Hyperpigmentation

Hyperpigmentation is a darkening of the skin due to an overproduction of melanin. It can be brought on by various injuries to the skin, acne vulgaris, sun damage, and inflammation. It is most common in people with darker skin tones who spend a lot of time in the sun, although anyone with any type of skin tone may develop it. Examples of hyperpigmentation include liver spots, sun spots, age spots, freckles and melasma, also known as (the mask of pregnancy),.

There are three types of hyperpigmentation:

Epidermal

Light brown spots, not as dense as dermal.

Dermal

Deep brown spots on the skin, some may appear ashen-grey and quite dense and solid.

Mixture

A mixture of epidermal and dermal, presenting as dark brown spots.

Symptoms

Darkened areas on your skin are the sole symptom of hyperpigmentation. These areas may be localized on your face or hands, or may even cover your entire body.

Who is Affected

Even though anyone of any race or color can be affected by hyperpigmentation, genetically those with darker skin tones as well as Asians and those of Asian descent, are at increased risk. People who spend excessive amounts of time in the sun put themselves at more risk of developing hyperpigmentation because UV rays stimulate melanocytes into becoming hyperactive, and these are the cells that produce the Pigment ( Melanin )

Causes

While hyperpigmentation is usually caused by an excessive production of melanin from your melanocytes due to over exposure to sunlight, there are many different reasons behind why the body starts overproducing melanin. Generally, when the skin is damaged in some way, hyperpigmentation is your body’s defense reaction. Various causes include:

  • Sun exposure ( The most common cause of hyperpigmentation & melasma )

  • Chemotherapy side effect

  • Certain medications

  • Changes in hormone levels ( pregnancy, hormone therapy, menstrual cycle )

  • Pregnancy

  • Endocrine diseases

  • Acne

  • Heredity

  • Skin treatment side effects

  • Scratching

  • Various metabolic disorders

  • Rashes

  • Surgical procedures

  • Chicken Pox

  • Eczema

  • Severe sunburn

  • Razor bumps

  • Insect bites

  • Birth control pills

How to Diagnose Hyperpigmentation

What is most important when diagnosing hyperpigmentation is not the darker skin spots themselves but the reason behind why they have appeared. Generally, hyperpigmentation is strongly linked and most commonly associated with overexposure to sunlight, however, there are a number of other possibilities behind why hyperpigmentation has presented, and a doctor will need to delve into your medical history and current medical status to make a diagnosis.

A Wood Lamp is used to analyze the areas of your skin that have developed hyperpigmentation. A Wood Lamp emits black light that allows the skin care practitioner to see any fluorescence—a sign of hyperpigmentation.

Types of Hyperpigmentation include:

  • Solar lentigines: these spots are harmless and usually affect people over the age of 40. They are caused by excessive exposure to UV rays which then cause a proliferation of melanocytes and an accumulation of melanin in your skin cells.

  • The mask of pregnancy: this usually occurs in women (but can develop in men too). Melasma is caused by hormonal changes in your body, as well as excessive sun exposure.

  • Post-inflammatory hyperpigmentation: this happens when there is an injury to your skin such as a lesion, wound, insect bite, acne scar, chicken pox scar, etc. that leads to excess pigmentation.

How to Treat Hyperpigmentation

Topical prescription medications such as 4% hydroquinone are often used to treat hyperpigmentation. This medication bleaches your skin, though it may take several months for the affected areas to lighten and are temporary. Once you stop this medication your hyperpigmentation is likely to come back.

Treatments for the following degrees of Hyperpigmentation

Mild Hyperpigmentation

  1. Over the counter brightening products that contain one or more of the following. Retinol, kojic acid, Hydroquinone, Tretinoin, Resorcinol, Arbutin, Azelaic acid and Vitamin c, Vitamin e,

  2. Hydro Peel’s “ Microdermabrasion “

  3. Glycolic Acid Peels

  4. Lactic Acid Peels

Moderate Hyperpigmentation

  1. TCA Peels “ Best treatment for melasma

  2. IPL Treatments treatments involves intense pulsed light to treat the affected areas

Dark Hyperpigmentation

  1. Photofacial (IPL) treatments involves intense pulsed light to treat the affected areas

  2. Carbon Yag Phototherapy

It is also important to keep in mind that these treatments are effective only for epidermal hyperpigmentation, as dermal pigmentation cannot be treated from the surface of your skin. Instead, it must be treated with lasers or even invasive surgery (as a last resort) to penetrate the top layer of skin (epidermis) down to the dermal layer. If you have been using brightening creams to treat your hyperpigmentation and, after weeks or months of use, don’t see a difference, you likely have dermal pigmentation and will need to seek treatment from a doctor or dermatologist.

You may also have a combination of epidermal and dermal hyperpigmentation and as such may need to use multiple treatment methods.

Hereditary freckles, on the other hand, cannot be treated.

How to Prevent Hyperpigmentation

Most hyperpigmentation is caused by excessive sun exposure, which means the most important prevention technique is to limit sun exposure, wear sunscreen lotion, and use protective clothing when you are in the sun.

Other modes of prevention include:

  • If you see dark spots of hyperpigmentation developing, immediately begin using brightening products from the drugstore. Look for creams that contain kojic acid, licorice root, pine tree bark extract, or vitamin c as all of these ingredients inhibit the production of tyrosinase: an enzyme that is responsible for the development of melanin.

  • Your skin is sensitive, and it will react to picking and scratching. If you notice a pimple, blackhead, or insect bite on your skin, don’t pick at it. Manipulating these spots will increase inflammation and increase the risk of hyperpigmentation.

  • If you purchase over the counter agents to lighten your skin, be sure they contain other ingredients that will benefit your skin such as hyaluronic acid, glycerin, and retinol. All of which encourage cell turnover.

  • Individuals who are prone to dark spots on their skin should address issues as soon as they arise. Acne should be immediately treated with acne medication, and insect repellent should be used to prevent insect bites. Use sunscreen lotion if needed, but make it a priority to say out of the sun as much as possible.

  • When spending time in the sun, wear a hat and clothing with good coverage to limit the exposure of your skin to intense UV rays.