Frequently Asked Questions

Pigmentation can be caused by different conditions.

Sun exposure is the commonest culprit. Fair skinned people are more likely to develop freckles, brown spots and broken veins in areas exposed to excessive sunlight.

Hormonal pigmentation is often triggered by use of the contraceptive pill or by pregnancy. It is termed chloasma or melasma. It tends to form larger, irregular brown patches on the forehead, cheeks, around the eyes and above the top lip. This type of pigmentation is often seen in darker skinned, brown or green-eyed patients. It often fades some months after birth or stopping the contraceptive pill, but sometimes does require treatment. Ultraviolet A is often the trigger for this type of pigmentation so make sure that your sunblock has good UVA protection.

Post-inflammatory pigmentation follows any type of rash, injury or acne breakout on the skin. It appears once the original rash has healed. This is a self-limiting condition that usually clears on its own, but this can take many months and cause much distress to the patient. Wearing a good sunblock with an SPF of 50 and UVA (Ultraviolet A) protection will help this condition to fade more quickly.  Many skin-care ranges have creams that will help the marks to lighten, or your doctor can prescribe a prescription cream for this.

Pigmentation can be either superficial (epidermal) or deep (dermal). Superficial pigmentation is much easier to treat and usually clears within 6 to 12 weeks of using lightening cream and sunblock. Light treatments such as BBL (broad band light) or IPL (intense pulsed light) will lighten freckles and brown spots, as these tend to be superficial.

Deep pigmentation is much more difficult to treat.  It often requires additional treatment such as the Fraxel Dual laser or Dermapen (micro-needling) which can be set to treat both epidermis and dermis.

Skin care products should be geared towards your skin condition, skin type (dry versus oily), age, lifestyle and budget. For instance, an older drier skin needs a richer cream with anti-ageing antioxidants. A younger, more oily skin with breakouts needs a lighter cream with ingredients to dry and fade the blemishes. Skin care products alone may not be enough to cure a skin condition, but may may help it to heal more quickly and make the skin feel more comfortable. If products alone do not help your skin condition, consult your doctor, dermatologist or skin clinic.

Yes! It has been proven that sunblocks, applied correctly, are very safe and protect skin from skin cancers and sun-related rashes. We do most of the damage to our skins before the age of 18 years, so it is important to protect your child's skin from the sun. Sunblocks may be physical eg zinc, titanium dioxide and these work immediately on application by bouncing the sun's rays off the skin. They are also known as mineral sunblocks and tend to cause less allergic reactions. Chemical sunblocks are a mixture of chemicals which absorb the sun's rays. They need 30 minutes after application to the skin to become activated.

Sunblocks come in sprays, gels, lotions and creams and this is purely a matter of personal preference. Many moisturizers and foundations have an SPF of 15 or 20. This is adequate for daily use but is not enough for severe outdoor sun exposure such as hiking or being on the beach or at the pool. An SPF of 50 with good UVA protection should be used outdoors and re-applied after swimming or if you are in the sun for a long period of time.

Acne is a blockage and infection of the oil glands surrounding the hair follicles on the face and trunk. There are many skin care products designed to help acne and these usually contain salicylic acid, and other agents to dry the spots and reduce inflammation. A good sunblock which is not greasy is also useful to help fade marks left by healed pimples.

If pimples are very deep and do not go away with the correct skin products or you are developing scars that form hard lumps or holes in the skin, you must consult your doctor for oral therapy. Antibiotics, hormones or isotretinoin tablets may be necessary.

Eczema is a condition where the skin's barrier function (the ability to keep moisture in and to protect itself from environmental factors) is impaired. Skin is usually dry and sensitive. There are different types of eczema and it can occur in childhood or adult life. Anything that dries your skin out (strong detergents, soaps, antiseptics) can make eczema worse. Skin should be moisturized with hydrating washes and moisturizers. Even ordinary soap can dry the skin and there are special soap bars called "syndets" made for eczema sufferers. If the eczema does not go away or is very itchy or infected, you need to see your doctor. Eczema is usually managed with cortisone or anti-inflammatory creams, light therapy or medication that calms down the body's immune system.

Psoriasis is a genetic condition that causes thick, pink, scaly patches to build up on the scalp and body and may also affect joints and nails. It can start in childhood and can be triggered by a Streptococcal (bacterial) throat or tonsil infection. This usually presents as many small, round, scaly patches on the body and usually clears up with treatment. Adults tend to get larger thick scaly patches that are lifelong. Psoriasis can be much improved and managed but unfortunately cannot be cured. Creams, light therapy, tablets and biological agents should be prescribed by a dermatologist. Stress, infections and alcohol are big triggers for psoriasis.

It can be confusing to know which spots are harmless and which are not. Lumps, bumps or sores that grow or do not heal may be cancerous. It is also really difficult to check your back, scalp, buttocks and the back of your legs. Fair skinned people with a history of excessive sun exposure are most at risk for skin cancer. If you have a family history of skin cancer or cancerous moles (melanoma) you should definitely check your skin. Your dermatologist can advise you on how often you need to have follow-up visits.

Anti-ageing creams usually contain antioxidant molecules. These repair and prevent further skin damage from ageing, sun exposure, pollution, smoking, poor lifestyle or smoking. There is a large variety of antioxidants, including vitamins A, B, C, and E, acidic compounds, ferulic acid and phloretin, which are very effective. Sunblocks are often included in these products or should be applied over them as necessary. Most skin care ranges have an anti-ageing range and your products should suit your skin type, lifestyle and budget.

Some antioxidants, such as vitamin A are excellent for improving skin texture but should never be used on a super-senstive skin or if a patient suffers from rosacea. Vitamin A can irritate and flare these skins and can also make skin sensitive to sunlight. Always ensure that the person who is selling you the products is trained in their usage and can advise you correctly. It is a waste of time and money to go to a shop and pick a product off a shelf without knowing what it does and if it would suit your skin.

Also, the products that you put on your skin have more impact than the foods that you eat. Food-borne antioxidants have to get from your gut to your bloodstream, go through your liver, go to other organs and a very small amount actually ends up in your skin. Unfortunately, drinking lots of red wine (which contains resveratrol, a potent antioxidant) may be fun but won't help your skin.

Hyaluronic acid, the gel between your collagen and elastin fibres, helps to plump skin up. Collagen is too big a molecule to penetrate skin in cream form, but a recent local study shows that it actually makes its way to skin and bones when supplemented orally. We also keep the Pro-Active Collagen, a Type 2 collagen supplement in a liquid form, used to improve skin quality, bone density, hair and nail growth.

Sugar is BAD for your skin as it hardens (glycates) tissues and causes premature ageing.

This is patient dependant. Each person's hair is different. Colour, thickness and phase of growth, effects how many treatments a person will need and how often the treatments will be done.

Usually the redness lasts for around an hour. Rarely there can be scabbing or small blisters that occur. These will usually last about a week to 10 days.

Yes. Depending on how deep we treat the skin, will determine the length of down time. When treating superficial pigmentation, the down time is usually a day or so. If scarring is being treated, the down time can be up to 5 to 7 days of redness and swelling. Wearing a sun block after any laser treatment is extremely important.

 

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Dr Judith Budavari

Dr Judith Budavari, Dunkeld West, Johannesburg

FAQ

Dr Judith Budavari, Dunkeld West, Johannesburg