Inflammation: No Quick Fix For Pigmentation


*Sponsored article by ZO Skin Health South Africa*

Pigmentation of the skin is a normal physiological process, yet hyperpigmentation is an undesirable response that can be brought on by uncontrolled inflammation. This cycle can be especially challenging to stop in its tracks, writes Dr Burt Jooste.

Pigmentation is determined by our genetics, regulating the amount of ultraviolet radiation penetrating the skin and controlling its biochemical effects. Unfortunately, due to external factors such as inflammation, sun damage, hormonal influences and skin injuries, people can develop hyperpigmentation – which is the uneven darkening of a specific area of the skin, caused by increased melanin.

Melanin is produced by the melanocytes in the lower layer of the epidermis, and people from different ethnic races have different skin colours mainly because their melanocytes produce different kinds of melanin. Melanin is responsible for producing colour in the body in places such as the skin, eyes and hair. With the uncontrolled regulation and over-stimulation of melanin by factors as described above, hyperpigmentation occurs.

Post-inflammatory hyperpigmentation

The focus of this article is on the inflammatory contribution to pigmentation – known as post-inflammatory hyperpigmentation (PIH). When the body is injured, a normal, controlled inflammatory response is needed to repair and restore the area affected. It is very important for this process to be controlled, started and stopped. One of the biggest challenges in modern-day medicine is chronic, low-grade inflammation or silent inflammation.

This happens when the inflammatory process never turns off, and continuously reacts to negative stimuli in our environment, such as free radicals, chemicals, chronic stress, lack of sufficient sleep and poor diet (which includes inflammatory-prone food like wheat, gluten, dairy, sugar and synthetic sweeteners). If we don’t control or decrease this silent inflammation, it will eventually develop into auto-immune diseases, heart disease, cancer, mood problems and pain disorders.

One of the conditions very closely associated with silent inflammation is PIH, where low-grade inflammation aggravates the pigmentation usually formed on the skin of the face and neck, as well as other areas of the body. For as long as the silent inflammation remains at heightened levels, it will be extremely difficult to treat the pigmentation where it presents. Our approach should always be to address these conditions holistically – i.e. treating the skin as well as the underlying inflammation – by looking at the following:

  1. Lifestyle changes

    1. Eat whole unprocessed foods, and cut out wheat, gluten, sugar, synthetic sweeteners and dairy.
    2. Sleep a minimum of seven uninterrupted hours every night.
    3. Follow a regular exercise routine of at least 150 minutes per week.
    4. Drink 2 ℓ of fresh water per day.
    5. Evaluate and balance your hormones – by doing this, estrogen dominance (which is a significant contributor to silent inflammation) can be controlled. Taking person-specific supplementation that has been recommended by a health practitioner with the necessary knowledge of the complex inflammation process will further assist you in getting rid of unnecessary harmful inflammation.
  1. Topical medical skincare products

This component forms an integral part in the treatment and management of pigmentation. All forms of pigmentation should always be viewed in the same light as any other chronic medical condition like, for example, high blood pressure. Because of our environment and the stressors of modern life, this is a condition that we have to manage on a daily basis, and with the correct, advanced skincare products such as ZO Skin Health, you can definitely be successful. Their approach is completely different to the conventional approach in skincare.

When it comes to topical protocols, nothing is more important in inflammation control and skin rejuvenation than restoring the barrier of the skin. A compromised barrier will present itself in the form of dryness, sensitivity or breakouts and pigmentation. ​

​In order to repair the barrier of the skin, we need to go back to the basics – such as eliminating moisturisers that shut down the skin’s own ability to heal itself​. We also need to introduce exfoliation and DNA repair ingredients. Daily exfoliation removes the dead layer of cells on the surface of the skin; by doing this, both blood circulation to the skin and new cell formation are stimulated. With the right products, we can balance the pH of the skin and deliver reparative ingredients to repair damaged DNA in the cells. And by doing this, we can achieve well-hydrated, tolerant skin.

Our aim is to achieve skin that is smooth, firm, tight, even in colour, well hydrated and free of disease. Once this has been achieved (normally within six weeks using the ZO Skin Health by Zein Obagi MD programme), we then evaluate the skin and identify the next treatment phase.

When pigmentation is a concern, we need to address internal inflammation through the integrative approach, as described above, as well as introduce a combination of active vitamin A serum and pigmentation ingredients in the form of Zein Obagi MD Brightenex Serum, by ZO Skin Health.

While this addresses internal inflammation, it also slows melanocyte activity. Once these have been attended to, the skin is ready for procedures. Any procedure that causes a controlled injury or raises the skins temperature to 42°C (peels/laser/radiofrequency) could stimulate the melanocyte, resulting in rebounding PIH. To reduce the risk of this occurring, we prep the skin, and make sure the barrier is repaired and the melanocyte under control. We will then perform the most appropriate procedure to best suit the particular skin.

  1. Sun protection and the importance of reapplication

With all the treatments and protocols we are able to offer today, it is more important then ever to be diligent with your sunscreen or photoprotective agents, as we like to call them today.

We are often so focused on protecting ourselves from UVA and UVB exposure (which is extremely important due to the risks of skin cancer from prolonged sun exposure) that we completely forget about the other culprits that contribute to the ageing and damage of our skin. Filters for IR-A radiation – which is specifically caused by heat from the sun, fluorecent lights, TV screens and computer monitors – as well as for visible light are included in all ZO Skin Health Oclipse sunscreen products to ensure optimal protection from these environmental factors that damage and age our skin.

Futhermore, it was identified that most consumers only apply sunscreen in the morning, and rarely reapply it every two hours – as prescribed. Reasons for this include people not liking the consisitency of sunblock and the fact that it messes up women’s make-up.

As a result, Colorescience developed a mineral-based, powdered sunblock – Sunforgettable Brush-on Sunscreen – which is non-greasy, does not leave a film on the skin and, best of all, can be applied over make-up. ​It offers two hours of protection and is water and perspiration resistant.


A2 Disclaimer: This article is published for information purposes only, and should therefore not be taken as an endorsement or advertisement for any product or medical treatment –  nor should it be regarded as a replacement for sound medical advice. 

Issue 23 – September 2017 (Spring)

This article was written by Dr Burt Jooste and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine September Spring 2017 Edition (Issue 23). 

A2 Magazine prints only four magazines each year – reporting seasonally on everything you need and want to know about aesthetics, anti-ageing, integrative medicine, quality and medical skin care, cosmetic dentistry and cosmetic surgery in South Africa – where to go, who to see, what to expect, something new and so much more! Never miss an edition – click here for more info about where you can buy the print and/or digital copy of A2 Magazine (including back copies).

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About Author

Rochelle Friedman

Rochelle is co-owner of A2 Aesthetic & Anti-Ageing Magazine - she looks after A2's Blog and the Sales & Marketing for the A2 Magazine. Follow her on twitter by clicking the birdy on the top right of this block.

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