Therapy
In principle, the pigment disorders that occur when taking the pill are completely harmless and do not require any therapy. However, one should not underestimate the level of suffering of those affected and treatment steps can be initiated from an aesthetic point of view. In principle, treatment should be carried out by an experienced dermatologist to avoid scarring or further irregular pigmentation.
As a prophylactic measure, the risk factors already mentioned above should be avoided first, for example using a sun cream with a high sun protection factor or protecting oneself sufficiently from excessive sunlight. In addition, the skin must be treated in a disciplined manner before and after each treatment. Extensive sunbathing or visits to solariums should be avoided.
A sun protection factor of 30-50 should be applied in summer. In addition, there are special creams that are massaged in to guarantee a good after-treatment and maintenance of the skin texture.A simple cosmetic option is a well covering skin make-up, which often compensates the color differences sufficiently. If necessary, camouflage products can be used to achieve even better coverage.
Other cosmetic products are available in the form of acidic peelings. On the one hand, the acids cause the upper horny cells and thus the pigment to peel off and on the other hand, the production of new pigment is reduced. However, this form of treatment requires sufficient pre-treatment of the skin for 2-3 weeks.
It is important to avoid exposure to the sun and to observe a smoking ban during therapy. However, the acids penetrate deep into the skin, so this is not necessarily a skin-friendly alternative. Chemical peelings also include peeling with alpha hydroxy acid, which causes blistering of the skin.
This causes the blister to detach and thus the pigmentation disorder to disappear. In addition, one can try to bleach the hyperpigmented skin areas. There are various creams with different substances such as tretinoin, hydroquinone, arbutin, alpha hydroxy acid, kojic acid, trichloroacetic acid, ascorbic acid, glycolic acid, azelaic acid, adapalem, liquiritin, niacinamide and B-resorcinol.
B-resorcinol can cause a significant brightening of the affected skin areas within approx. 4 weeks. B-resorcinol achieves this effect by inhibiting an enzyme, tyrosine kinase.
The enzyme tyrosine kinase is jointly responsible for the production of the skin pigment. Arbutin is a natural hydroquinone source. It is not quite as effective as the industrially produced hydroquinone and is often marketed in Asia.
Hydroquinone is available only on prescription and cannot be sold in the EU at the moment, because it is suspected to cause toxic reactions. Kojic acid is also not available in many countries and is offered on the Japanese market. Ascorbic acid or vitamin C is also considered a potent skin bleaching agent and is often used in creams in combination with other substances.
Another form of treatment is laser therapy, which includes Fraxel and Erbium-YAG-Laser. This is also considered one of the most effective methods. The laser irradiation causes a comminution of pigments, which can then be eliminated by immune cells.
This is done by using high-energy light. Depending on the characteristics of the skin, the laser must be allowed to penetrate the upper layers of the skin and, in more serious cases, deeper layers as well, so that the pigments that are still being transported from the bottom to the top are still reached. However, laser treatment is usually still relatively expensive compared to other treatment methods.
In addition, further over-pigmentation can occur after the treatment as a result of inflammatory reactions. Furthermore, skin burning, skin irritation and infections can occur. In addition, there is the cold treatment (kyrotherapy), in which the upper layer of skin freezes and dies off, thus eliminating the pigment disorder.
Pigment spots can also be carefully removed surgically. Due to the treatment methods, the skin is usually still irritated afterwards and should be protected from irritation, such as too harsh skin care products or too much sunlight. Another possibility is, of course, always to switch to another contraceptive method or to try out a different type of pill.