Overproduction of melanin which may lead to formation of black spots (dark spots) on the skin is referred to as “Hyperpigmentation”. Various forms of increased skin pigmentation comprise of freckles, liver spots, age spots, Melasma, sun spots (solar lentigenes), under-eye dark circles, pregnancy mask, etc. Several treatments for reducing or removing darker skin are available
What exactly is Hyperpigmentation?
Hyperpigmentation – Melasma
When dark pigments seem to appear on the skin, it is known as hyperpigmentation. This is because, the skin starts producing more melanin, which is a pigment responsible to give skin its color. The dark pigmentation on face can ruin a person’s appearance as the face looks blotchy and uneven.
Hyperpigmentation can also be termed as dyschromia or increased pigmentation. There are certain areas of skin wherein melanin is produced in excess, resulting in formation of deposits of dark pigmentation on face, which result in producing skin patches that are darker than the skin in the surrounding area. The most commonly affected areas include those parts of body that are exposed to sun such as hands, arms and face.
Excessive sun exposure leads to formation of sunspots or freckles. When it comes to mountain areas of the United States of America or Australia the smallest of exposure or sun rays that can come through your window, may affect you. The sun is very strong in the above mentioned areas and slightest of sun exposure may result in freckles. The main components that characterize Melasma are the type of skin pigmentation and its distribution on the face. At times, your Plastic surgeon may recommend removing a small skin sample (numbed by local anesthetic) for assessment under the microscope (skin biopsy) so that other diagnoses may be ruled out.
Hyperpigmentation occurs very commonly and it’s comparatively harmless. It might be a cosmetic embarrassment for people who suffer from it. Hyperpigmentation or dark pigmentation patches on the face gives rise to unusually high concentration of skin pigments that are responsible for producing melanocytes. Hyperpigmentation is most likely to affect races like Mediterranean, Asian, African or Latinos.
What may be the probable causes of hyperpigmentation?
Exposure to sun
Botched skin treatments
Melasma – Commonly termed as the ‘pregnancy mask’, Melasma results due to hormonal changes that take place during pregnancy and is manifested as pigmented, patchy areas generally over the face (excluding the eye area). Melasma can be an epidermal (upper skin), dermal (lower skin) or mixed (dermal and epidermal) condition.
Treatment of Melasma on the face:-
The treatment of Melasma on the face begins with a diagnosis which in most cases is simple. But sometimes, Melasma may be due to different causes such as Lichen Planus, due to some inflammation, Guttate Hypomelanosis etc.
In some cases the treatment of Melasma on face may begin with a biopsy. Depending upon the exact cause of Melasma, the best treatment for Melasma includes some of the following precautions:-
- Stop taking any medication which may be causing hormonal upheaval.
- Wear a hat to protect your face from the sun. Use a sunscreen always irrespective of the weather and the sunscreen should have a broad spectrum.
- Do not use harsh cleansers for face.
A very important thing to remember is that best treatment for Melasma on the face will only be completely effective is good care of the skin is taken on a regular basis.
Most dermatologists start Melasma treatment in India with a topical therapy. The aim of treatment of Melasma on face is to stop the melanocytes from forming any new pigments. Most commonly for the treatment of Melasma on face Hydroquinone is used. Over the Counter hydroquinone gels and lotions etc. have less potency as compared to the ones that are recommended by dermatologists. Azelaic acid and Kojic acid are also commonly recommended for Melasma treatment in India. Almost all hospitals in India perform Melasma treatment in India.
Solar Lentigenes – mostly known as ‘age spots’, liver spots’ and ‘sun spots’, solar lentigenes are nothing but freckles caused when the skin gets exposed to sun.
Lentigenes/ Lentigo – one freckle is referred to as Lentigo; whereas numerous freckles are termed as lentigenes.
Post –inflammatory hyperpigmentation (PIH) – When the increased skin pigmentation is caused due to botched skin treatment, acne or any other cause of inflammatory skin condition.
In most of the cases, hyperpigmentation is a harmless skin condition; however presence of moles or any signs of cancer should be scrutinized by a Plastic Surgeon.
