Sometimes called age spots, or liver spots, these tend to occur on the face and hands, but also on the scalp, neck and chest - basically anywhere that gets a lot of exposure to sunlight. They’re part of the same bundle of age-related delights that includes melasma, also known as “pregnancy mask”, which can be caused by certain types of medication, but also by hormonal fluctuations. Irregular pigmentation can also occur as a result of acne scarring, especially if you get large and angry blemishes.
Essentially, squiffy melanin. Sun, hormones, skin ageing and genetics can all affect the normal production of melanin, changing the amount of pigment produced and also how and where it is distributed. The result is an uneven skin tone, with pockets of melanin collecting accumulating where they should not. You will notice, for example, that children have virtually no skin pigmentation: this is because they are young, and the top layer of the epidermis has not yet been sullied by environmental factors. As we get older, however, and the skin defends itself against the elements, this changes. The top layer of the skin becomes mottled and uneven, leading to a more aged appearance. In fact, when people say they look old, it is this uneven pigmentation that is often to blame, and not wrinkles, which everyone obsesses about.
Better to prevent rather than cure. You can avoid pigmentation (or at least minimise it) in the first place by taking care to protect the hands and face from excessive sunlight. Given the current epidemic of vitamin D deficiency, it is important to get some sunshine. But if you sunbathe a lot without adequate protection, you are storing up trouble for later. Many of the pigmentation problems that women suffer from in their forties are the result of over-exposure in their twenties. That said, it is never too late to start, and some pigmentation, especially the type that is hormonal, will get worse in the sun. It is especially important for pregnant women to use a sunscreen, as melanin production can really go into overdrive during pregnancy.
The market is currently awash with products claiming to fade pigmentation. Whether they work will depend on a) what has caused the pigmentation in the first place and b) how rigorous you are about application. There is no point in using any of these products if you are not prepared to also use a sunscreen during the day, since the pigmentation will simply come back if exposed to UV rays. New to the market is Creme de La Mer’s Blanc de la Mer Brightening Collection (www.cremedelamer.co.uk, or call 0870 034 2566 for stockists). This was initially developed for the lucrative Asian market, where a porcelain complexion is considered highly desirable. There are three products in the range, designed to be used together for maximum efficacy: The Lotion Intense (£65), the Infusion Intense (£85) and the Essence Intense (£220). The one with the most active ingredient is, needless to say, the most expensive; but it does have a noticeable effect. The aim is not to lighten skin tone overall, merely to make the complexion brighter and more even-toned.
Clinique has a similar product, Even Better Clinical Dark Spot Corrector (from £39,www.clinique.co.uk) which is much cheaper and has garnered favourable reviews. It partners with a moisturiser that has a helpful SPF of 20 (£35). If you prefer your products natural, Jurlique’s Purely White Brightening range is also excellent; again, there is a core product (the Essence, £48, www.jurlique.co.uk) which may be used with the moisturiser of your choice, or an entire companion range from Jurlique.
Laser treatment is effective at fading pigmentation but it is a) costly and b) unpleasant. Whether you can withstand it rather depends on your pain tolerance, lifestyle and also determination. Personally, we wouldn’t recommend it, but if you’re determined bear in mind that one treatment may not be enough. Fraxel laser is the most up-to-date method, and is also used in the treatment of acne scarring. Essentially, the laser removes the very top layer of your skin, exposing the untainted tissue beneath and stimulating the skin to repair itself by producing new collagen. You’ll need an anaesthetic during treatment, and afterwards your skin will look and feel like you’ve got sunburn. The Sk:n clinics in Harley Street and Birmingham offer it (www.sknclinics.co.uk), as does top dermatologist Nick Lowe, via his Harley Street Cranley Clinic (www.drnicklowe.com). He also has his own at-home product, Super Light Skin Tone Perfector Cream, developed via his own research, which costs just £18.99.
The new generation of so-called BB creams (BB stands for Blemish Balm) was also developed for the Asian market, and are great for concealing uneven skin tone. There are many to choose from, but the best is Garnier Miracle Skin Perfector Daily BB cream (£7.49, www.garnier.co.uk). This was one of the first out of the box in Europe, and it represents excellent quality for the money.
Another top-ranker is Clinique Age Defense BB Cream (£25 from www.clinique.co.uk). The former is siutable for all skins, whereas the latter is better for older complexions - and also has a higher spf (30 vs 15), so great for wearing on holiday.