Ask the Medical Cosmetics Expert – Dr. Burger

medical cosmetics expert

Ask the Medical Cosmetics Expert – Dr. Burger


Pigmentation problems are one of the toughest conditions to properly treat in the Aesthetic industry. Results can be obtained easily, but to maintain the permanently improved effect is tricky.

How the Body Works:

In the deepest layers of our skin reside melanocytes, which produce pigment and color to our skin.  Heritage (genetics) determine each person’s specific skin color from African Americans (many melanocytes) to someone who is Albino (little to no melanocytes). We have melanocytes to protect our bodies against harmful UV rays from the sun.  When human skin is exposed to sunlight we produce more melatonin and our skin ‘tans’ to a darker shade. When melanocytes become “sick” or malfunction they will either produce too much melatonin (hyperpigmentation or dark spots) or when they die off they stop producing melatonin altogether (hypopigmentation or lighter spots) Melanocytes live decades, so their unwanted pigment production is long lasting, and tends to get worse as the years go by mainly because we lose the ability to regenerate cells as we age.

What causes Hyperpigmentation?

Some medical conditions,  (eg pregnancy) certain medications (eg older types of birth control pills) and skin injuries can cause pigmentation problems.  UV light (the sun and ALL other sources of tanning) would be the biggest cause of Hyperpigmentation. UV light creates free radicals (harmful molecules) that accumulate in our skin.  Free radicals deplete the vitamins (anti-oxidants that fight free radicals) in our skin, so instead of the vitamins in our bodies fighting ageing, they now fight sun damage and the ageing process gets away from you!  Very often what is seen as “ageing” is actually sun damage leading to sallow, thin, wrinkled looking skin on top of dark spots. In smokers, the demands on the skin and the consequent vitamin depletion is beyond, the ability of our bodies to correct.  Perfumes (oil based plant extracts) are absorbed into our skin easily, as the skin likes oil.  When UV light is added to this mixture you can be guaranteed hyperpigmentation in your skin.  Think of those heavily perfumed sunscreen we slather on and then go in the sun – it is a sure recipe for dark spots that take years to remove.

***Vitamin D plays no roll in skin rejuvenation, it has effects on bones and intestines.  We produce Vitamin D in our skin during the first 15 minutes in the sun, after that UV light will actually break down the Vitamin D that was created.

Preventing Pigmentation Problems:

The mainstay is to avoid damage – do not tan too much, wear proper sunscreen/hat/sunglasses for your eyes and do not smoke cigarettes if you can help it at all. Sunscreen should be maximum SPF 30 and should have a metal component (Titanium, Zink etc) to help reflect UV rays. The SPF molecule is a harmful molecule to our body whether it is SPF 15 or SPF 100. They all need to be re-applied every 2 hours. The higher the SPF, the more we damage the skin. This means the youngest most sensitive skin gets the most harmful molecules and it is saturated in perfume. Invest in a Non-Perfumed sunscreen with a metal component (it does not absorb at all, only sits on the skin and reflects the UV light away like little mirrors) and maximum SPF 30. A high quality product with lower SPF is always better than the big guns that smell nice.

When I consult patients with pigmentation issues, I exclude or diagnose and manage Medical conditions that contribute to the problem.

Treating Pigmentation Problems:

Firstly, remove the cause(s) in order to obtain a permanent “cure”. We put heavy emphasis on replenishing the vitamin levels in the skin with products that have proven absorbability. The most helpful here is Vitamin C with Vitamin A in second place. Pigmentation cannot be treated with Chemical Peels or Microdermabrasion as these only scourge the top layers of the skin while the diseased Melanocytes are located in the deepest layers of the skin. It is a common misconception in the industry and amongst clients – it is impossible to correct the problem this way. The only way to remove the collected, unwanted Melatonin permanently, is to laser it away. It is important to do your homework on the type of laser, as the little guys just don’t cut it. As I discussed in a previous article on Hair Removal – the laser has to be of substantial physical size to generate a laser beam that is strong enough to obtain the effect we want medically. In our Spa, treating Pigmentation problems is done as a medical treatment – I consult clients myself as there could be underlying Medical issues that need to be addressed as well. Then a detailed plan is customized for that particular client to make it a real world solution (a jogger will not stop running, a truck driver will get a lot of sun from the left side etc.) The bottom line is this can be treated with the correct methods, qualifying products and a lot of patience. Please feel free to call us if we can be of assistance at 403-529-2006.

*Avoid *skin lighteners” like the plague. A molecule called Hydroquinone is banned in the whole world (Europe, Africa, Asia, South America), but is freely available in North America. It will make the pigmentation worse on a cosmetic level and has been associated with skin cancer. Buyer beware!!

**Vitamins are destroyed by UV light and oxygen/air, so any skin care product in a transparent container or a jar that opens up, will have very little to zero active molecules in it after a couple of weeks. Buyer beware!!