The ESK blog
Where have all these sunspots come from? Decoding menopausal pigmentation
19 August 2024
Dr Anne Thomson
Where have all these sunspots come from? Decoding menopausal pigmentation
Noticing some new sunspots and wondering where they came from? Let’s decode menopausal pigmentation and figure out what’s going on with your skin.
The Role of Oestrogen
Oestrogen, our trusty hormone that does so much, also plays a role in pigment production. During menopause, oestrogen levels drop and cause pigmentation. Bear with me while I explain this. I know what you’re thinking; oestrogen increases pigmentation! That’s why we get melasma when we’re pregnant or even just from taking the pill. And yet, studies show that almost 10% of melasma starts after menopause. The theories are two fold:
- Most pigmentation is due to general sun damage to the skin. And menopause turbocharges skin aging. So if we treat your general skin aging we can combat your pigmentation at the same time.
- Pigment becomes more prominent in patches while other parts of the skin produce less pigment making the pigmentation appear more blotchy.
The Mystery of Mottled Pigmentation
As we get older, especially around menopause, our skin can start to show signs of pigmentation changes. This mottled pigmentation can show up as uneven patches of colour on your skin, making it look a bit like a patchwork quilt.
Solar Lentigines: The Fancy Name for Sunspots
These benign, pigmented, sometimes irregular flat spots sit on chronically sun-exposed bits of your skin. They are also called solar lentigos, age spots or liver spots (even though they have absolutely nothing to do with the liver!). They’re all caused by long-term sun exposure. Think of them as little reminders of all those sunny days spent outside.
When to Worry About a Dark Spot
Most of the time, these spots are harmless, but it’s good to keep an eye on them. Here’s when you should check in with a dermatologist:
Changes in Size or Shape: If a spot starts to grow or change shape, it’s worth getting it checked.
We recommend the ABCDE technique for checking your own skin:
Asymmetry. The two halves of the spot are completely different from each other.
Borders. Irregular Borders: If the edges of the spot are uneven or blurry.
Colour. Multiple Colours: Spots that are more than one colour can be a red flag.
Diameter. Spots that are more than 6mm across are more suspicious.
Evolving. Spot changing? Get it checked!
If you have any of these or any itching or bleeding, or if it becomes tender please get it checked by a doctor.
Keeping Your Skin Happy
An ounce of prevention is worth a pound of cure! Protecting your skin from further sun damage is key. Here are a few tips:
- Use Sunscreen: Every day, even if it’s cloudy. Look for broad-spectrum protection.
Zinc Shade is a lightweight matte day cream and primer. Its non-greasy, matte finish allows for smooth application and works well under makeup. We spent countless iterations perfecting this lightweight, non-greasy formula to avoid the typical white cast and thick feel of zinc products. The results? A matte finish that works beautifully under makeup. With well tolerated matte finish, it's also well suited to irritable and blemish and bump prone skin. With SPF 15 it also provides broad-spectrum sun protection against UVA and UVB rays. Key features: Lightweight, matte formula suitable for daily use Smooth application with minimal white cast Broad-spectrum UV protection Tested SPF 15 with enhanced UVA coverage Usage: Apply evenly to all exposed areas of skin before sun exposure. Reapply as needed throughout the day.
Zinc Shade
- Wear Protective Clothing: Hats, sunglasses, and long sleeves can help shield your skin.
- Seek Shade: Especially between 10 am and 2 pm when the sun is strongest.
Treating pigmentation around menopause
The buzzword here is tyrosinase inhibitors, which turn off the enzyme that helps create pigmentation. But relying on one product alone isn’t enough. Most guidelines suggest a combination approach because there are several other steps on the road to pigmentation we can also target directly such as:
- blocking the transfer of the pigment melanin into the keratinocytes (skin cells)
- boosting the process by which melanin is flushed out of the skin cells
So, here are my top 4 ingredients to fight pigmentation:
- 4-N-butylresorcinol (4NB)
If you’re dealing with pigmentation, a tyrosinase inhibitor is a must because tyrosinase is crucial for melanin formation. Studies show that 4NB is the most potent inhibitor of human tyrosinase out there. It’s shown fantastic results at just 0.1% twice daily or 0.3% once daily in 8 weeks. How effective? A whopping 84% of people see a significant reduction in their pigmentation, even when used alone. It’s well-tolerated and can be used long-term.
