What is Skin Pigmentation?

Skin pigmentation is any condition that causes darkening of a general or specific areas of skin. This can range from birthmarks that are found from a young age, to age spots that develop when older.

There is a specific type of pigment found in our skin called Melanin. Parts of our body such as our hair, eyes, skin color are all determined by the Melanin content inside them. When melanin production in our skin becomes altered, it might cause pigmentary conditions. In general, people who have fairer skin tend to have a lower melanin content in their skin, while people who have darker skin tend to produce more melanin. This is why pigmentary conditions tend to be more common, harder to treat, and also more recurrent in darker skin individuals.

With pigmentation treatment, it is usually important to rule out dangerous skin conditions before starting treatment, specifically melanoma which is a cancerous condition.

Skin pigmentation conditions include:

This surface layer (epidermal) pigmentation problem usually presents as spotted discrete brown marks in the mid-face areas. Usually extremely easy to remove with very little risk and with minimal recurrence. Can take as little as 1 session for removal.


Melasma presents as symmetrical, patchy and unevenly pigmented patches that can happen on the whole face, most commonly over the mid face, but also in the lower face and forehead areas. This condition is extremely common in Asian skin types and can be very difficult to treat without the proper knowledge and expertise (especially melasma around the eyes – periorbital melasma). Many experts will tell you that there can only be mild improvement when you develop this chronic disease, but the truth is there can be substantial improvement and even a cure with a precise approach.


Age spots
Otherwise known as lentigenes (plural of lentigo), they happen with aging and sun exposure. These are quite similar to freckles but usually deeper and harder to remove completely. More treatments may be required to remove completely.


Acne and PIH marks
This epidermal and dermal pigmentation (both surface and deep) can occur after any type of skin damage, and it is known as post-inflammatory pigmentation (PIH). Acne-induced PIH is one of the most common types of pigmentation. PIH usually will fade with time, but can take extremely long in some individuals. The good news is there are simple treatment methods that can remove them efficiently. Certain lasers also have the benefit of treating and preventing acne, hence avoiding the PIH altogether.


Cafe-Au-Lait macules
These are light coffee coloured birthmarks that can occur on the face or different parts of the body. Treatment of choice is with lasers and complete removal is possible, but with some risk of recurrence.


Nevus of Ota and Nevus of Hori
These conditions are dermal (deeper) pigmentary conditions, and can be congenital or acquired. These dermal melanocytotic usually require more sessions of therapy to achieve good clearance. Hori’s nevus in particular can occur in conjunction with other pigmentation types, and if not careful, the treatment of one condition may worsen the other.

A melanoma is the most dangerous type of skin cancer that develops from melanocytes and is usually caused by UV light in those with strong genetic predisposition. Diagnosis is through a proper consultation and skin biopsy, and treatment involves surgery to remove it entirely. In the later stages of the disease, it may spread throughout the body (metastasis) and may require chemotherapy or radiation therapy.


Various Evidence Based Options

Never start pigmentation treatment without a proper medical examination to rule out dangerous or cancerous skin disease. Treatment with good skincare, topical and oral medication and medical peels are all age-old proven therapies for many types of pigmentation. More recently, lasers are proving to be the mainstay of pigmentation treatment based on the direct targeting of diseased pigmentation cells with various lasers. Various lasers help target different types of pigmentation more effectively.

The Veritas Method

Pigmentation needs to be first ASSESSED ACCURATELY and diagnosed properly before treatment. Without the proper tools and assessment, this step is frequently ignored with people seeking the hype of laser treatments. Proper photo-documentation is proper medical record taking for pigmentation problems.

If treatment is deemed to be suitable, it should be approached holistically, with proper preparation, adjuncts and post care if necessary.

Veritas developed the BLEND and PERFECT laser protocols which was designed for efficient and multi-layered treatment of complex pigmentary conditions (especially more complex in Asian skin types). The intricacies are about achieving the correct combination, at the correct individual setting.

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