There’s nothing more coveted than glowing, bright skin. Most people desire clear skin that’s free from blemishes, excessive texture or discoloration. But sometimes, blemishes like acne or even hormonal changes can cause stubborn hyperpigmentation. While this is something that can be treated and managed, it can be difficult to understand what causes it. Let’s deep dive into what causes hyperpigmentation and what to do to reverse the effects.
What is Hyperpigmentation?
According to the National Institute of Health (NIH), hyperpigmentation simply refers to an overflow or increased production of pigment, or melanin, in the skin. One of the main causes across skin tones is increased exposure to the sun. However, other issues such as dermatological conditions, age, hormones, genetics, or even skin injuries and inflammation can all trigger hyperpigmentation.
Causes of Hyperpigmentation
While there are a wide variety of factors that can contribute to hyperpigmentation, a specific few scenarios are most likely to trigger this skin condition:
Hormonal Hyperpigmentation
Hormonal reasons can include conditions like melasma or chloasma. Meanwhile, women are predisposed to the condition thanks to the increase in estrogen and progesterone. Both of these hormones are specifically responsible for boosting melanin production, especially after exposure to sunlight. Incidentally, hormone replacement therapy (HRT) can actually encourage hypopigmentation which is when melanin production is reduced, resulting in patches of skin that are lighter than surrounding areas.
Hyperpigmentation from Skin Injuries and Post-Inflammation
Hyperpigmentation caused by injuries and post-inflammation is simply due to damage or injuries. Everything from routinely popping pimples to temporary inflammation after facial or skin treatments can be to blame for this type of hyperpigmentation. However, in the case of chemical peels for hyperpigmentation treatments, any darkening effects are usually temporary.
Diagnosing Hyperpigmentation
Hyperpigmentation is a visible condition since a dermatologist can clearly see dark spots on a patient’s skin with the naked eye. However, determining the underlying cause correctly is critical to create a treatment plan that effectively tackles the problem. In most cases, people will give a medical history, undergo a physical exam, or even have a skin biopsy performed to accurately pinpoint the cause.
Treating Hyperpigmentation
For most people, topical treatments as well as in-office laser treatments and facials can be the most effective way to tackle hyperpigmentation.
Topical Treatments for Hyperpigmentation
Topical solutions can include over-the-counter (OTC) and prescription products such as hyperpigmentation creams or serums. These are usually the most common options most dermatologists will first recommend. The most frequently prescribed option is a cream containing hydroquinone because this ingredient is known to lighten the skin. However, it’s usually recommended as a spot treatment to effectively fade blemishes rather than used all over.
Still, using hydroquinone for extended periods can be damaging since it can ultimately create the opposite effect and darken the skin after a while. Alternatively, people can opt for topical retinoids which are often found in hyperpigmentation serums that are marketed to tackle blemishes.
Retinoids encourage cellular turnover, which can aid in lightening dark spots. Unlike hydroquinone, retinoids can be used for extended periods without the risk of encouraging future hyperpigmentation. However, retinoids can increase the skin’s sensitivity to the sun — so proper care is recommended.
Most dermatologists will recommend that anyone first beginning a retinoid treatment plan start by only applying the serum or cream at night to prevent increased sensitivities. Still, people are encouraged to apply a good SPF during the day to help avoid burning which can further increase hyperpigmentation.
Other treatments that might be recommended can include:
- Glycolic acid (an alpha-hydroxy acid or AHA)
- Salicylic acid
- Azelaic acid
- Corticosteroids
- Kojic acid that works like an at-home chemical peel for hyperpigmentation
- Tretonin which is similar to retinoids
- Niacinamide which is a slightly gentler alternative to retinoids.
In most cases, people can expect to see results anywhere from three to six months after beginning treatment with consistent use.
In-Office Hyperpigmentation Treatments
When at-home treatments are ineffective or don’t create dramatic results, some people might want to consider in-office treatments either at a dermatologist or with a licensed esthetician. One of the most popular options are laser treatments for hyperpigmentation — although the right specialist should be chosen with care.
As with other laser treatments on darker skin like hair removal, any dermatologist or esthetician that’s treating hyperpigmentation on melanated skin should be someone that’s well-versed and experienced in using the right type of lasers for deeper skin tones that target the problem without encouraging adverse side effects. Using the wrong ones, such as CO2 and IPL lasers that are only rated for fair to medium skin tones, can encourage more hyperpigmentation. By contrast, options like the Pico and nd:Yag are specified as safe to use on darker skin tones.
Finding the Right Solution to Reverse Hyperpigmentation
Even though hyperpigmentation usually isn’t a harmful condition and won’t typically adversely impact someone’s health, it can impact their self-esteem depending on how extreme it is. Thankfully, there are a variety of topical and in-office solutions that can produce clear skin.