Problems with the pigmentation of the skin are incredibly common. One of the most common conditions affecting your skin’s coloration is called hyperpigmentation.
Hyperpigmentation comes in many different forms. And although hyperpigmentation does not physically harm your health, many people are bothered by this problem in their skin. They may wish to reverse hyperpigmentation to achieve a more even-toned complexion.
Hyperpigmentation of any type is the result of excess melanin in the skin. Melanin is the naturally occurring source of brown pigment in the skin and is normally present in all skin tones. But when extra amounts of melanin form in concentrated deposits in the skin, it causes the appearance of dark spots or patches on the skin’s surface. Because these areas of melanin deposits are darker than the skin around them, it produces an uneven skin tone that is often undesirable.
Luckily there are several ways that hyperpigmentation may be treated. Here we’ll review the different types of hyperpigmentation, what causes them, and options for improving these conditions. Finally, we will discuss how hyperpigmentation can be prevented, as prevention is the most effective way to protect skin and keep pigmentation even.
The Different Types of Hyperpigmentation
Freckles may be the most common form of hyperpigmentation. Many people around the world develop freckles throughout their life. These small brown spots can appear in groups or may be scattered across the body, and they can develop anywhere. Most often, they are seen on the face and arms.
Freckles are caused by inherited genes, and you often find that freckled skin runs in families. While you cannot control if you have freckles or not, they are certainly affected by sun exposure. Spending time in the sun will darken freckles while keeping your skin protected from sunlight will help freckles fade with time.
Melasma is characterized by large patches of darkened skin. They may be brown in color or even grayish. These patches are usually triggered by changes in hormones, such as pregnancy.
Hormones can influence the skin’s production of melanin, and sometimes these dramatic hormonal shifts bring about overproduction of melanin. The excess melanin caused by pregnancy often shows up in different areas of the body, but most commonly it appears on the face. When this happens it is often referred to as the “mask of pregnancy.”
Taking oral birth control pills is another possible cause in hormonal melasma. Unsurprisingly, this condition occurs more often in women than in men. It is often those who have a darker skin tone that are more prone to getting melasma. This is because these skin types already contain more pigment-causing melanin. It also seems that if you have a family member with melasma, that you are more likely to get it yourself.
3) Solar Lentigines
Solar lentigines are a type of hyperpigmentation that is caused by excess sun exposure. They are often found on people over the age of 40 and are commonly referred to as age or liver spots. This may be because they become more and more apparent with age, as a lifetime of cumulative sun exposure reveals the extent of skin damage. They are most often located on the areas of the body that receive the most sunlight, namely the face and the hands.
The size and appearance of solar lentigines vary quite a bit. They can be small or large and may be any color from light tan to black. They also come in many different shapes, with some being very round and others being very irregular. They are most likely to be seen in those who have very light-colored skin.
Solar lentigines are caused by exposure to the sun’s ultraviolet radiation. When your skin absorbs this radiation it causes the creation of melanin. Sometimes the dangerous skin cancer melanoma can look very similar to a solar lentigo, so it is very important to pay attention to changes your skin and consult a dermatologist with any uncertain spots.
4) Post-Inflammatory Hyperpigmentation
When your skin suffers from a condition or injury that causes inflammation, it can also lead to hyperpigmentation. Doctors refer to this as post-inflammatory hyperpigmentation or PIH.
A common cause of post-inflammatory hyperpigmentation is acne, especially in severe cases. But rashes and wounds can also lead to this inflammation. The reason that these injuries and conditions leave behind hyperpigmentation has to do with the skin’s response to inflammation. During the healing process, melanin is produced. Where too much melanin is created a darkened area will remain, even after the inflammation has dissipated.
There are different degrees of discoloration that can develop, and this along with your skin tone determine the way that PIH will appear on your skin. All types of PIH are flat areas of skin that differ in color from your normal skin tone but may range in color from black to brown, to pink and red. Anyone with any skin tone can get post-inflammatory hyperpigmentation, but generally, those with darker skin colors will have more severe discoloration.
Post-inflammatory hyperpigmentation is very common, especially for those with acne. While severe and very inflamed cases of acne are more likely to cause more prominent areas of discoloration, the truth is that any pimple can leave behind this pigmentation. The risk of discoloration from breakouts increases when you try to pop or extract blemishes, or if you use aggressive cleansing and exfoliation methods.
Reducing inflammation is the key to minimizing post-inflammatory hyperpigmentation. And once the source of inflammation has cleared, PIH can fade with time. However, this process of fading may not be complete and may take several months or more. To help speed up the process, and prevent the source of irritation from returning (for example, acne), many will want to turn to some of the treatment options discussed below.
Treatments For Skin Discoloration
In most cases of significant skin discoloration, it is best to work with your dermatologist to determine the cause of the problem. This will help you decide on the best route for reducing the discoloration and improving your skin tone. Additionally, some of the best ingredients for treating skin discoloration are available by prescription only.
However, if you are dealing with very minimal discoloration or dark spots, then there are a few over-the-counter options you can try before seeing your dermatologist.
