Generally, skin colour is the result of the combination of various pigments (melanins) made by cells called melanocytes.
Under the action of the sun’s ultraviolet (UV) rays, melanocytes produce a lot of melanin, which leads to an increase in skin pigmentation and the creation of a uniform tan that naturally protects the skin.
However, pigmentation abnormalities can appear in the form of hyperpigmentation brown spots mainly caused by prolonged and repeated exposure to UV rays, resulting in excess melanin production. They are generally benign but do not hesitate to have them examined by a specialist.
There are several types of hyperpigmentation
These are round, light brown spots. They can be born or appear after a certain age, due to repeated sun exposure, in Caucasian subjects. They are called “age spots” or “sun spots” and appear on the neck, décolleté, face and hands.
Chloasma, melasma or pregnancy mask
These are irregularly contoured stains. They are due to an excess of melanin production associated with hormonal imbalances. The latter are observed in certain particular situations, such as pregnancy or taking contraceptive pills.
These bilateral and symmetrical spots, which give a mask-like appearance, appear on the cheeks, cheekbones, forehead and upper lip.
Only epidermal melasma can be treated. There is no effective curative treatment for dermal melasma. In pregnant women, the treatment will only be applied after childbirth and once the breastfeeding period is over.
Ephelides or freckles
They are hereditary and can become more pronounced in the sun.
Often congenital, they are flat or slightly raised spots of varying size and shape that can develop into cancer (malignant melanoma), which is why they should be monitored.
Special case: actinic keratosis
Actinic or solar keratosis is not a pigment spot but a small raised lesion (red spot, small crust) surrounded by brown spots. An actinic keratosis that bleeds, changes in appearance, itches or becomes painful must be examined as it is considered a precancerous lesion. It occurs on sun-exposed areas of the face, back, hands, forearms, ears, on the scalp of bald people and on women’s legs. Their size is usually very small, a few millimetres at the most.
These hyperpigmentations can be particularly ugly and may motivate some people to resort to cosmetic medical care (peeling, laser) and/or the use of depigmenting creams that can slow down the production of melanin.
Treatment of brown spots :
Brown spots have been treated for a long time by cryotherapy, which sometimes leaves white marks on the skin, as the cells making the skin pigment are very sensitive to cold.
by intense pulsed light (IPL)
Laser or pulsed light is a very good solution for epidermal melasma since it destroys the melanocytes by photo-thermolysis and thus gradually reduces the spots without damaging the skin.
by depigmenting peeling
The depigmenting peel treats the superficial part of the middle dermis. It is very effective if the skin is well prepared with depigmenting creams, to prevent the appearance of new spots, and if it is protected from the sun before and after the peel.
A very effective complement: photomodulation by LED lamp.
It is an ideal complement to peeling, laser and intense pulsed light by acting on the skin texture and the inflammatory nature of certain skins.
Course of treatment and precautions to be taken
It will take 2 to 3 sessions spaced 6 weeks apart to remove the majorité́ brown spots. Some will never completely disappear. Scabs will appear in the days following the session and will last about a week. They should not be torn off but a healing and moisturizing cream should be applied.
It is conseillé́ to use creams that will act on the pigmentation, some will reduce the synthesis of melanin (hypopigmenting creams) thus limiting the appearance of new spots, others will lighten existing spots (depigmenting creams). These creams will complement and prolong the effects of the treatments performed.
Sun creams should be used every day during sunny periods, even during occasional exposure (walking, drinking on a terrace, etc.).