Pigment spots: vectors of correction

---

Olga Bondarenko, cosmetologist, trainer in injectable techniques, speaker of all-Ukrainian and international congresses

---

Melanin formation occurs in melanocytes, which are located at the level of basal keratinocytes — the boundary line between the epidermis and dermis. Direct synthesis of eu- and pheomelanin occurs in organelles — melanosomes. As melanosomes mature, they move along the dendritic outgrowths of the melanocyte and are transferred to the basal keratinocytes, after which they begin to degrade as the keratinocytes mature.

The start of melanogenesis begins with the interaction of tyrosinase with L-tyrosine. The enzyme tyrosinase acts as the main catalyst for the steps: hydroxylation of tyrosine to DOPA and oxidation of DOPA to DOPA-quinone. The multistep branched process results in the formation of black-brown pigments (eumelanins) and red-brown or yellow pigments (pheomelanins).

Important regulators of melanogenesis that are found in the epidermal and dermal layer are a-melanocyte stimulating hormone (a-MSH) and adrenocorticotropic hormone (ACTH). These substances are produced by keratinocytes, melanocytes, fibroblasts and endothelial cells. In addition, inflammatory mediators, growth factors, neurotransmitters, and hormones (estrogens, glucocorticoids) play a significant role in melanin synthesis.

The density of melanocytes in different areas of the body ranges from 1000 cells per square mm to 2000 cells per square mm (head, forearms), regardless of race. Skin pigmentation will be determined by melanocyte activity and a proportional eu/pheomelanin ratio. Disruptions in the process of melanogenesis may be associated with abnormalities in:

● melanocyte morphology;

● tyrosinase synthesis;

● melanosome genesis;

● melanosome structure;

● the process of melanin granule transfer to keratinocytes.

The following types of dyschromias are most commonly encountered in the cosmetologist's practice:

● primary — ephelides, melasma, lentigo (solar, senile);

● secondary — post-inflammatory (traumatisation, local inflammatory elements).

[…]

Peptide complexes can be used as all-season topical regulators to normalise melanin synthesis, which can be combined with acid treatments when UV activity is reduced. Modern technologies for transporting active substances into the skin allow for deep penetration of topical agents, thereby enhancing the effectiveness of complex correction.

Understanding of etiopathogenetic aspects, correct collection of anamnesis, identification of concomitant pathologies that served as possible triggers for the occurrence of a particular type of melanosis, make it possible to make an effective plan of complex treatment and better predict the results of the proposed therapy.

*Full version of the access article in Ukrainian and Russian

First published in the Magazine «Cosmetologist» № 3, 2021