Understanding hyperpigmentation: Causes, prevention and treatment

Dre Emilie Bourgeault

Friday, June 7, 2024

What is Hyperpigmentation?

Hyperpigmentation refers to the darkening of the skin in certain areas, often due to an excess production of melanin, the pigment responsible for skin color. This can result in spots or patches that are darker than the surrounding skin. Common types of hyperpigmentation include:

  • Melasma: Often triggered by hormonal changes, melasma appears as brown or gray-brown patches, typically on the face with a reticulated appearance

  • Post-Inflammatory Hyperpigmentation (PIH): This occurs following an injury or inflammation of the skin, such as acne, eczema, or trauma.

  • Sunspots (Solar Lentigines): These are caused by prolonged sun exposure and usually appear as small, dark spots on sun-exposed areas.

Causes of hyperpigmentation

Several factors can contribute to the development of hyperpigmentation:

  1. Sun Exposure

    UV radiation stimulates the production of melanin, leading to sunspots and worsening other forms of hyperpigmentation.

  2. Hormonal Changes

    Pregnancy, birth control pills, and hormone replacement therapy can trigger melasma due to increased levels of estrogen and progesterone.

  3. Skin Injuries

    Inflammation from acne, eczema, or other skin conditions can lead to PIH as the skin heals.

  4. Medications

    Certain medications, such as antibiotics, chemotherapy drugs, and some anti-seizure medications, can cause hyperpigmentation as a side effect.

  5. Genetics

    A family history of hyperpigmentation can increase the likelihood of developing the condition.

Preventing Hyperpigmentation

While some causes of hyperpigmentation are unavoidable, there are several steps you can take to minimize your risk:

-Sun Protection: Use broad-spectrum sunscreen with an SPF of at least 50 every day, even on cloudy days. Wear protective clothing, hats, and sunglasses, and seek shade whenever possible. In patients with melasma, it is recommended to wear a tinted mineral cream. This molecule protects better due to the presence of iron oxide.

-Avoid Picking at Skin: Avoid picking, scratching, or squeezing pimples and other skin lesions to prevent PIH.

-Gentle Skincare: Use gentle, non-irritating skincare products. Harsh treatments can aggravate the skin and lead to hyperpigmentation.

-Hormonal Management: If you’re prone to melasma, discuss hormone management options with your healthcare provider.

Treating Hyperpigmentation

If you already have hyperpigmentation, several effective treatments can help lighten the dark spots and improve your skin’s appearance:

Topical Treatments:

-Hydroquinone: A skin-lightening agent that reduces melanin production. It’s often considered the gold standard for treating hyperpigmentation.This option will be evaluated in the short term since this molecule can possibly cause permanent hyperpigmentation by ochronosis.

-Retinoids: Vitamin A derivatives that promote cell turnover and reduce pigmentation.

-Vitamin C: An antioxidant that helps brighten the skin and reduce melanin production.

-Tranexamic Acid: Topical or oral by prescription.

-Azelaic Acid: A naturally occurring acid that can help reduce inflammation and pigmentation.

-Chemical Peels: Peels containing alpha-hydroxy acids (AHAs) or beta-hydroxy acids (BHAs) exfoliate the skin and promote the shedding of pigmented cells.

Laser Therapy:

Fractional lasers, intense pulsed light (IPL), and other laser treatments can target and break down melanin in the skin. Usually used as a last option.

Microdermabrasion and Dermabrasion:

These procedures exfoliate the top layers of the skin, helping to reduce pigmentation.These techniques should be used with caution since they could potentially accentuate hyperpigmentation if they are not carried out adequately.

Hyperpigmentation is a common skin condition, but with the right knowledge and approach, it can be managed effectively. Prevention through sun protection and gentle skincare is key, while various treatments can help reduce existing pigmentation. If you’re struggling with hyperpigmentation, consult with a dermatologist to develop a personalized treatment plan that addresses your specific needs. Achieving clearer, more even-toned skin is possible with the right care and professional guidance.

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