Limelight for Hyper pigmentation

Hyperpigmentation is characterized by a darkening of an area of skin caused by the overproduction of a pigment in the skin known as melanin. It is relatively common and usually harmless, but for cosmetic reasons, it is a nuisance to those who have it.
Hyperpigmentation is the result of either of two occurrences: (1) an abnormally high concentration of melanocytes produce melanin or (2) when melanocytes are hyperactive. For instance, sun exposure stimulates the production of melanin. Although it can affect anyone, this condition is more prevalent among certain ethnicities such as Asian, Mediterranean, African, or Latin. Hyperpigmentation can affect any part of the body including the face, hands, and neck.

The following are examples of hyperpigmentation: lentigo/lentigenes, pregnancy-induced melasma, stain, nevus, a tan, freckles, solar lentigos (i.e., sun spots, age spots) and under-eye dark circles.
• Lentigo/Lentigenes - Lentigo simply means one freckle; lentigenes are multiple freckles.
• Solar Lentigenes - widely known as ‘sun spots,’ ‘age spots’ and ‘liver spots,’ solar lentigenes are freckles caused by sun exposure.
• Melasma - Often known as the ‘pregnancy mask,’ melasma is caused by hormonal changes due to pregnancy and is characterized by splotchy, pigmented areas usually on the face (except the eye area).

There are various causes of hyperpigmentation, including
• Overexposure to the sun
• Heredity
• Picking at the skin
• Hormonal changes
• Certain medications such as antibiotics, hormone treatments, and anti-seizure drugs
• Inflammation and skin injuries such as acne vulgaris

There is no ‘cure’ for hyperpigmentation. There are, however, options to treat this condition by lightening the appearance of it.

Any area of the skin that is darker than the rest is potentially considered hyperpigmentation. It can occur on any area of your body (even the feet) but hyperpigmentation usually tends to appear on Sun exposed skin

Post Inflammatory Hyperpigmentation or PIH occurs after a pimple, burn, cut, abrasion or a minor injury, leaving a mark on the surface of the skin (epidermis) that is darker than the rest of the skin.

Sometimes it can be difficult to clearly distinguish between an acne scar and hyperpigmentation. However, some ‘acne scars’ are actually not true acne scars but rather a type of Post Inflammatory Hyperpigmentation. If a mark that has developed from an acne lesion does not heal and go away after 6-12 months, then chances are that particular mark is a true scar. In other words, if it’s a permanent mark, it’s a scar, but if it eventually fades away, it is only a type of Post Inflammatory Hyperpigmentation.

1) Wearing a sunscreen of at least SPF 20 daily and avoiding sun exposure is crucial in preventing hyperpigmentation.
2) Be mindful that discoloration is also in dead surface cells so it is imperative to exfoliate regularly to slough off the build-up, which will help minimize hyperpigmentation.
3) If you have dry, sensitive or mature skin, it is best to exfoliate 1-2 times a week. If you have combination to oily skin, exfoliating 2-3 times a week is recommended. However, facial scrubs should not be used on acne erupted skin as they are too abrasive and can worsen the condition. A mild exfoliant should be used containing glycolic or salicylic acid.

With a customized skin care regime, you can minimize the appearance of hyperpigmentation. In addition to using sunscreen, there are key ingredients to look for in skincare products that can help treat hyperpigmentation such as alpha hydroxy acids (AHAs). Examples of AHAs are glycolic and lactic acid. AHAs help remove the build-up of dead surface cells that are already stained with pigment, thus lessening discoloration. Other ingredients that are excellent for treating hyperpigmentation include Kojic Acid and vitamin C

Limelight treats benign pigmented lesions, sun and age spots, uneven skin tone and diffused redness. The visible light delivered by the Limelight is absorbed by the pigmented spots or redness in your skin. It can also treat widespread blotchiness, freckles, skin redness and individual fine veins. This treatment is sometimes referred to as photo-rejuvenation.

LimeLight uses light to heat the pigment in the top layer of your skin to reduce discoloration and promote a more even skin tone.

We can treat almost any part of your body with sunspots, freckles and/or redness. The most popular areas for treatment are the face, chest, shoulders, arms, hands and legs because they have suffered from the most sun exposure.

When the pulse of light is delivered, you may feel a mild, brief stinging sensation.

Immediately following the treatment, the sun spots may start to darken. You may notice a slight reddening of the surrounding skin. This typically subsides within a couple of hours. Over the course of the next one to three weeks, darkened spots will fade and flake off. If you have diffuse redness or the fine veins are treated, you may have some swelling for a few days after treatment. The blushing will gradually lighten over the treatment package.

Multiple treatments (Cutera does not specify how many treatments) are necessary to see results Additional treatments may be required for very large or dark spots or for densely covered areas. When you come in for your consultation, we will give you information tailored to your particular needs and desires.

Most will find that the majority of their treated spots have shown improvement within two to three weeks of treatment. However, your final result may not be apparent for several months.

