Hyperpigmentation refers to abnormal darkening of the skin due to increased production of melanin, the pigment that gives skin its color. The problem can appear in small patches or involve larger areas of the skin. These darkened areas can be challenging to conceal with regular cosmetics. What causes this condition and what can you do about it?
Most frequently areas of abnormal pigmentation are due to sun damage or injury to the skin. Darkly pigmented areas called solar lentigines or age spots are very common on the hands and face. They are caused by damage due to sun exposure. Some medical conditions can contribute as can certain medications. Exposure to toxins or chemicals can also play a role. The hormonal changes associated with pregnancy and oral contraceptives can also cause temporary, patchy pigmentation of the skin. It is also very common for people with acne to experience persistent red or purple marks on the skin after acne lesions heal. This is more prevalent among people who pick at their blemishes.
It is also typical to see areas of increased pigment with other skin conditions such as psoriasis, pityriasis rosea, lichen planus and atopic dermatitis. These skin diseases cause inflammation, which stimulates melanin-producing cells called melanocytes to secrete more melanin. Inflammation can cause skin cells called melanocytes to produce too much pigment.
Hyperpigmentation occurs more frequently in people with skin that is darkly pigmented. There is a skin condition called melasma that occurs more often in those with deeper skin tones. The condition causes dark patches to form on the face, especially on sun-exposed areas. Melasma is more prevalent during pregnancy and is often referred to as the “mask of pregnancy.”
One of the most effective ingredients for lightening darkly pigmented areas is a chemical called hydroquinone. It works by blocking an enzyme responsible for synthesizing the skin pigment melanin. It is most effective when combined with a weak acid such as glycolic acid that exfoliates the surface of the skin. The combination of these two ingredients helps to lighten and lift excessive pigment. Lightening products require up to 2 months for visible results. Some people experience skin irritation and sensitivity.
Lemon juice is a home remedy commonly used to treat pigmented areas such as age spots. Lemon juice is a weak acid, which may help to exfoliate the upper layer of skin and lighten the pigment. It’s unlikely to be as effective as hydroquinone, kojic acid or glycolic acid, but you may see some gradual lightening over time with repeated use.
Dark hyperpigmentation that doesn’t respond to hydroquinone combined with glycolic and kojic acid can be treated with a prescription medication called TriLuma. It contains hydroquinone combined with Retin-A. There is a downside to this option. Retin-A causes skin irritation, redness and peeling in many people, so it’s best to use it only if other products don’t work. Laser therapy, dermabrasion and chemical peels can also be used, but these treatments are expensive and require downtime while the skin heals.
One way to prevent future pigmentation problems is to wear a sunscreen with an SPF of at least 30 that is effective on both UVA and UVB rays. Sun exposure stimulates melanin-producing cells which causes and worsens hyperpigmentation. In addition to applying sunscreen, wear protective clothing and stay out of direct sunlight as whenever possible.
Corrective cosmetics can camouflage pigmented areas and even out skin tone. These products provide good coverage and include a sunscreen to help prevent future pigmentation due to sun exposure. Treatments and cosmetics for excessive pigmentation work best when combined with sunscreen protection.
Skin hyperpigmentation is a common problem. It can usually be lightened by using a combination of hydroquinone with glycolic acid and kojic acid but there are prescription options for unresponsive and more severe cases. Always use sunscreen to prevent future discoloration and to keep existing spots and patches from getting worse.