Hyperpigmentation, or dark spots on the skin, can be tricky to get rid of. If you are dealing with this condition, you are not alone.
Many people struggle with this common condition.
The good news is there are a number of treatments that can help lighten your skin and get rid of the pesky brown spots on your face and other areas of the body.
Many are available over-the-counter (OTC) or as a prescription given by a dermatologist.
What Is Hyperpigmentation?
The American Osteopathic College of Dermatology defines hyperpigmentation as, “a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin.”
Melanin is a brown pigment that is responsible for determining a person’s skin color. It is made by special skin cells known as melanocytes.
These cells can be found in between the outer layer of skin (the epidermis) and the deeper layers of skin (the dermis).
The more melanin that is made by melanocytes, the darker your skin will be.
Hyperpigmentation develops when there is more melanin made by some skin cells than others, which creates dark spots that stand out from your normal skin.
Types of Hyperpigmentation
There are three main types of hyperpigmentation: age spots, melasma, and post-inflammatory hyperpigmentation.
Each type is caused by something different, whether it be sun exposure, aging, pregnancy, or more. Knowing the type of hyperpigmentation you have can help you choose the right treatments to get rid of it.
Age spots are one of the most common types of hyperpigmentation.
These are flat dark spots on the skin caused by sun exposure, and they are mainly found on the hands, arms, shoulders, and face.
Age spots are common in people ages 50 and older, but they can occur in younger people who are in the sun for extended periods of time. Other names for age spots include sun spots, liver spots, or solar lentigines.
Melasma, also known as chloasma, is a hyperpigmentation condition that can develop for a number of reasons.
It can appear as blue-gray, light brown, or dark brown areas on the skin, mainly in the forearms and face. Melasma affects women much more than men (90 percent of cases are in women, while only 10 percent are in men).
In fact, melasma is known as the “mask of pregnancy” because it can make dark patches on the faces of pregnant women.
Between 15 to 50 percent of pregnant women will develop melasma. Other causes for the condition include taking certain medications, family history, and using certain skin care products.
Post-inflammatory hyperpigmentation (PIH) develops in areas where there has been inflammation from acne or psoriasis, bug bites, or other skin damage.
PIH can develop in anyone, but it is more common in people with darker skin (African Americans, Native Americans, Hispanics/Latinos, Asians, Pacific Islanders, and people of Middle Eastern descent).
Treatments to Get Rid of Hyperpigmentation
If you are looking for ways to get rid of your hyperpigmentation, there are several options you can choose from.
Some treatments may work better for you than others, depending on the type of hyperpigmentation you have, your skin tone, and how sensitive your skin is.
Consult with your doctor and/or dermatologist before beginning any of these treatments to ensure you are making the best choice for your specific case.
Skin acids, or face acids, are safe chemicals that exfoliate the skin and clear away dead skin cells to make room for new ones.
This can even out your skin tone and lighten up areas of hyperpigmentation. Examples of skin acids include:
- Azelaic Acid: used to treat redness and swelling caused by acne; it can also be used alongside other skin acids to treat hyperpigmentation
- Kojic acid: lightens the skin by preventing skin cells from making melanin
- Salicylic acid: reduces inflammation and is an effective treatment for PIH
- Ascorbic acid: derived from vitamin C, it prevents skin cells from making melanin and can break it down; because it is an unstable compound, it is combined with licorice or soy to treat hyperpigmentation
- Alpha hydroxy acids (AHAs): includes citric acid, lactic acid, glycolic acid, and tartaric acid
Skin acid products are sold as oils, lotions, and creams.
The Food and Drug Administration (FDA) recommends using products that contain 10 percent or less AHA. Products that contain more may be too intense to use at home, and are best used by a dermatologist.
If you are using products with AHA, be sure to apply sunscreen to prevent sunburns.
Your hyperpigmentation may become worse if precautions are not taken because it is sensitive after these treatments.
Retinoids are compounds derived from vitamin A. They are extremely useful for treating hyperpigmentation because they prevent skin cells from making more melanin.
