Understanding Hyperpigmentation

Whether a result of sun damage, hormonal fluctuations or simply an unwanted reminder of acne past, all types of hyperpigmentation have one thing in common: melanin. The overproduction of melanin causes darkening of the skin known as dyschromia, or hyperpigmentation.

In addition to giving skin and hair their natural color, melanin serves an important role as our body's natural sun protectant. When skin is exposed to long-term UV rays, melanocytes are prompted to produce more melanin causing discoloration to develop. That all-too-frequently coveted tan? It’s really a result of the skin trying to protect itself from the sun.

Pigmentation can also occur after trauma to the skin in the form of an acne lesion, cut, burn or other injury. This type of discoloration is known as post-inflammatory hyperpigmentation (PIH); in our office, it’s referred to as the “ashes after the fire.” While these wounds can heal over time, dark spots can be permanent if not treated early.

Melasma—often referred to as “pregnancy mask” because of the mask-like way it covers the skin—is a type of hyperpigmentation that often surfaces on the cheeks, nose or forehead. It is caused by a combination of genetics, hormonal factors and sun exposure.

Though hyperpigmentation is a medically benign condition, it can be the cause of much cosmetic frustration, especially for skin of color. Dark or olive-toned complexions are more likely to suffer from darkening of the skin, namely because the cells that produce pigment react more strongly to inflammation and injury.

Sunscreen is truly the best mode of defense against all forms of hyperpigmentation. Applying and reapplying an SPF of 30 or higher every day is a must, as is wearing a broad-brim hat and sun protective clothing as needed.

I recommend SkinMedica's Environmental Defense Sunscreen SPF 50+ to my patients along with Colorescience® Sunforgettable Mineral Powder SPF 30, a brush-on powder that’s perfect for reapplying protection throughout the day (every two hours, to be exact).

Because hyperpigmentation affects so many, topical treatment options have flooded the market in recent years. Don’t be fooled by gimmicks: the best treatments for hyperpigmentation contain tried-and-true ingredients like retinol and prescription hydroquinone, a skin lightening cream known to be very effective at treating hyperpigmentation when used in conjunction with sunscreen.

At your doctor’s office, chemical peels using trichloroacetic, glycolic and salicylic acids are some of the most effective ways to target stubborn discoloration. I love SkinMedica’s Vitalize and Rejuvenize Peels, which improve the appearance of skin discoloration and texture.

Intense pulsed light (IPL) treatments can also reduce unwanted dark spots in a series of three to five treatments. IPL treatments offer the benefit of little downtime; in fact, patients often have the procedure performed during a lunch break and return to work afterward.

Whatever the treatment, it’s important for patients to be informed and seek out an experienced doctor or skin care specialist to help avoid the occurrence of further damage to the skin.

Lastly, some common sense advice: avoid intentional sunbathing or excess time spent in the sun. Being aware of your environment, taking extra precautions and making smarter choices will make a difference in the long-term health and appearance of your skin.