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Interview with dr. Drenski about about pigmentation spots
Hello Dr. Drenski! Would you like to present yourself to the readers of Baroness site?
Yes of course. My name is Svetozar Drenski and I am a dermatologist with 25 years of practice. After specialization of 3 years I began private practice that continues till today.
Could you tell us about pigmentation spots?
Pigmentation spots (dark spots or hyperpigmentations) are brown lesions on the skin of the face and hands, and much less on the body. Their color is due to increased melanin deposition. When the melanin is deposed in the epidermis, the spots are epidermal and in the dermis – dermal. There are also mixed of them. According to latest studies, every second woman after 40 years has different form of hyperpigmentations.
What are the most frequent dark spots?
Melasma (or mask of pregnancy) is on the first place
Also lentigo senilis(or liver spots),
Lentigo solaris (after long sun exposure),
Freckles,
Post inflamatory hyperpigmenations (PIH) etc.
Tell us more about melasma!
Melasma causes patches of hyperpigmentation. The patches are darker than typical skin color. It typically occurs on the face and is symmetrical. Other areas of your body that are often exposed to sun can also develop melasma.
The most common cause is the pregnancy (after 6-th month, when levels of estrogen and progesterone are very high), but also anemia, oral contraceptives, tetracyclines, and some cosmetic products (containing essential oils, psoralens, etc.). .
Melasma is more common in brunettes and became more visible in the summer (due to strong solar radiation).
It should not be forgotten that this disease can be a symptom of liver disease or malignancy!
What are the characteristics of other pigmentation spots?
Liver spots is a benign pigmented lesions that occurs in individuals over 55-60 years. They are on more exposed areas of the face and back of the hands. The main reason for their appearance – chronic and prolonged sun exposure. I have had patients (sailors, agricultural workers) who have liver spots at 40 years old.
PIH appears after acne, herpes, and other viral diseases of the skin. Usually they disappear within a few weeks.
What about freckles?
Most important for them to know is that they are inherited genetically in families with blond or red hair. They appear after the first prolonged sun exposure on the face and neck. There are no larger than 2-5 mm in diameter and have an oval shape.
It is important to note that because of their genetic origin, freckles removed very difficult and slow!
What is the treatment of pigmentation spots?
The target of treatment is lightening and elimination of dark spots. The most important is to find the root cause and possibly eliminate it! I always tell my patients that the best time for depigmentation begins in fall or winter. And they have to be prepared using sunscreens every day, for months and years!
And so, the treatment of dark spots includes various depigmenting creams, serums and masks, peelings with various acids, microdermabrasion, lasers etc.
Can you tell us more details to about depigmenting creams and serums?
Of course. The creams contain mainly:
- “Tyrosinase inhibitors” (major enzyme involved in the formation of melanin) – hydroquinone (prohibited in EU) and its derivatives, kojic acid, arbutin and etc.
- Exfoliating (peeling substances) – Vit. C, glycolic acid, azelaic acid etc. They “remove” overload of melanin.
These products are applied 1-2 times daily (serum only in the evening), the skin must be perfectly clean. Their application should be at least 15-20 min. before any other skin care (hydration, photoprotection, makeup, etc.).
I want to say a few words about hydroquinone…
…it is a kind of phenol and is one of the most effective bleaching ingredients. It is used in a concentration up to 2% and rarely up to 4%. Especially popular in the USA, Latin America, Asia and the Middle East. In the European Union is prohibited by Directive 76/768, and also in Japan and Australia. This is due to the many side effects – allergies, photosensitivity, suppression of immunity. There is a very dangerous depigmentation ”type confetti”, due to hydroquinone. It causes at patients applying a product with hydroquinone on the face and after that they receive a permanent depigmentation (like vitiligo) on their hands!
Is it really so important to use sunscreens during the treatment of dark spots?
Yes of course. I would say it is very important!
Patients who are not willing to use sunscreen for a long period, it is better for them to not begin this therapy! The problem is that it is proven the existence of “cellular melanocytic memory!” That means these parts of the body where melanocytes were producing more melanin will do it again. Naturally, when there are an appropriate stimulation – f. ex. Sun. The treatment of hyperpigmentation is slow and very long (sometimes takes months)! And then if they stay in the sun (without sunscreen) for a few hours, everything starts again!
What are the most effective depigmentation products?
Almost all companies have quality products for depigmentation. But in my opinion, the most effective are the products NEOTONE of ISISPHARMA, FRANCE. This range includes 2 products – NEOTONE serum and NEOTONE RADIANCE 50+ cream. Serum contains 6 active ingredients. Three of them are active keratolytic (glycolic, ascorbic acid and salicylic acid), which peel previously accumulated melanin. The other three (lumiskin, alpha-arbutin and licorice extract) inhibit tyrosinase and formation of melanin. NEOTONE serum is applied in the evening on the desired areas.
NEOTONE RADIANCE 50+ cream contains several active ingredients. Vit.C acts exfoliation of already established melanin. The other two (lumiskin and bi-white), inhibit tyrosinase and thus prevent the formation of new dark spots. This cream contains UVB / UVA filters with a SPF of 50+, and applied throughout the day on the desired areas.
Both products are very safe! They are free of hydroquinone, kojic acid and paraben!
Dr. Drenski, thank you for all this information. What will we discuss in our next publication?
I propose to comment vitiligo, which affects 1-2% of the total population in the world.
Do not hesitate to ask questions to Dr. Drenski that are associated with this publications!
