What Your Dermatologist Wants You to Know About Hyperpigmentation
The causes, types, and remedies for one of the most common skin issues
What is hyperpigmentation?
Hyperpigmentation is a broad term used to refer to discoloration on the skin. Usually, hyperpigmentation manifests in the form of dark spots or patches of skin that are relatively darker than their surroundings. The root of this problem is found to be the overproduction and irregular distribution of melanin in the skin. Melanin is produced by cells called melanocytes, which live in the outermost layer of our skin, the epidermis. Melanocytes can be stimulated as a consequence of multiple factors. They are triggered most commonly by inflammation and UV radiation due to sun exposure and visible light. The key to treating this issue is identifying which type of pigmentation has occurred from among the three main ones (dark spots, post-inflammatory and melasma) so that targeted prevention and treatment can be carried out.
What are the three main causes?
1. UV Radiation: Every time we step outside, we are inevitably exposed to the harsh rays of the sun. For the most part, sunscreens help with protection. However, our face and hands are the two most sensitive areas that are prone to damage inadvertently caused by high exposure to harmful UV rays of the sun. In such a situation, the melanocytes are naturally triggered to produce more melanin — this is actually our body's way of protecting itself. As a result, when the pigment is evenly distributed, it appears as a 'tan', but over time and with increasing sun exposure, most of the pigment ends up being distributed unevenly. This uneven distribution is hyperpigmentation, and it can take form as freckles, age spots or melasma.
2. Inflammation: Damage, inflammation or irritation on the skin due to acne, dermatitis, cuts etc. can produce substances that affect pigment production. This is known as post-inflammatory hyperpigmentation.
3. Hormones: Fluctuations and an imbalance of hormones, especially in women, lead to hyperpigmentation as well. A combination of UV rays and hormonal imbalance causes the specific type of pigmentation referred to as melasma. Estrogen and progesterone, the female sex hormones, stimulate the overproduction of melanin which leads to dark spots.
What are the different ways in which hyperpigmentation can appear?
· Age spots: A common sign of skin aging, this form of hyperpigmentation is caused by overexposure to UV rays (i.e. sun damage). Areas that are the most prone to developing age spots are those that are exposed to the sun most frequently, such as the face, neck, forearms and hands.
· Post-inflammatory hyperpigmentation: This is the term for the skin discoloration that lingers after certain skin trauma, such as acne, eczema, a rash or a cut.
· Melasma: This is a form of hyperpigmentation that's more common in women and believed to have hormonal ties. It manifests as patches of discoloration usually on the cheeks, the bridge of the nose, the forehead, the chin, and above the upper lip. It is commonly triggered by the hormonal changes associated with pregnancy.
· Freckles: Usually genetic, but they may become darker and more visible with UV exposure.
How to prevent and treat hyperpigmentation?
There are some basic precautions that should be followed and incorporated in our daily routines to avoid the issue of hyperpigmentation, such as avoiding overexposure to the sun and choosing the right ingredients in our topical creams. These ingredients help to reduce pigmentation on the skin:
Sunscreen: Using a daily broad-spectrum sunscreen with SPF-30 or higher, ideally with a physical sunblock such as titanium dioxide or zinc oxide, is recommended.
Vitamin C: A rich antioxidant serum containing vitamin C for the daytime is also essential because it treats hyperpigmentation by inhibiting the enzyme tyrosinase, which is responsible for melanin synthesis.
Hydroquinon, Kojic Acid: Skin lightening agents that function by reducing the amount of melanin in the skin and thereby prevents discoloration.
Azelaic Acid: A gentle exfoliant that sheds the outermost layer to form an even-toned and smooth skin.
Niacinamide: A vitamin B3 derivative and another skin lightening agent that lightens dark spots and treats hyperpigmentation caused primarily by sun damage.
Retinols: OTC and prescription retinols or retinoids penetrate deep into the skin and stabilize melanin production. They also promote cell-turnover.
Clinical Treatments
For faster and more long-term results, the ideal method to prevent and treat hyperpigmentation is an in-office procedure. Consulting a dermatologist is recommended so that the issue can be analyzed and diagnosed before an appropriate treatment is identified. We offer the following cosmetic treatments to treat the persistent issue of hyperpigmentation:
A suggested treatment with very little downtime, chemical peels are designed to treat hyperpigmentation, improve acne, even out skin texture, brighten skin tone, and reduce the appearance of fine lines.
What to expect: In this treatment, a chemical solution containing glycolic acid (alpha hydroxy acid) or lactic acid is applied to the skin. The outermost layer with the dark patches is eventually ‘peeled’ off leaving behind fresh, glowy skin that is facilitated by new skin cells that have been pushed to the surface.
Results: The products used in this treatment coupled with medical and professional supervision ensure a thorough treatment of hyperpigmentation, and brighter and even-toned skin.
Another highly recommended treatment for hyperpigmentation is dermaplaning. A deeply exfoliating procedure that removes build-up of dead skin cells leaving behind healthy, glowing, fresh skin, and visibly reduced dark spots.
What to expect: A licensed medical aesthetician gently scrapes the surface of the skin with a surgical scalpel to remove build-up of dead skin cells and peach fuzz, instantly revealing brighter skin with a smooth finish. It takes off most of the epidermis, the outermost layer of your skin, regulating certain growth factors, like fibroblasts and vascular. This, in turn, also stimulates collagen production.
Results: This treatment has multiple benefits ranging from plump, smooth skin to reduced acne and breakouts. An important benefit, in this context, is the instant brightening and glowing skin that is revealed as a result of the deep exfoliation. This diminishes dark spots, patches and discoloration that occurs.
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