Many of us know hyperpigmentation as "dark spots." According to the American Osteopathic College of Dermatology, hyperpigmentation is "a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin." While many of us may link hyperpigmentation to acne, there are actually a few different ways hyperpigmentation can happen on the skin. Depending on the cause of the hyperpigmentation, there will be different ways to treat it. Let's discuss those different types and the best ways to treat them.
Post-inflammatory hyperpigmentation (PIH)
PIH is the type of hyperpigmentation that often happens after you had a breakout, which is why many people just refer to them as "acne scars." In actuality, PIH isn't scarring. Acne scars occur when there is either a loss of tissue or an overgrowth of tissue on the skin leaving a raised scar. These scars may even look pitted or depressed. PIH is the discoloration of the skin that occurs after your acne has healed or after there has been any type of trauma to the skin. PIH can also occur after an insect bite or scratch. According to The Skin of Color Society, certain skin conditions can lead to PIH. Some of these conditions include eczema, allergic reactions, and psoriasis. A common remedy for PIH is retinol. According to the American Academy of Dermatology, retinol is "an over-the-counter form of vitamin A." Although it may not seem like much, it is a super powerful ingredient that increases your skin's cell turnover rates while exfoliating to even out your skin tone. Other ingredients such as topical hydroquinone, corticosteroid, azelaic acid, glycolic acid, and kojic acid are also great for treating PIH. So it's best to be mindful to look for these ingredients in your skincare products when trying to treat PIH. In more advanced cases, chemical peels and/or microneedling may be recommended. Chemical peels involve applying an acid solution to the skin, which eventually peels off, making way for new skin. Unfortunately, it can be painful and cause a burning sensation that can be treated with a cold compress or over-the-counter medicine. Microneedling involves puncturing the skin with thin needles to create tiny wounds, triggering the deep layer of skin to repair itself and promote more collagen. There are at-home microneedling kits that one can buy, but for the best results, it's best to go to a professional. All in all, the best way to avoid this form of hyperpigmentation is to resist the urge to pick at your skin when it's going through issues, especially breakouts. Doing so is a recipe for hyperpigmentation because you're causing trauma to the skin.
According to the American Academy of Dermatology, melasma is characterized by “gray-brown patches” on the face, specifically on the cheeks, bridge of the nose, forehead, chin, and above the upper lip. While melasma doesn't have a specific cause, certain factors such as sun exposure and hormones trigger it. Women are statistically more likely to get it than men. Pregnancy, birth control, and hormone replacement therapy are all factors that can make a woman susceptible to melasma. In pregnancy women, it can be referred to as "the mask of pregnancy". Women on birth control can get melasma either prior or post birth control use, due to the fluctuations in hormones. Sun exposure can make it worse by making the patches even darker. The most common treatment for melasma is hydroquinone, a topical skin-bleaching agent. Hydroquinone can be found in some over-the-counter products, but the potency won't be as high as a product that's prescribed by your dermatologist. In cases that are a bit more advanced, your dermatologist may prescribe you tretinoin or a corticosteroid to add on to your hydroquinone medicine. Some dermatologists will prescribe a "triple cream" which includes all three ingredients. All ingredients are meant to enhance skin lightening. In the event where none of these topical medicines work, your dermatologist may recommend a chemical peel, microdermabrasion, dermabrasion, laser treatment, or a light-based procedure. A few tips to prevent melasma would be to wear sunscreen daily and avoid waxing. Waxing can cause skin inflammation which can worsen melasma.
Photoaging goes by so many different names, such as "age spots", "liver spots", "sunspots", etc. However, the cause is all the same - sun exposure. Photoaging usually occurs in your late thirties to early forties. The more time you spend in the sun, the more photoaging becomes apparent. Some may confuse it freckles, but sunspots are often larger than freckles and usually appear in clusters. Chemical peels are the most popular way to tackle photoaging. However, applying sunscreen is always important regardless. Intense pulsed light (IPL) is also an option for those who have lighter skin. According to John Hopkins Dermatology, IPL is a treatment for brown spots, redness, age spots, broken blood vessels, and rosacea. Generally, patients need three to six treatments. Cryotherapy is also a great option for treating sunspots. According to the American Society for Dermatologic Surgery, cryotherapy fades age spots by freezing them with a liquid nitrogen solution or nitrous oxide, causing the darkened skin to peel away from the body. The procedure is pretty quick and well-tolerated.
It would be shocking for many people to know that freckles are actually a breed of hyperpigmentation. The only difference between freckles and the other types of hyperpigmentation is that they are hereditary. Due to the fact that they are hereditary, they are the most difficult to get rid of. Sun exposure can trigger more freckles to appear on the skin, therefore it's important to wear sunscreen daily with a high SPF. Since it's impossible to get rid of them completely, sunscreen along with limited sun exposure is the best way to reduce their appearance.
With holistic remedies being all the rave right now, many people prefer natural remedies for their ailments. Fortunately, there are plenty of natural remedies for hyperpigmentation. Aloe vera, vitamin C, and vitamin E are all great for hyperpigmentation, especially when it's due to sun exposure. Aloe vera contains active compounds that aid in lightening sunspots. While Vitamin C and E, both provide protection against harmful UVA and UVB rays. Licorice extract is great for hyperpigmentation, especially melasma. Some also recommend acidic juices such as apple cider vinegar and lemon juice to treat dark spots. However, both can dry the skin if overused. All these remedies should be applied topically and can be mixed together for extra potency.
All in all, whether you are suffering from a mild case of hyperpigmentation to a severe one, there are plenty of options in treating it. Most mild cases can be solved with topical creams and natural remedies, but some may require professional treatments. When using any of these treatments, it's important to remain diligent and patient throughout the process. Hyperpigmentation doesn't fade overnight, but with consistency, results will become more apparent. It is also important to remember that no one person is the same and what may work for a friend, may not work for you. It is always best to consult with a dermatologist to decide what's best for you and skin's needs. Skin type, skin color, and age are just some factors that affect how your skin will respond to a specific treatment.