MD offers a variety of laser-based treatments for uneven skin tone.
Sunspots in lighter skin patients are most effectively treated with Forever Young Broad Band Light (BBL) and can be combined with Halo or Moxi. PicoSure Pro is another ideal option for sun related pigmentation and will be highly effective for mixed pigmentation, darker skin types and patients with melasma.
Moxi provides a gentle resurfacing and improves the presence of sunspots, post inflammatory hyperpigmentation and some types of melasma.
Halo laser is ideal for patients with sunspots and post inflammatory hyperpigmentation who also want a textural improvement in fine lines, wrinkles and acne scarring. The dual wavelength function of the Halo laser, induces skin tightening and collagen production. For all of these reasons, the Halo is one of our most commonly performed treatments and in certain patient types combining this with Forever Young BBL yields outstanding results. The Halo laser will improve sun spots and PIH.
PicoSure Pro is our go to powerhouse for treating all skin types and all kinds of pigmentation, including melasma. It improves skin texture and induces collagen, has a low downtime and is an industry gold standard in treating pigmentation. This laser is known for treating all skin types effectively but stands out in its safety profile for skin of color and melasma. Large areas are easily treated.
The Aerolase is highly effective at treating post inflammatory hyperpigmentation on the face and large body areas. There is minimal pain, no downtime and it also effectively treats concurrent conditions such as rosacea, dermatitis, eczema and psoriasis that could be causing pigmentation to develop in the first place.
Microneedling with Platelet Rich Plasma (Vampire Facial) is another ideal alternative to the use of laser treatments. There is minimal chance of exacerbating melasma, there is low downtime and this can be done on all skin types. A research review article in 2021 published in the Journal of Dermatologic Therapy confirmed that PRP is a highly effective and safe treatment that has a low side effect profile and high patient satisfaction.
If you have made it to the bottom of this page, hopefully we have convinced you that we are experts in the treatment of pigmentation! We look forward to working with you to build a treatment plan that is highly effective and factors in your skin type and cause of pigmentation. We will also do our best to treat underlying skin conditions as one of the most important first steps to reaching your skin care goals.
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Before & After Gallery
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*Individual results may vary.