Skin Discoloration

Skin spots or dyschromia are among the most common and widespread skin blemishes. The appearance of these pigmentations often causes discomfort, especially when they appear on visible and exposed areas such as the hands and face.

Dyschromia is a change in skin colour caused by an excess of melanin or, in some cases, by the deposition of other pigments in the epidermis. It can be localised in a specific area or more diffuse.

Not all skin spots are the same: each type has a different origin and depth, and not all discolorations share the same cause.

Classification of skin spots

Sun spots

These appear as irregular spots of variable size whose colour ranges from yellow to brown. They mainly develop on areas most exposed to sunlight and are caused by excessive sun exposure without adequate protection. They mostly affect people over the age of 45–50.

Age spots

Unlike sun spots, these are due to cumulative damage caused by sun exposure over time. They usually appear as brown macular lesions, generally about 1 cm in diameter, and are more common in men. The most frequently affected areas are the face and the back of the hands.

Melasma

Melasma, or chloasma, is linked to an irregular and intense accumulation of melanin, not accompanied by melanocyte proliferation but by overproduction of the pigment itself. Spots are often visible around the lips, nose, cheeks, chin, forehead and sometimes even on the neck.

Although the aetiology of melasma is still being investigated, the main causes include UV exposure and the use of oestrogens. The mechanism appears related to hormonal levels, especially 17-β-estradiol, which has been shown to significantly increase tyrosinase activity when added to melanocyte cultures.

Post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation appears as irregular darkly pigmented spots surrounding an area that was previously inflamed. It is common in darker phototypes and can occur on any body area. It may result from acne, eczema, folliculitis, burns, scars or treatments such as peels and lasers.

“Tanning-bed” lentigines

Unusual melanocytic lesions have often been reported after exposure to UV radiation from tanning beds. They may resemble solar lentigines, but histological analysis has revealed melanocytic hyperplasia. Patients with such lesions may therefore be at increased risk of skin cancer and should undergo regular dermatological checks.

Dark circles around the eyes

The cause of dark circles around the eyes is still not fully understood, although they are very common in both men and women. Many believe that the thinning of the skin in this area makes the underlying blood vessels more visible. Inflammation or vasodilation may also appear as darkening. Although many cosmetic companies promise improvement, the effectiveness of whitening agents for this indication remains questionable.

Prevention is better than cure…

There is no doubt that prevention is the most effective weapon against hyperpigmentation, especially sun-related discoloration and ageing-associated spots.

In these cases, using sunscreen products with UV filters and formulations containing high concentrations of antioxidant compounds can help prevent the appearance of spots.

UV filters

According to the Regulation, UV filters are substances intended exclusively or mainly to protect the skin from certain UV radiation by absorbing, reflecting or scattering UV rays. They can be broadly divided into chemical filters (organic) and physical screens (inorganic).

Chemical filters are molecules able to absorb UV radiation within a certain wavelength range by transitioning to an excited state. They can be divided into UVA, UVB and broad-spectrum filters. To guarantee proper protection, a product must absorb across the relevant wavelength interval.

Physical filters are inorganic molecules that provide a mechanical shielding effect against both UVA and UVB. They are generally less efficient than chemical filters but are not subject to degradation after sun exposure.

Antioxidants

Antioxidants are functional molecules widely used in cosmetics thanks to their ability to prevent damage caused by oxidative stress. They can help prevent pigmentation through anti-inflammatory mechanisms, since inflammatory phenomena are often followed by the formation of skin spots.

Which treatments are most effective for brightening the skin?

Exfoliating actives

The application of exfoliating actives causes partial or complete removal of portions of the epidermis, followed by stimulation of controlled regeneration. In the treatment of pigmentation-related blemishes, these agents are useful because they accelerate epidermal cell turnover, reduce melanosome transfer to keratinocytes and help improve the visible uniformity of skin colour.