What gives our skin its colour is melanin, produced by cells in the skin called melanocytes. In some genetically predisposed people, sun exposure increases the amount of melanin in certain areas and pigmentation spots form.

The sun is the biggest factor in the formation of pigmentation. Hormonal causes such as pregnancy and birth control pills, ageing, use of medication, and other causes that irritate the skin such as waxing, scratching and plucking combine with the sun to cause pigmentation. In addition, some people have a genetic predisposition. In genetically predisposed people, the sun causes pigmentation.

Where does pigmentation occur most?
Pigmentation can be seen on any part of the body with certain diseases and with advancing age, especially in areas where the skin is sensitive and has the most contact with the sun and chemicals. The hands, due to contact with the sun and chemicals, and the face and neck, due to high sun exposure, are the areas where pigmentation is most commonly seen.

How can pigmentation be prevented?
Try to avoid direct exposure to sunlight as much as possible, and always use sun protection. Another cause of pigmentation is going out in the sun after irritating procedures such as waxing. Do not use irritating hair removal methods such as waxing, threading or tweezing on areas exposed to the sun. If you have done so, try to protect yourself from the sun.

Types of Acquired Skin Pigmentation

Melasma
These are dark or light brown patches that can appear on the cheeks, forehead, upper lip and chin. They darken in summer and lighten in winter. Melasma-type sun spots occur more often in people with darker skin.

Sun spots are more common in people who spent time in the sun in childhood or youth. They can be seen particularly during pregnancy and in those using hormone medication or birth control pills.

Patients with melasma-type sun spots should use broad-spectrum sun protection continuously and stay away from artificial light sources such as solariums.

Melasma is more common in women than in men. On the face it is often bilateral and symmetrical. Histologically, sun spots are divided into superficial, deep and mixed types. Superficial sun spots respond better to treatment.

Solutions for sun spots / melasma
* Laser treatments
* Lightening creams
* Chemical peeling and enzymatic peeling
* Mesotherapy – PRP

Post-inflammatory Hyperpigmentation
Post-inflammatory hyperpigmentation refers to pigmentation that develops as a result of skin damage or inflammation, that is, due to trauma such as irritating the skin by removing hair with waxing, threading or tweezing, scratching or picking the skin, and also due to conditions that irritate the skin such as eczema and acne.

Solar Lentigo
Popularly known as sun spots or age spots. They occur in fair-skinned people with long-term sun exposure. Occupational groups who worked outdoors for long hours in their youth, such as farmers, sailors and construction workers, are at risk. Despite the name "age spot", they can also develop in young people. In particular, sunburns that follow uncontrolled sunbathing in summer heal by forming this type of spot. Fair-skinned, blonde people whose skin pigments easily should not expose themselves to the sun unprotected for long periods.
Freckles
They usually appear around the age of three. They are hereditary (autosomal dominant inheritance). They darken in summer and fade in winter. In blondes, fair-skinned people and redheads they form on the nose, cheeks and forearms. They are only an aesthetic problem. Treatment options for those who wish to get rid of their freckles include laser, chemical peeling and lightening creams.

Congenital Pigmentation

Naevus of Ota
Naevus of Ota is a type of benign mole that appears on the face as a blue, green, grey or brown patch, on one or both sides, and often also involves the eye. It can appear at birth or during adolescence. Its cause is unknown. Naevus of Ota is very common in Japan and Far Eastern countries. Although Naevus of Ota is a benign formation, it rarely carries a risk of developing the skin cancer called malignant melanoma.

How is Naevus of Ota treated?
Naevus of Ota is treated for cosmetic purposes. Apart from lasers, there is no effective treatment for Naevus of Ota.

Naevus of Ito
These are blue-black lesions located on the back and shoulder. Localised patches observed at birth or a few months later are not significant unless they are numerous. However, if they are numerous they should be evaluated for neurofibromatosis.

Areas of Application of Pigmentation Treatment
* Sun spots
* Melasma (mask of pregnancy)
* Ephelides (freckles)
* Lentigines (age spots)
* Post-inflammatory hyperpigmentation (pigmentation resulting from skin injuries)
* Acne marks

Methods Used in Pigmentation Treatment

* Enzyme Peeling – Pigmentation Treatment with Cosmelan
* Pigmentation Treatment with Chemical Peeling
* Pigmentation Treatment with Dermaroller
* Pigmentation Treatment with PRP
* Pigmentation Treatment with Fractional CO2 Laser
* Pigmentation Treatment with Nd-YAG Laser