Anyone with a light or medium colour skin may be a candidate for the LimeLight treatment. Darker skin tones are not suitable. We will assess your particular skin type and let you know if you're a candidate at the time of your consultation.

Ideally the treated hyper pigmented skin/ Sun Spots should darken within 2 – 3 days after the patch test, and shed/flake away over the following 2-3 weeks. The skin may be mildly red afterwards and have some puffiness for a few days. So essentially it can take 2-3 weeks to notice a difference. If this does not happen a second patch test is required on higher settings

Clients may require 2-3 patch tests, so that your laser operator can safely select the most effective treatment parameters for your hyper pigmentation. Client should give the clinic feedback on how well they responded to the patch test, so that settings can be adjusted for the next patch test. The clinic will only give a full Limelight treatment to clients that respond positively to the patch test. This also ensures you will have the least down time, by slowly choosing ideal treatment settings

• Any dark hair in the treatment area may be permanently reduced. (i.e. on arms, legs, beard). This hair must be shaved prior to your arrival at the clinic.
• Fake Tan must not be applied in the treatment area for at least 2 weeks prior to treatment.
• Moles cannot be treated.
• Cancerous skin lesions cannot be treated.
• Sun bathing or sun bed use is not permitted between treatments and will affect the clinical results if used after the treatment to the lesions
• Areas that have injectable dermal fillers should be avoided- as side effect is unknown.
• Clients must arrive to the clinic without make up on, for the treatment.
• Pregnant clients cannot be treated - Contraindication
• Dark skinned clients cannot be treated due to a high risk of unwanted alteration in pigment
• Clients taking anticoagulant medication (i.e. aspirin, warfarin) are at an increased risk of bruising.
• Clients taking Accutane medication (Acne medication) , must wait 6 months after ceasing taking it, before having the treatment.
• Clients on Gold Therapy pain injections – Limelight may cause blue/grey discoloration

• Avoid heat treatments for 48 hours afterwards i.e. steam room, sauna and hot showers.
• No make-up allowed for 48 hours afterwards, except mineral make up.
• A cold compress may be applied regularly afterwards to reduce any swelling or puffiness and will also reduce the heat from the skin. (ice packs can increase the amount of swelling)
• Apply Aloe Vera to the treated skin to sooth & calm it.
• Daily SPF is essential both winter & summer to reduce the possibility of additional pigment formation. The pigmentation/sun spots/freckles will darken shortly after the treatment, and should flake away within one – 2 weeks from the face, and 2 weeks on the body. In some cases, it may take longer for the darkened area to shed & flake away. The darkened area must be allowed to flake away by itself; exfoliation or scrubbing the area is not recommended. Intervals between treatments are usually monthly.
• Pigmentation can return very easily if you expose your treated area of skin to sunlight/daylight even if you do wear a daily sunscreen.
• In the unlikely event that a wound develops, a topical ointment is recommended. The goal with superficial burn wounds is to create a moist, clean environment that will optimize epithelialization.
• Use preventative skincare, ones that contain Tyrosinase inhibitors suppress the enzyme Tyrosine, that is required for pigment production) is helpful in suppressing the enzyme responsible for pigment production as well as wearing a sunscreen.
• Avoid using irritating products (i.e. depilatory cream, harsh chemicals i.e. Tretinoin, Retinol, Benzoyl Peroxide, Glycolic, salicylic acid, astringents) for 24 hours pre & post treatment.
• For clients having the treatment on areas that there is dark hair, the hair may be permanently reduced in the treatment area.
• Horizontal or vertical foot printing or striping is common (whereby the track or imprint of the rectangular treatment window may be evident after a treatment. This can be eradicated by using the opposite treatment plan than the previous one. (i.e. if the hand piece was used in a vertical mode on one treatment, it can be used on horizontal mode on the subsequent treatment.).
• Treated Lentigines (freckle type sun spots) will shed off the face within about one - 2 weeks and off the body in 2-3 weeks.

• Sun damage causes pigmentation problems in light skinned individuals. The main cause of dark spots in light-skinned individuals is sun damage. Years of sun exposure can result in spotted hyperpigmentation, a condition marked by increased pigment production that results in patchy skin colour or a blotchy complexion.
• The extent of sun damage depends largely on a person’s skin colour and his or her history of sun exposure. Hyper-Pigmentation may be superficial or deep.
• The more superficial the pigment is, the easier it is to treat.
• There are dermoscopy devices that are used to visualize deeper pigment and deeper pigment is coloured differently. Some clients respond instantly while others require multiple treatments.
• To treat pigmentation problems due to sun damage in light-skinned individuals, a choice of treatments ranging from chemical peels to Laser or IPL treatments can help.
• Daily sun protection with a sunscreen that provides broad-spectrum protection from UVA and UVB rays and has a Sun Protection Factor (SPF) of 30 or greater is essential in preventing further sun damage and resulting dark spots.

There is no cure for Hyper Pigmentation. Treatments may improve the appearance of it, but it will come back again due to both sun exposure, as well as the hyper pigmented skin cells rising to the surface of the skin over time