Why Do Some Spots Disappear While Others Just Don’t Go Away?

Types of Pigment

If you've noticed a spot that overtime hasn't faded, it might be as fixed to your skin as a tattoo. That's because there are two types of pigment:

• Epidermal (Superficial)
• Dermal (Deep)

Epidermal pigments appear as dark brown with clear borders under a Wood’s Lamp. These are fairly easy to remove by laser treatment and usually disappear within 1-2 cell cycles (40-90 days). Dermal pigments appear as grey brown to light blue with ill-defined margins. Since they’re in the dermis, they are more permanent and usually last for years.

How are they caused? 

Both kinds of spots are caused by multiple factors (see our pigmentation series) but the way a superficial spot turns into a deep one isn’t fully clear. Some studies argue that macrophages (think of them as the skin’s janitors) can migrate to the border of the epidermis, grab a melanin pigment and move back to the dermis. Once they’re in the dermis, the pigments get stuck. What’s worse is that even if these pigment loaded macrophages die, their offspring recapture the melanin.

As Permanent as a Tattoo 

The mechanism for dermal pigmentation is similar to tattooing. When the pigment is deposited in the dermis, macrophages try to clean up the pigment. The only difference is that the pigments in tattoos are much bigger so the macrophages simply surround the pigment to prevent it from spreading. They nibble on the pigment bit by bit, which is one of the reasons why tattoo colours change overtime. 

Does tattoo removal work on dermal spots? 

It would seem that if dermal pigmentation and tattooing are similar, the removal process should be too. It can work, but there is a high chance that rebound pigmentation will happen so it’s not the first choice of treatment.

How can you prevent this?

A weak basement membrane can be a factor in the formation of dermal pigmentation. Sometimes epidermal pigmentation falls to the dermis because of a hole in your basement membrane. Boosting your basement membrane can be helpful in preventing the formation of dermal pigmentation. Tranexamic acid is an ingredient that’s unique in dealing with pigmentation as it is also strengthens the basement membrane to prevent dermal pigmentation. This is one of the many reasons why it works well to target melasma and why we’ve included it in our Level Serum.