Abnormality in pigment is one of the most common topics readers inquire about on BFT. Most frequently it has to do with hyperpigmentation that results from an inflammatory insult (PIH) or hormonal flux (melasma or “mask of pregnancy”), but many readers have sought information as to how they can lighten or “brighten” their general complexion.
This post provides information about new approaches to managing pigmentation issues, something your hosts have been working on for a considerable time. We will examine this work and the novel multi-prong approaches incorporated into these new and unique products.
For those who wish to learn the basics about pigment issues, we suggest you visit our earlier BFT blogs on the subject.
The management of aesthetically displeasing skin pigmentation is changing. To describe it, we must discuss work performed by the team at Cellese Regenerative Therapeutics over the past couple of years. Regular readers of BFT know that DrJohn and DrGeorge wear day hats as principals of Cellese.
Pigment Basics Revisited
Melanin is an evolutionary protective pigment whose skin function is as a barrier against ultraviolet (UV) solar radiation. All races have similar numbers of melanin producing cells located within the stratum basalis of the epidermis. Skin color differences result from the pigment content and characteristics of the melanosomes produced by the melanocytes.
Caucasian skin has the smallest amount of pigment and smallest melanosomes; darkly pigmented skin has larger, wider and denser melanosomes. Inflammation from any source, including damage from UV radiation, is a potent stimulus for increased melanin production. Darker Fitzpatrick skin types are more prone to develop aesthetically displeasing hyperpigmentation.
As a general rule, melanosomes produced by melanocytes are expelled and subsumed into nearby keratinocytes. The melanin-laden keratinocytes slowly migrate to the skin surface where they are eventually sloughed off, a process that takes four to six weeks.
Melanogenesis takes place within the melanosomes, catalyzed by the enzyme tyrosinase. Inhibitors of this enzyme have long been mainstay ingredients in depigmenting products, the most well-known of which is hydroquinone. This approach, however, addresses only one of the several processes involved in melanin production, deposition and disposal.
Differences Between Epidermal and Dermal Pigmentation
During embryogenesis, melanocytes are genetically programmed to eventually settle in the lowest region of the epidermis (basal layer), just above the dermal-epidermal junction that separates the epidermis from the dermis. Typically, about one in every ten cells in this layer is a melanocyte, with a ratio of one melanocyte to thirty keratinocytes, which is the predominant cell of the epidermis. Epidermal pigmentation occurs from keratinocyte uptake of melanosomes produced by melanocytes.
As melanocytes (actually the precursor cell, the melanoblast) transit the dermis to the epidermis, some may finally reside within the dermis. Epidermal and dermal melanocytes appear to be biologically different populations. Dermal and epidermal melanocytes participate differently in pigmented lesions. The table below describes the role each layer plays in specific pigmentation scenarios.
|Type of Pigmentation||Surface (i.e. Epidermal)||Deep (i.e. Dermal)|
|Brown birthmarks, café au lait spots||No||Yes|
|PIH from injuries (burns, cuts, abrasions, etc.)||Yes||Yes|
The illustration below demonstrates the pigment deposition patterns of common skin lesions.
It’s a fact of life that dermal pigment is more difficult to remove than epidermal pigment. Topical products are less able to penetrate to deeper skin layers, although microneedling can be of significant benefit. Pigmented spots that don’t readily respond to topical brightening treatments are likely to involve the dermis.
Multiple Pathways Involved in Melanin Production, Dispersal and Disposal
As was the case when we launched our hair growth products, we approached pigmentation from a deep-science perspective, knowing that melanogenesis is but one part of a complex multi-step pigmentation process. Several other pathways are involved. The steps below can each be addressed to reduce pigmentation.
- Inhibit tyrosinase activity and co-factors
- Promote tyrosinase degradation
- Down regulate gene expression that promotes melanogenesis
- Inhibit the pro-melanogenetic effects of UV
- Inhibit melanosome transfer from melanocyte to keratinocyte
- Increase exfoliation of pigmented keratinocytes
- Counter the inflammation stimulus of UV and other stresses
Your hosts have formulated products with active ingredients that influence each of these pathways. A daily-use topical product with all ingredients, and a microneedling solution with those that are physiologically compatible when used in conjunction with 1.0 mm medical needling. The products affect pathways involved in melanogenesis, keratinocyte melanin uptake and cellular exfoliation.
Active ingredients and mechanisms of action in daily-use topical:
Active Ingredients and mechanisms of action in microneedling topical:
Products were tested in a 90-day randomized study of thirty-one participants aged 30 to 70 years of age of both genders with Fitzpatrick skin types I to V. Using a zero to five-point scoring system, a skincare specialist analyzed before and after high-resolution photos with different wavelengths of light. Using the same scoring system, each participant also completed subjective questionnaires at the beginning and end of the trial. Photo analysis and questionnaires confirmed significant and safe brightening and improved appearance of undesired facial pigmentation, regardless of its cause. Participant satisfaction was extremely high. No adverse events were reported during the study.
Slow & Steady
Treatment of abnormalities of facial pigmentation requires a slow steady approach as overzealous treatment can have devastating consequences. As an example, experience with higher doses of hydroquinone has repeatedly shown it is possible to end up with pigment abnormalities that are significantly worse than the original problem. The most severe pigment problems occur in people with skin that is especially prone to darkening, higher Fitzpatrick skin types. Gradual cautious lightening is preferable to inadvertent injury that can be counterproductive and worsen the problem.
The products tested function to affect the seven pathways of skin pigmentation: -melanocyte stimulation and control, melanin synthesis and production, melanin uptake and dispersal, and cellular exfoliation – using multiple gentle yet effective physiologic “nudges.”
Additional information will soon be available at anteage.com.
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