Here is a list of both over-the-counter and prescription ingredients that are known to help lessen discoloration and promote an even skin tone.
1) Vitamin C
One of the best overall ingredients for your skin is vitamin C, so it may come as no surprise that this powerful antioxidant can improve discoloration in your skin.
When applied topically, Vitamin C can help fade dark spots and promote a brighter complexion. It can do this because of its melanin-inhibiting properties. By halting melanin production, current areas of hyperpigmentation will fade, and future discoloration will be prevented.
It does this without lightening the normal areas of your skin, too. The best way to use vitamin C on your skin to fight discoloration is by applying a serum containing ascorbic acid. Ascorbic acid is just a particular form of vitamin C and one that works best in skincare. Just be sure to read the label carefully for this ingredient.
2) Alpha Hydroxy Acids (AHAs)
The gentle exfoliating action of chemical exfoliants such as alpha hydroxy acids is beneficial in reducing hyperpigmentation in those with PIH. This is because alpha hydroxy acids can be left on the skin to promote increased cell turnover. As old skin cells are sloughed off, fresher and brighter skin cells are revealed.
Alpha hydroxy acids are easy to use and available in many forms, no prescription required. It is a multi-purpose product, and this makes it an excellent choice for mild cases of discoloration.
3) Azelaic Acid
This acid may be used as an alternative to hydroquinone for those who cannot tolerate it. Based on studies of azelaic acid, it seems to be just as good as hydroquinone at reducing hyperpigmentation.
Azelaic acid is also a good treatment option for post-inflammatory hyperpigmentation caused by acne. This is because it can help fight acne, exfoliate the skin, and reduce inflammation at the same time.
You must get a prescription to use azelaic acid. It may be used alone or in combination with other medications, as your doctor sees fit.
Perhaps the most commonly used skin lightener, hydroquinone is available both with and without a prescription. Formulated as a cream, you can find it at the drugstore in lower, 1-2% strengths. For higher strengths, you will need to talk to your doctor and obtain a prescription.
Hydroquinone is effective at reducing discoloration because it actually blocks the skin from creating more melanin.
This is a potent lightening ingredient, and therefore needs to be handled with caution. It should only be applied to the darkened areas of your skin, as a spot treatment. Otherwise, hydroquinone may cause your normal skin tone to lighten as well. It is also quite irritating for some people, and may not be suitable for everyone.
If you try hydroquinone over the counter, be sure to test it in a small area of healthy skin to check for a reaction. Some redness is a common side effect, but if you experience swelling or your skin becomes blistered or itchy, you will need to contact a doctor and discontinue the treatment.
5) Laser Treatments
When it comes to professional treatments for discolored skin, laser treatments are common. There are two types of laser treatments: ablative and non-ablative. Both require a professional technician to use a concentrated beam of light to break apart pigment in the skin.
This type of treatment can be very effective but does not work for everyone. In fact, for some people, laser treatments can actually make discoloration worse. If you want to try laser therapy for your discolored skin, speak with a qualified dermatologist to make sure you are getting the right treatment.
6) Chemical Peels
You can opt for a professional chemical peel in a dermatologist’s office or medical spa to reduce discolored spots on your face.
Chemical peels are deep exfoliating treatments, removing several upper layers of dead skin and revealing fresher layers beneath. This not only increases skin’s luminosity and texture but can decrease dark spots as well.
Chemical peels are sometimes harsh and irritating to the skin, so you will want to talk to a professional to see if you are a good candidate for this type of treatment. Keep in mind that it takes a series of several consistent treatments to see results on your dark spots.
Another form of professional exfoliating treatments, microdermabrasion is a gentle sanding of the skin. It directs minuscule particles against the skin’s surface, removing dead skin and leaving a polished look.
This treatment also requires many treatments, and may not be ideal for more severe cases of discoloration. However, it is much gentler and less likely to cause irritation than chemical peels.
How to Prevent Skin Discoloration
Protecting your skin from the sun is of utmost importance both while you are treating hyperpigmentation, and as a precaution to prevent it in the future. This is mainly because the damaging effects of the sun can cause or worsen discoloration. But it is also because many medications used to reduce discoloration also make your skin more sensitive and prone to sunburn and UV damage.
First and foremost, you will need to use sunscreen correctly every day. Look for a broad-spectrum sunscreen that is effective against both UVA and UVB radiation and apply it all over. Some of the best sunscreens for preventing any discoloration or darkening will also contain physical sunblocks, such as titanium dioxide or zinc oxide.
If you are going to be outside continuously, you will also need to follow a strict reapplication schedule—at least every two hours. This is because even water-resistant and sweat-resistant sunscreen cannot remain effective much longer than that. The protection wears away even if you stay dry. And of course, if you go for a swim or towel off, you will need to reapply immediately.
In addition to sunscreen, it is recommended that you wear protective gear when outside. This should include sunglasses, a broad-brimmed hat, and clothing that covers your skin. It is actually best if you avoid being in the sun during the brightest hours (typically from 10 in the morning to 4 in the afternoon). Stay in the shade whenever possible, because all sunlight can actually cause hyperpigmentation.