AskID: IPL

We asked Prof Niki Ralph:
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‘Pigmentation of the skin normally varies according to racial origin and the amount of sun exposure. There are 6 Fitzpatrick phototypes (skin types ranging from the most fair, type I to the darkest, type VI). Pigmentation disorders are often more troublesome in skin of colour.
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The pigment cells or melanocytes are located at the base of the epidermis and produce the protein melanin. Melanin is carried by keratinocytes to the skin surface.
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The melanocytes of dark-skinned people produce more melanin than those of people with fair skin. More melanin is produced when the skin is injured, for example following exposure to ultraviolet radiation. The melanisation process in dark skin is protective against sun damage, but melanisation in white skin (for example after sunburn) is much less protective.
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Localised facial pigmentation is much more common compared with generalised pigmentation which can be seen in certain underlying illnesses.
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Causes of localised pigmentation include:
- Benign pigmented lesions such as lentigines (freckles), solar lentigoes (sun-induced lesions which occur with age), seborrhoiec keratosis and naevi (moles).
- Post-inflammatory hyperpigmentation due to previous injury/trauma to the skin or prior inflammatory skin condition such as dermatitis/eczema, previous skin infection.
- Melasma which is most commonly noted on the face around the eyes and above the upper lip. Melasma may be exacerbated by hormones such as during pregnancy, taking oral contraceptives and of course is more obvious as the Summer progresses due to UV exposure.
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IPL is not the ideal treatment for melasma therefore if you suspect you might have melasma you should discuss a course of treatment with your Dermatologist.
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Melasma is a commonly acquired skin disorder which presents as bilateral, blotchy brown pigmentation. It is also known as the “mask of pregnancy."

‘Treating this type of pigmentation with IPL can actually make it worse, especially in certain skin types (skin type III and darker). Therefore, it is vital you have an appropriate skin care routine to treat melasma firstly and then only potentially add IPL in certain individuals.
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You must use a physical/mineral sunscreen on a daily basis, preferably tinted such as @eltamdskincare UV Clear tinted or @revisionskincare Intellishade.
Addition of Hydroquinone 4% twice daily to the affected areas, over a period of months will reduce the pigmentation. Some individuals may benefit from addition of IPL once the pigmentation is significantly reduced.
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IPL (Intense Pulse Light) for pigmentation correction effectively fades and removes age spots/sunspots and discolouration to greatly improve overall skin tone, texture and radiance/skin uniformity.
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If you are undergoing a course of IPL it is ideally performed during the Winter months. IPL is performed at a minimum of every 4 weeks and a course of 4 treatments is recommended. It is important that during IPL and for post treatment maintenance, that a physical/tinted SPF is used daily. If you don’t continue to use a physical SPF daily, the benefits from IPL will be lost over time.’