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  5. What Is Hyperpigmentation - Causes, Treatments, Prevention Tips

The effort to cover up dark patches with makeup can be tedious! Thanks to sun damage, acne scarring and hormonal imbalances, dark patches or hyperpigmentation has become a common issue today.

Our chief dermatologist Dr. Harish Koutam, an accredited member of Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) and Cosmetic Surgeons of India, opines that there is no quick fix for hyperpigmentation. However, religious use of topical creams or timely in-office treatments can fade away your dark patches over time. Let’s tell you how.

What Is Hyperpigmentation?

Hyperpigmentation is a skin condition where patches of the skin are darker than the rest. Dark patches on the face, neck and around mouth are formed due to deposits of extra melanin - color producing pigment [1].

When pigment producing cells (melanocytes) are damaged, they produce more melanin that bundle together. Clusters of melanin on certain parts of the skin lead to dark patches or hyperpigmentation. It can occur on any skin type and age group, but is generally harmless.

Causes Of Hyperpigmentation

  • Sun exposure
  • Skin Inflammation
  • Melasma
  • Age spots or solar lentigines
  • Certain drugs

Common Types Of Hyperpigmentation And Their Symptoms

It is important that you understand the different forms of hyperpigmentation before we dive into the treatments for each of them.

Post-inflammatory hyperpigmentation (PIH) occurs as a result of a skin injury, acne [2] or injury due to procedures like chemical peels, dermabrasion and laser therapy due to an increased production of melanin. The patches can appear pink, red, brown or black in color.

Solar lentigines (age spots or liver spots) and melasma manifest on parts of the skin exposed to sun. When the skin is exposed to the harmful UVA and UVB rays, it triggers melanocytes to produce more melanin as a defence mechanism. High levels of melanin leave discolored patches on the skin.

Melasma [3] also occurs due to hormonal changes in pregnant women (also called mask of pregnancy). Age spots [4] are usually a result of photoaging - sun damage that accelerates skin aging process.

Dr. Harish recommends a visit to the dermatologist in case you notice a change in the skin color or size, shape and structure of the existing moles.

Treatments For Hyperpigmentation

1. Topical Creams

Topical creams are the first line of treatment for hyperpigmentation [5]. Be consistent with the use of creams or serums and expect visible results only after weeks or months of usage.

A. Hydroquinone

Hydroquinone is a skin lightening agent that functions by reducing the amount of melanin in the skin

B. Azelaic Acid

Acne causes inflammation and can leave the skin with hyperpigmentation. Azelaic acid treats discoloration and is a leave-on gentle exfoliant. It is one of the safest and effective treatments for hyperpigmentation.

C. Kojic Acid

Kojic acid is a natural skin lightening agent derived from a fungus. It inhibits the production of tyrosine, an amino acid required for melanin synthesis.

D. Retinoids

Retinoids is a broad term used for vitamin A derivatives. Most common forms of retinoids are retinol and tretinoin. They are a miracle ingredient in skin care known for their incredible benefits like anti-aging and skin lightening.

E. Vitamin C

Vitamin C or ascorbic acid is a powerful antioxidant that reduces hyperpigmentation caused by sun damage. It functions by inhibiting the activity of enzyme tyrosinase that is responsible for melanin synthesis.

F. Niacinamide

Niacinamide is a vitamin B3 derivative that helps in treating hyperpigmentation caused by sun damage. It also helps in production of collagen.

2. Cosmetic Procedures

These are usually performed by a certified dermatologist in their office and require professional equipment. Some of your options are:

Intense pulsed light h4 Intense pulse light (IPL) or photo facials are performed in a dermatologist's office or a medical spa. Powerful and rapid flashes of light penetrate into the skin where it breaks down the melanin [6]. The tiny fragments of melanin rise to the surface of the skin.

A. Chemical Peels

Chemical peeling can be described as the controlled chemical burning of the skin. It uses chemicals like glycolic acid (alpha hydroxy acid) or lactic acid to remove the top layers of the skin [7]. This peels away dark patches or hyperpigmented skin and allows fresh skin cells to push up the surface.

B. Laser Therapy

If your hyperpigmentation is deeper, consider a laser resurfacing treatment. Light beams are targeted at the skin to remove the epidermal layers of the skin [8]. Look for medical advice to understand if your skin is compatible for this kind of laser therapy.

C. Microdermabrasion

Microdermabrasion is a dermatologic treatment that uses a hand held machine attached to an abrasive. When this machine is rolled on the skin, it removes the top layer of the skin and the associated pigmentation [9]. The procedure is performed in several sittings for maximum benefit.

3. Home Remedies

Even though home remedies for hyperpigmentation treatment are found effective by many people, they do not contain scientific proof. Nevertheless you can give these a try:

A. Aloe Vera

The active ingredient in aloe vera is aloin, which helps in depigmenting the skin. Apply pure aloe vera gel before sleeping and rinse the next morning. Repeat until you find visible changes in the skin.

B. Licorice

Licorice root extract has an active compound called glabridin that has a lightening effect on the skin.

C. Green Tea

Green tea contains polyphenols that help in inhibiting tyrosinase activity. You can choose from a variety of topical skin care products that contain green tea.

Diagnosis Of Hyperpigmentation

Hyperpigmentation is diagnosed through physical examination by a certified dermatologist. To understand the type and severity of hyperpigmentation, your dermatologist may recommend biopsy.

Wood’s lamp examination [10] is done to rule out other skin pigment disorders like vitiligo. The procedure involves the use of light to illuminate certain areas of your skin and is performed in a dark room.

Tips To Prevent Hyperpigmentation

  • Wearing sunscreen is the number one preventive measure for hyperpigmentation. Pick a broad spectrum sunscreen [11] and apply it 20 minutes before you go outdoors.
  • Wear hats, sunglasses, stoles and protective clothing while you are outdoors to protect the skin from the harsh rays.
  • Pay attention to your skin care routine. Incorporate a mild exfoliating cleanser containing salicylic acid (beta hydroxy acid). Use a good moisturizer for hydration and to prevent further development of acne.

Is Post Inflammatory Hyperpigmentation Permanent?

Post inflammatory hyperpigmentation (PIH) fades away on its own. It may take 3-24 months for the dark spots to vanish. There may be stubborn hyperpigmentation that refuses to go away on its own, which require certain treatments.

With so many treatment options available, you no longer have to live with darker skin.

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