What is Hyperpigmentation

If you’re struggling with hyperpigmentation, know that you’re not alone. Hyperpigmentation is skin discoloration or darkening that can affect any skin color or skin type.

This darkening occurs when the skin produces more melanin, the brown pigment that gives skin its color. It can make patches or spots of skin appear darker than surrounding areas.

Hyperpigmentation can be frustrating to deal with. It may be unsightly or psychologically disturbing for some people affected by it.

Types of hyperpigmentation

There are several types of hyperpigmentation, each with different symptoms and underlying causes.

Type Symptoms Where on the body? Who can it affect?
Age spots also termed solar lentigines or liver spots Tan, brown, or black spots that appear on the skin with sun overexposure Face and hands, or other sun-exposed areas of the body Usually affect older adults or after prolonged sun exposure
Melasma also termed “the mask of pregnancy” or chloasma Large patches of darkened skin Face, forehead, and stomach Women who are pregnant or taking birth control pills; People with darker skin are more likely to develop melasma
Post-inflammatory hyperpigmentation Patches or spots of darkened skin that result from an inflammatory skin condition, such as eczema or acne Face or neck People with skin inflammation or injury

Age spots

Age spots, also called solar lentigines or liver spots, are a common type of hyperpigmentation. They appear as the body produces more melanin to protect the skin from prolonged sun exposure over time.

These small, darkened spots are usually found on body parts (e.g., hands, face) that are exposed to the sun for prolonged periods.

Melasma

Melasma is hyperpigmentation that occurs as hormonal changes cause patches of skin to turn greyish or brown. Areas that are commonly affected include the face, forehead, bridge of the nose, upper lips, and cheeks.

Melasma may also appear in other areas of the body, especially those exposed to a lot of sunlight. These areas include the forearms, neck, and shoulders.

Melasma is more common in women with a darker complexion. This type of hyperpigmentation is also common during pregnancy, causing the “mask of pregnancy” on the face and abdomen area.

Post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) is a temporary discoloration of the skin following inflammation. This can result from acne, lupus, eczema, thermal burn, or an injury to the skin. In particular, acne-related hyperpigmentation may develop after the blemish has healed. People with darker skin complexion are more susceptible to developing PIH.

PIH appears as flat spots of discoloration on the skin. The lesions range from pink to red, brown, or black, depending on the skin tone and depth of discoloration. The more inflammation there is, the more prominent the area of discoloration will be in terms of color and size. Exposure to the sun can aggravate the symptoms of PIH, darkening the affected patches, and prolonging the time it can take for them to fade.

PIH does not cause scarring. Even without treatment, it will improve over time. Recovery rates vary from person to person: the timing depends on the difference in skin tone between the natural skin tone and the darkened patches – the more significant the difference, the longer it will take for the skin tone to rebalance.

Prevention

While it’s not always possible to prevent hyperpigmentation, there are measures to protect your skin from further discoloration or to stop it from becoming more permanent.

Avoid exposure to the sun

Wearing sunscreen every day is a must. Apply sunscreen every morning and reapply as needed throughout the day.

Be sure to use a sunscreen with at least SPF 30 to protect the skin and stop hyperpigmentation from becoming darker. Alternatively, you can wear hats or UV-protective clothing to block the sunlight.

Avoid picking at the skin

Avoid picking at scabs, spots, and acne to prevent hyperpigmentation from forming after an injury.

Address the underlying cause

Address the underlying medical condition or stop using the medication that causes hyperpigmentation as a side effect.

How to get rid of hyperpigmentation

There is a range of medical treatment options that you can try to lighten dark patches of skin and eliminate hyperpigmentation.

Lightening creams

Over-the-counter (OTC) lightening creams can help decrease the appearance of hyperpigmentation if applied once or twice a day.

Hydroquinone

Hydroquinone is a bleaching agent that eliminates dark spots while also slowing down melanin synthesis. It works best for darker spots on any skin tone. It is widely used in the treatment of post-inflammatory hyperpigmentation.

Hydroquinone cream often contains additional lightening ingredients, such as glycolic acid, kojic acid, retinoids, or vitamin C. These combination creams can confer you better results than using hydroquinone alone.

