What is a stain?
The word stain is a very comprehensive terminology in dermatology. It may occur congenitally (moles, freckles) or later; They may occur due to pregnancy, use of hormonal drugs or drugs that cause sun sensitivity, deterioration of the structure of the skin due to any reason (acne, eczema, herpes, wound, cut), and most of all, exposure to ultraviolet rays without protection.
Brown spots that occur due to reasons such as pregnancy, menopause, use of oral contraceptives (birth control pills) and drugs that cause sun sensitivity (tetracycline, isotretinoin) are defined as melasma (pregnancy mask).
Especially in white-skinned people, numerous brown-toned, small-scale sunspots (lentigo) may occur on the shoulder and back area after excessive exposure to the sun or after sunburn. The light-dark brown spots seen on the back of the hands, forearms and face after the age of 40 are described as lentigo (age spots).
Small spots that appear in sun-exposed areas, starting from childhood in people with red hair and white skin. Brown spots are generally inherited and are called ephelis (freckles). Apart from this, after the age of 30, there are spots diagnosed as seborrheic keratosis (age spots), some of which are smooth and some are rough, seen on the face and body equally in both men and women.
Blemish treatment
First of all, any brown spot on the skin must be evaluated and diagnosed by a dermatologist
. As I mentioned above, the natural treatment of brown spots that occur for very different reasons is also different. Among these treatment methods; chemical peeling, PRP, spot
mesotherapy, spot mask and Laser applications are available.
At the beginning of the treatment, creams containing various acids (hydroquinone, glycolic acid, N-acetylcysteine,
tretinoin, steroid, azelaic acid, kojic acid, ascorbic acid) are used. In cases where clinical response is not achieved despite the spot lightening products that are generally used at night and on the blemish
, different peeling
applications can be added to the treatment. Using chemical peeling and topical spot lightening products together has a synergistic effect in the treatment. In the evaluation of the patient before peeling, determining the depth of pigmentation (superficial-deep-mixed) using wood light
examination is important to give us an idea about the possibility of the patient benefiting from this treatment
. It is also important to prepare the skin appropriately before the procedure and to carry out the post-peeling procedures meticulously. Chemical peels accelerate the renewal of the epidermis and ensure that the stain material is removed from the epidermis. Thus, the stains lighten. Chemical peeling; It is used to heal and correct the skin by applying chemical solution (fruit acids,
TCA, glycolic acid, salicylic acid) to the skin, by peeling the upper layer of the skin. Nowadays, superficial and medium depth applications are performed more frequently.
It can be applied as a superficial peeling every 2 weeks on average, or as a medium depth peeling every 2-4 weeks and in 3-4
sessions.
Blemish mesotherapy is another treatment method. Mesotherapy; It is the process of administering various medications to the middle layer of the skin in order to treat the problematic area. In stain mesotherapy, a cocktail consisting of many stain lightening drugs (glutathione, traxinamic acid, vit c, niconitamide, n-acetyl glucosamine) is injected into the stain at certain intervals using fine diameter needles. It is implemented with clarity. Applying medication directly to the stained area allows us to treat only the stain without damaging the surrounding tissue. At the same time, it is a method that can be easily applied in the summer months as it does not affect the upper part of the skin.
For patient comfort before the application, topical anesthetic is applied half an hour in advance. The procedure takes 15-30
minutes depending on the size of the area. Depending on the density and depth of the patient's stain, 5-10 sessions are performed at intervals of 15 days - 1 month.
Blemish mask; It is an enzymatic peeling method that can be used for many blemish problems. It is in the form of kits
and comes in two forms. Kits are available in a lighter form for superficial stains, and with a slightly higher peeling effect for deeper and more intense stains. It helps to reduce the amount of melanin in the skin, plays a role in suppressing pigmentation, and suppresses the mechanism that triggers the formation of spots on the skin.
It is a single-session application. After the patient's skin analysis is performed, it is decided which kit to apply.
After the skin is prepared with the special cleansing solution in the kit, the mask is applied to the entire face or on the blemishes on the neck,
decollete, abdomen, hands and legs. Depending on the patient's skin type, the diagnosis of the spot, and its duration, the mask is kept on the skin for 8-12 hours. And then the patient continues to follow the easy-to-apply follow-up protocols at home. In addition to spot treatment, it also provides skin renewal, lightening of fine lines
and shrinking of pores.
PRP means "Platelet Rich Plasma - plasma enriched in platelets". In the PRP
method, platelets with growth factors that initiate all wound healing and tissue regeneration processes are obtained, and this obtained platelet-rich serum is administered under the skin. It is given with
small needles. Adding PRP to spot treatments makes the treatment results better and more permanent.
Spot treatment with PRP should be done for at least 3 sessions with other spot treatments at 2-4 week intervals.
Laser treatments; In general, lentigines (age spots), ephelis (freckles), dermal melanocytosis (deeply located, congenital spots) disappear completely or significantly with various laser treatments, while cafe-au-lait macules (congenital spots) disappear completely or significantly with various laser treatments. Although different results are obtained with laser treatment in milky brown spots), post-inflammatory hyperpigmentation (spot developing after wound
) and melasma (pregnancy mask), there is a high recurrence rate.
Another detail in the treatment; Since the biggest factor in the formation of spots is the sun, sun protection measures are extremely important in the success of the treatment and in ensuring the continuity of the results obtained.
Sunscreens suitable for the skin type and structure of our patients are applied regularly in both summer and winter
They must use it, reapply it every 3-4 hours due to the decrease in the effectiveness of the protectors due to contact with sweat and water in the summer months, and be very careful not to be exposed to the sun during the hours when the sun is perpendicular to the earth (10-16). In addition to these precautions, the patient must be patient in spot treatment because it is not possible to suppress the spot formation mechanism all at once. If we consider that it spans a long
period of time, many treatment methods are used together, and each treatment method is effective through different
mechanisms, we can understand how difficult a process
spot treatment is.
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