In addition, retinoids are small compounds that can reach the melanocytes in the deeper layers of the skin to be more effective than other treatments.
They can also help skin cells rejuvenate and get rid of old, dead cells.
Hydroquinone reduces the number of melanocytes in the skin, creating a bleaching effect that lightens the skin over time.
This can also help stop hyperpigmentation from coming back, because there are fewer cells to make more pigment.
Retinoids are available OTC in the form of retinols, or as a prescription from your dermatologist. They can be used to treat melasma and PIH.
Lightening creams are made with special ingredients that help lighten the skin. Ingredients, like licorice extract, niacinamide (from vitamin B3), and N-acetyl glucosamine stop skin cells from making melanin.
They can also stop dark patches from forming after exposure to ultraviolet B (UVB) rays, which come from the sun.
Chemical peels use higher concentrations of skin acids to remove the layer(s) of skin with hyperpigmentation.
Melanocytes, which are the skin cells that make melanin, are found between the epidermis and dermis. Chemical peels can remove these layers to take away the pigment-producing cells, treating hyperpigmentation.
Chemical peels can be intense treatments, and it may be best to seek the help of a dermatologist.
There are products available over-the-counter (OTC) as well that can be used with caution. However, if you have sensitive skin, you may want to consider other treatment options.
Chemical peels contain skin acids that can make the skin sensitive to sunlight. Be sure to apply sunscreen before going outside in the week after a chemical peel, or your skin may become inflamed and make your hyperpigmentation worse.
These treatments can be used for age spots, melasma, and PIH.
A dermabrasion uses an electric device with an abrasive brush or wheel to gently remove the top and middle layers of the skin.
One type of dermabrasion, known as a microdermabrasion, works on only the top layers of skin to remove areas of discoloration.
Once the skin has healed (after about eight weeks) it will be smoother and the dark patches of skin will be gone.
It may take a few sessions of dermabrasion to see improvements, especially if the hyperpigmentation is spread over a large area or it is deep in the skin.
Laser treatments use intense beams of light to treat hyperpigmentation. These procedures are called laser peels or skin resurfacing.
There are two types of lasers used, ablative lasers and nonablative lasers.
Ablative lasers work just like chemical peels to remove the outer layer of the skin. They also heat the deeper layers of the skin, causing them to make collagen.
This means that there are several benefits, including removing areas of hyperpigmentation while making the skin tighter and smoother
Nonablative lasers, on the other hand, do not remove any layers of skin.
Instead, they stimulate the skin cells to make more collagen, which can make it smoother and even out the tone. One type of nonablative laser treatment is intense pulse light (IPL) therapy, which can work well for treating hyperpigmentation.
References, Studies and Sources:
- Hyperpigmentation – American Osteopathic College of Dermatology
- Skin layers and melanin – Mayo Clinic
- Age spots (liver spots) – Mayo Clinic
- Melasma – Cleveland Clinic
- Postinflammatory Hyperpigmentation – StatPearls [Internet]
- Postinflammatory Hyperpigmentation – The Journal of Clinical and Aesthetic Dermatology
- Cosmeceuticals for Hyperpigmentation: What is Available? – Journal of Cutaneous and Aesthetic Surgery
- Azelaic Acid Topical – MedlinePlus
- The effect of Vitamin C on melanin pigmentation – a systematic review – Journal of Oral and Maxillofacial Pathology
- Dual Effects of Alpha-Hydroxy Acids on the Skin – Molecules
- Comparative Study for 35% Glycolic Acid, 20% Salicylic Acid–10% Mandelic Acid, and Phytic Acid Combination Peels in the Treatment of Active Acne and Postacne Pigmentation
- Alpha Hydroxy Acids – Food and Drug Administration
- Topical Retinoids for Pigmented Skin – Journal of Drugs in Dermatology
- Chemical peel – Mayo Clinic
- Dermabrasion – Mayo Clinic
- Laser resurfacing – Mayo Clinic
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