Enlighten is specifically designed to help reduce the appearance of pigmentation. This lightweight cream helps to gently create a more even skin tone and hydrate and improve the barrier function of the skin. While rarely used, 4-n-butylresorcinol (4nB) has some of the best evidence in this arena. Enlighten combines 4nB and Niacinamide (Vitamin B3) to create a rare combination of gentle yet effective ingredients. Enlighten helps tackle a mottled or uneven skin tone and is suitable for long term daily use
Enlighten
Featuring:
- Niacinamide
Niacinamide tackles pigmentation in two powerful ways. First, it reduces the transfer of melanin from melanocytes (melanin-producing cells) to keratinocytes (skin cells) by 35-68%, and it can reduce pigmentation in just 4 weeks. PLUS, pigmented areas are drier with more transepidermal water loss and impaired skin barrier function than unpigmented skin. Ensuring your skin barrier is in top shape helps, and niacinamide boosts the skin’s water content.
B Calm is formulated to support irritable and blemish prone skin while maintaining a healthy skin barrier. Ceramides strengthen resilience, Salicylic Acid exfoliates and calms the skin, and Niacinamide helps regulate oil and reduce the appearance of blemished skin.
B Calm
Featuring:
- Ingredients to support an improved skin barrier
- Helps manage excess oil production
- Supports a clearer-looking skin
- Retinal (the ultimate form of vitamin A)
Vitamin A fights pigmentation through multiple mechanisms: it combats oxidative stress, reduces melanosome transfer from melanocyte to keratinocyte, and most importantly, increases keratinocyte turnover, flushing excess pigment out of the skin. It’s usually paired with a tyrosinase inhibitor for the best results. I recommend retinal (retinaldehyde) because it’s the most effective and best-tolerated form of vitamin A, being 20 times more powerful than retinol.
Ultimate A Night Cream contains 0.06% Retinal, the most gentle and effective form of Vitamin A, paired with Niacinamide to help maintain skin barrier function and support brighter, firmer and more even looking skin tone and texture. Well suited even for the most irritable skin. Usage: Apply at night after cleansing (and serum if being used) as part of your evening skincare routine.
Ultimate A
Key features:
- Vitamin C
Vitamin C is a powerhouse when it comes to skin brightening. It works by inhibiting tyrosinase and thereby reducing melanin production. Additionally, it has antioxidant properties that protect your skin from UV damage, which can exacerbate pigmentation. Regular use of vitamin C can lead to a more even and radiant complexion.
C Forte Morning Serum is packed with 16% L-ascorbic acid, the purest form of Vitamin C, combined with vitamin E and ferulic acid for maximum results. Vitamin C (Ascorbic Acid) is an anti-oxidant helping neutralise free radicals (associated with exposure to the sun). The result? A brighter, firmer, plumper looking skin with fewer fine lines apparent and a more even skin tone. Formulated at the ideal pH (2.5-3.5) and housed in airless, opaque packaging, C Forte ensures stability and effectiveness, delivering radiant skin with every use.
C Forte
Featuring;
- Evidence based ingredients and formulations for superior efficacy.
- Potent skin brightening ingredients
- A plumper, more hydrated and even toned skin.
Note: C Forte can exacerbate acne and may be too strong for irritable skin.
So, mix and match these ingredients for a comprehensive approach to managing pigmentation. And always remember to consult with a skincare professional to tailor the right routine for your skin needs!
Abnormal pigmentation around the time of menopause is a common part of aging, but with a bit of care, you can keep your skin looking its best. And remember, if anything seems off, it’s always a good idea to get it checked out.
Stay sun-safe and keep glowing!