Avoid hydroquinone creams if you have sensitive skin or are allergic to it. Use it only under the care of a dermatologist to prevent adverse effects.

Vitamin B-3 (niacinamide)

Niacinamide is derived from niacin (vitamin B-3). Some research has found 5 percent of niacinamide concentrations can help lighten dark spots, possibly by increasing collagen production (1). Benefits were seen after four weeks, but not beyond two months.

N-acetyl glucosamine

N-acetyl glucosamine has been shown to reduce melanin production (2). It can also be combined with niacinamide for a more potent skin lightening effect.

Who should try lightening creams?

Lightening creams or gel works best for flat scars, such as age spots or melasma. They’re useful on most skin types.

Retinoids

Derived from vitamin A, retinoids such as retinol, tretinoin, and retinaldehyde can trigger skin cell proliferation, resulting in more rapid cell turnover and exfoliation. This renewal will help to fade post-inflammatory hyperpigmentation.

Retinoids may come in either an OTC or prescription formula. The OTC version tends to be weaker – if you don’t observe any results after several months, talk to your dermatologist about prescription tretinoin (Retin-A).

Start at the lowest strength of retinol to prevent potential irritation. Work your way up to higher concentrations as your skin adapts to it. SkinMedica Retinol Complex comes in three different potencies – 0.25%, 0.5%, and 1.0%.

Who should try this?

OTC retinoids are typically safe for all skin tones, but consult your dermatologist if you have darker skin and plan on using these products long-term.

Face acids (skin acids)

Face acids work by exfoliating or shedding the uppermost layer of your skin. As a result, new skin cells surface to replace the old ones. The process helps to even out your skin tone and makes it appear smoother overall.

Many face acids are available OTC. Popular options include:

Alpha-hydroxy acids (AHAs)

AHAs such as glycolic acid, salicylic acid, and mandelic acid peels can be used to reduce acne-related hyperpigmentation. It helps accelerate the skin’s natural exfoliation process, which can help improve the appearance of post-inflammatory hyperpigmentation.

Azelaic acid

Azelaic acid is another remedy for acne-induced hyperpigmentation, melasma, and raised brown spots. It works by reducing inflammation and speeding up cell turnover rates.

Azelaic acid is most effective in concentrations of 20%, which is as useful as 4% hydroquinone at treating hyperpigmentation. It is a good alternative for those who may not be able to use hydroquinone.

However, there is a risk of hypopigmentation if you have dark skin.

Kojic acid

Kojic acid is a natural bleaching agent and a gentle alternative to hydroquinone. It penetrates the outer skin layers and inhibits melanin production. It’s often used for age spots and may work best for brown-colored acne-related hyperpigmentation.

Kojic acid may pose a risk of causing hypersensitization or allergic reactions in some people.

Who should try acids?

Face acids are suitable for mild hyperpigmentation on fairer skin tones.

Chemical peel

A chemical peel uses high-concentration acids to treat moderate-to-severe skin conditions. They erase hyperpigmentation by removing the epidermis. Unlike face acids, in-office professional-grade chemical peels penetrate the dermis (middle layer of your skin) and yield more dramatic results.

Chemical peels involve applying a chemical solution (e.g., AHA) to exfoliate the skin, stimulate the growth of new skin cells, and reveal new skin.

Possible risks of chemical peels include redness, blistering, and irritation. Furthermore, chemical peels can cause your skin to be more sensitive to the sun, which may worsen the hyperpigmentation.

Who should try chemical peels?

Chemical peels may work if you have:

  • Sun damage
  • Age spots
  • Blotchy skin
  • Melasma

They work best for fairer skin tones, and they may be more efficient than OTC face acids.

Laser peel (skin resurfacing)

A laser peel treatment uses high-energy light to resurface hyperpigmented skin areas. New skin grows back smoother and more evenly toned than before.

There are two forms of lasers: ablative and non-ablative. Ablative lasers are intense, and they involve penetrate deep layers of your skin. On the other hand, non-ablative procedures target the epidermis (surface skin layer) to promote collagen production and tightening effects.

Who should try this?

Laser peels may work better for people with fairer skin tones.

