Bothered by hyperpigmentation? Learn more about its causes and how to treat it

What is hyperpigmentation?

Hyperpigmentation is darkening of the skin caused by an overproduction of pigment. It affects women and men of all ethnic groups, and causes some patches of the skin to appear darker than the rest.

What Causes hyperpigmentation

Normal skin contains cells called melanocytes that produce the brown skin-coloring pigment melanin. There are several conditions in which these cells become overactive, or  appear in more concentrated clusters. Most skin conditions that cause discoloration are harmless.

What about the red/brown marks left behind after acne?

These kind of marks are very common and are a type of hyperpigmentation called ‘ postinflammatory hyperpigmentation.’  They are located at the site of a skin trauma after it has healed. Whilst it can be frustrating to have these marks, they respond well to treatment.

What is the cause of postinflammatory hyperpigmentation?

Post-inflammatory pigmentation  can result from acne, bites, burns or skin infections. The affected area may appear  light brown to black in colour, and will become darker if exposed to sunlight (UV rays).

Postinflammatory hyperpigmentation can occur in anyone, but is more common in darker skinned individuals, in whom the colour tends to be more intense and persists for a longer period.

When the skin suffers this type of damage, the activity of the immune cells and pigment producing cells (melanocytes) is altered. As a result, melanocytes produce more melanin (skin colour pigment), which is transferred to surrounding skin cells. This is known as epidermal melasma and can be treated with skin care products.

Another cause of post inflammatory hyperpigmentation is dermal melasma. This form of hyperpigmentation occurs in the deeper layers of skin and is caused when inflammation disrupts the basal cell layer. This form of cell damage occurs so deeply in the skin, it  is difficult to treat with skin care products. The good news is that mandelic acid has been specifically shown to treat dermal melasma.

What about marks caused by sun damage?

Larger flat brown spots on the face and hands arising in middle age also result from sun damage exposure. Unlike freckles they tend to persist for long periods and don’t disappear in the winter (though they may fade). Commonly known as age spots or liver spots, the correct term for a single lesion is benign solar lentigo (plural lentigines). Lentigines are common in those with fair skin but are frequently seen in those who tan easily or have naturally dark skin. Lentigines are due to accumulated pigment cells (melanocytic hyperplasia).

If the brown marks are scaly, they may be solar keratoses (sun damage) or seborrhoeic keratoses (senile warts). These are usually treated by cryotherapy.

It is important to distinguish the benign solar lentigo from an early malignant melanoma, the lentigo maligna. If the freckle has arisen recently, is made up of more than one colour or has irregular borders or if you have any doubts, see your dermatologist for advice.

What is the treatment for hyperpigmentation?

treating hyperpigmentation
how to treat hyperpigmentation

Usually, hyperpigmentation will gradually lessen over time and normal skin colour will return. However, this is a slow  process that may take up to 6-12 months or longer. Why wait a year if you can get results in weeks?

Four key treatments for hyperpigmentation are:

  1. Ascorbyl Tetraisopalmitate – STABLE Vitamin C ester (oil  soluble)
    Recommended product: EFA Intense nightly
  2. Sodium Ascorbyl Phosphate -STABLE Vitamin C ester (water soluble)
    Recommended product: Clarity C Face Wash morning and night
  3. Retinoids
    Recommended product: 2.5% Retinol Cream daily
  4. Mandelic Acid
    Recommended product: 10% Mandelic Serum at night, every 3 days

Combinations of these  treatments will result in significant improvement.

There are three essential elements to a successful treatment plan:

1) Exfoliation
This removes dead skin cells, reducing number of over-pigmented cells at surface

2) Increase Cell Turnover
This encourages healthy skin cells to form, and speeds up shedding of over pigmented cells in lower level of epidermis.

3) Anti-inflammatory Repair
This stops excess pigment being released in damaged area.

Mandelic acid & retinol achieves steps 1 & 2. Vitamin C achieves step 3. In addition, it  is advisable to use a good broad spectrum sunscreen daily to reduce further darkening.

Finally, avoid treatments that contain hydroquinone:

Hydroquinone – is effective but at a high biological cost. It is the biological equivalent of paint stripper or bleach. It might lighten your skin, but can lead to very nasty side effects. Considered significantly damaging and toxic to the skin it is banned in Europe.