Pigmentation FAQs with Dr Gupta Specialist Dermatologist

1. What are the different types of pigmentation? Solar lentigines - liver spots Seborrhoeic keratosis- wisdom warts Mel...





1. What are the different types of pigmentation?

Solar lentigines - liver spots
Seborrhoeic keratosis- wisdom warts
Melasma - hormonal pigmentation
Pigmented pre-cancerous sun spots (actinic keratoses)



2. What are the factors that can cause pigmentation?

The common causes of skin pigmentation are: liver spots (solar lentigines) - from UV exposure especially UVA which comes through window glass, wisdom warts (seborrhoeic keratosis) - these are part of the aging process but can look sinister and have a multitude of appearances including ; flat, warty, raised, flesh-coloured and brown or black. Some people have hundreds and in this case there is usually a family history of these. I treat these very successfully with a single treatment of a spot resurfacing laser - like peeling off the skin of an onion.

Another possibility is melasma, an hormonal pigmentation on the face and finally pigmented pre-cancerous sun spots and also moles both benign and malignant.


3. Can developing pigmentation in the skin be completely prevented by wearing sunscreen or can you still develop pigmentation from not being in the sun?
It depends on the cause. There are some rare hormonal conditions eg Addison’s disease that cause non-sun related pigmentation, but to all intents and purposes, it’s from the sun in 99% of cases.

Best advice is strict sun protection- apply and remember to reapply regularly. This will prevent sun spots and liver spots but won't treat or remove what is already there.


4. What factor do you recommend using on the face and body? I have heard that SPF 30 is all you need on your face and that using SPF 50 is actually no better, is this true?
Not true. There isn’t much difference between SPF 30 and SPF 50 but the main issue is that to achieve that SPF, the correct amount must be applied. Most people don’t use enough. Ego make a chart showing a “fingertip unit” ie an easy way to measure how much sunscreen to use on each body part.

Sunscreen Tips (image via http://www.heraldsun.com.au/)

5. Do you recommend any other products to use to prevent developing pigmentation?
Some cosmeceuticals such as Aspect Dr that we stock do have brightening serums and creams that can help. Dermatological grade skin peels, such as those performed by our specialist nurses and medical assistants under our guidance, are even more beneficial. The best treatment is laser or BroadBand Light. At our practice, it is the dermatologist, ie myself, that treats the patient, tuning and fine-tuning the settings to achieve the best end result. And as a bonus - your skin is tighter and brighter too!


6. What Professional treatments would you recommend for treating the pigmentation and why? Are there any potential side effects? Does it hurt? How many treatments would you recommend?
Best treatment for liver spots (solar lentigines) is pigment laser or BroadBand Light. Spots are removed permanently and collagen remodelling also occurs, resulting in a smoother and less lined skin. Usually 2 treatments for Anglo- Saxons and 3-4 for darker skin types is recommended. The treatment feels like an elastic band snapping

Side effects if done by an experienced specialist, such as myself, are fortunately minimal - perhaps mild swelling in 10% of patients. Make-up can be worn afterwards so there really is no downtime

For wisdom warts, spot ablative laser as above is excellent. It requires a single treatment with no recurrence.

Melasma - laser and IPL is best AVOIDED and can be treated with prescription fading creams, tablets and skin care.

Pigmented sun spots (actinic keratoses) - need medical treatment as they are pre-cancerous and can turn into squamous cell cancers of the skin


7. What at home treatments would you recommend for treating the pigmentation and why? Is there any potential side effects? Does it hurt? How many treatments would you recommend?
Some superficial fading can be achieved with retinoids (Vitamin A) based products and for sun spots, again topical retinoids and salicylic acid can thin them down but won't remove them. They are precursors to squamous cell cancer, which can spread and even kill, so they must be treated properly.

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8. Are there any products that you would recommend to lighten the skin? 
See 5


9. Can you look at someones skin or test it to be able to tell if it will respond to a treatment and know the pigmentation will be removed completely or is there always a chance that you may permanently be left with visible pigmentation in the skin?
Usually with a dermatologist’s trained eye, I can estimate degree of clearance but some people may be more resistant but that is uncommon.


10. Are results permanent after treatment or can the pigmentation come back?
All depends on sun protection and sun avoidance habits- that’s where patient education comes in which is a big part of what I do in every consultation!


About Dr Ritu Gupta 

Dr Gupta is a specialist dermatologist with a broad range of skills encompassing medical, cosmetic and surgical dermatology. She has been awarded a PhD for groundbreaking research into Vitamin D and the skin. This research has been a springboard for other research and local and international journal articles based on her findings continue to be published. She is a Fellow of the Australasian College of Dermatologists and has received numerous awards locally and internationally both for research and for her performance in examinations and conference presentations. Dr Gupta’s special areas of interest are cosmetic dermatology, management of acne and scarring, skin cancer detection and treatment and medical and surgical dermatology. Her goal is to provide excellence in medical care combined with a caring and holistic approach to the patient and their healthcare. 


Specialist Female Dermatologists Leading The Way at Platinum Dermatology 

Specialist Dermatologists, Dr Ritu Gupta and Dr Jacqueline Matulich have joined forces to offer state-of-the-art skin and body treatments at their new purpose built practice, Platinum Dermatology Skin Specialists. 

The specialists at Platinum Dermatology offer the usual dermatological services as well as a broad range of innovative treatments including cosmetic injectables, laser skin resurfacing, chemical peels, skin tightening and other skin rejuvenation therapies. Both dermatologists believe in tailoring customised solutions for each individual patient’s skin needs. 

Dr Gupta and Dr Matulich also believe it is imperative to stay at the forefront of technology.

Located in Broadway locality, ten minutes walk from Central station and only one block away from the Broadway Shopping Centre, Platinum Dermatology offers easy and convenient access. 


For more information or to get in touch with Dr Gupta and Platinum Dermatology please see below:

Dr Ritu Gupta - Specialist Cosmetic and Medical Dermatologist. 
Platinum Dermatology Skin Specialists 
Phone: 8014 6500

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