Dermabrasion

Dermabrasion involves the removal of your epidermis and the uppermost part of the dermis. It addresses uneven skin texture and hyperpigmentation.

During this procedure, your skincare provider will use a drill-like handheld tool with an abrasive attachment. They’ll move the device across your skin rapidly – but gently – remove your entire epidermis and the uppermost part of your dermis.

Who should try this?

Dermabrasion works best for fairer skin. It can decrease pigmentation at a faster rate than microdermabrasion.

Microdermabrasion

Microdermabrasion is used to treat superficial scarring that affects the epidermis only. It is a less aggressive form of dermabrasion but may still work well for acne-related hyperpigmentation. You may need weekly treatments to observe results.

Who should try this?

Microdermabrasion works best on superficial scars, especially in people with fairer skin.

What works best for your skin tone?

The effectiveness of hyperpigmentation treatments vary in people with different skin tones – people with darker skin need more time for the treatment to work.

Fair skin tone

Fair skin responds well to most types of hyperpigmentation procedures.

Medium skin tone

Medium skin tones may benefit from:

  • Chemical peels
  • Microdermabrasion

Dark skin tone

Darker skin might benefit from:

  • Microdermabrasion
  • Low-strength chemical peels
  • Low-intensity laser treatments, over a large number of sessions

The following might be off-limits if you tan easily or have darker skin:

  • High-beam lasers
  • IPL therapy

Home remedies

There are several anecdotal home remedies that you can try to minimize the signs of skin hyperpigmentation.

Sunscreen

Sunscreen is essential for improving and preventing hyperpigmentation. Opt for:

  • A mineral sunscreen, preferably with iron oxide or zinc oxide as the main active ingredient
  • At least an SPF 30 to 50
  • Broad-spectrum coverage

Use sunscreen daily. Reapply it every 2 hours if you’re out in the sun – more frequently if you’re sweating or swimming. You can also wear sun-protective SPF-infused clothing.

Aloe vera

Aloe vera has skin-lightening active ingredients, known as aloesin and aloin. They may minimize the appearance of hyperpigmentation by destroying existing melanocyte skin cells and inhibiting the production of melanin in the skin. Scientists have also shown that the topical application of aloe vera protects the skin from hyperpigmentation when exposed to the sun (3).

You can apply aloe vera gel to the skin daily.

  1. Rub a thin layer of the aloe vera gel on the hyperpigmented area of skin before bedtime.
  2. Rinse using warm water the next morning.
  3. Repeat daily until your skin tone improves.

Licorice

Licorice extract contains active ingredients (glabradin and liquiritin) that may lighten hyperpigmentation caused by sun exposure and melasma. It’s one of the safest and most gentle bleaching agents available.

Topical licorice extract creams are available over-the-counter. Use as directed on the packaging.

Orchid extract

Research showed that orchid extract is just as effective as vitamin C in improving the appearance of hyperpigmentation spots (4).

You can buy topical orchid extract products over-the-counter. Examples include orchid extract masks, creams, and scrubs. Use as directed for the best results.

Apple cider vinegar

Apple cider vinegar contains acetic acid, which could act as a natural peel that lightens pigmentation. Furthermore, it contains polyphenols, which act antioxidants that protect skin cells from damage.

To use apple cider vinegar:

  1. Combine 1 part apple cider vinegar and 1 part water.
  2. Apply to your pigmented area and leave on for two to three minutes.
  3. Rinse thoroughly with lukewarm water.
  4. Repeat twice daily till you achieve the desired results.

Milk or yogurt

Milk and yogurt contain lactic acid, which can help with mild hyperpigmentation. Use the specially-formulated milk and yogurt skin lightening products as directed.

Green tea

Research shows that green tea extract and its main active ingredient, epigallocatechin-3-gallate (EGCG), may have a depigmenting effect when applied to the skin (5). The green tea leaves themselves also contain ellagic acid and gallic acid, which may help improve skin tone.

You may take an oral EGCG supplement or apply a green tea skincare product to the pigmented area.

The Bottom Line

Hyperpigmentation is merely a harmless cosmetic concern. In some cases, dark spots will fade on their own with proper skincare routine. In severe cases, more aggressive treatment is needed.

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