How to treat Hyperpigmentation?
There are various treatment options available for managing Hyperpigmentation cases. The best treatment for hyperpigmentation will vary from one case to another. Some of them which can be used in isolation or in combination with each other include:-
- Perfumed cosmetics or oral contraceptive pills which are known to act as triggers should be avoided.
- Skin-lightening agents
- Resorting to appropriate measures which can avoid sun exposure and usage of sun-blocking creams.
- Dermabrasion, Chemical peels and Laser treatment.
- Cosmetic camouflage
The best treatment option for hyperpigmentation will depend upon the exact underlying cause of dark pigmentation on face. People with dark skin often suffer from hard to treat dark pigmentation on face. People who suffer from this condition often find themselves facing the dilemma on how to treat the hyperpigmentation. The best treatment methodology for hyperpigmentation can only be decided by a dermatologist.
Skin lightening/Skin whitening creams:
Hydroquinone is the most commonly used chemical that may help reducing the activity of pigment-forming cells in the skin. Hydroquinone creams are known to produce irritation and hence it’s very important to be extremely careful while using these creams as they may lead to excessive lightening of skin when used for a prolonged period of time. In very dark people, Hydroquinone may, very less often, result in increased darkening of the skin by a process known as ochronosis. Nowadays, only doctors can prescribe Hydroquinone creams. Skin products comprising of skin whitening components like retinoids, hydroquinone, kojic acid and Vitamin C are commonly applied to reduce pigmentation of the skin.
Sun-protection or sun-avoidance is an extremely important practice to be followed. This is because, a skin that is already dark and pigmented, darkens even more when exposed to sun. Affected individuals are advised to apply broad-spectrum sunscreens, with a sun protection factor (SPF) of 50 or more, daily throughout the year. Broad-brimmed hat usage is also recommended.
Alpha hydroxy acids (AHAs) may also prove to be beneficial in treating hyperpigmentation of the skin. Glycolic acid and Lactic acid are the commonly used AHAs. These assist in removing the buildup dead surface cells that are already stained with pigment, thereby help to reduce the discoloration. A series of mild AHA chemical peels will also help in lightening hyperpigmentation.
Micro-Dermabrasion, Chemical Peels, Laser Treatment:
Chemical peels can improve skin pigmentation by removing the cells of the epidermis which have the excess pigment. A TCA peel or deeper phenol peel is also used to treat hyperpigmentation. These techniques should be undertaken by well established and experienced plastic surgeons, as these techniques may worsen the pigmentation, make the skin too light or cause scarring.
Certain types of laser also remove the outer layer of skin, whereas others specifically target the pigment-producing cells.
IPL Photofacial – Treatment with intense pulsed light, or a Photofacial, is most commonly recommended by doctors to treat hyperpigmentation. Nonetheless, inappropriately administered IPL treatment can worsen hyperpigmentation. We believe that IPL (and Fraxel for that matter) treatments are the worst choice for Melasma for the vast majority of those that have it.
Skin pigmentation when treated with Q-switched laser technology, the best treatment results are acquired.
Cosmetic camouflage is a special make-up, which needs to be matched to the skin color of the individual and which will not easily come off. Your general practitioner or dermatologist may refer you to someone with beautician experience (Cosmetologist) who can assist you in finding the right product and teach you how to apply it.
See Our Patient’s Acne treatment Before After Photos
Quick home tips to treat Hyperpigmentation of Skin
Potato is a natural bleaching agent and may help in removing tanning and spots.
Aloevera may prove to be helpful in lightening spots. Mix aloevera gel along with some rose water and apply it on freckles. After keeping it for 10 minutes wash off with cold water. A visible improvement will be seen if this is followed regularly.
Dr. Rinky Kapoor is a top/ Best dermatologist, Cosmetic Dermatologist, Laser Skin Expert Doctor, currently based in Mumbai, India. She has won many awards as the Best Dermatologist in India, Top 10 Skin Doctor in India, etc. She specializes in all skin diseases & conditions and given her training as a dermato-surgeon, provides non surgical liposuction surgery, laser lipo & lipoplasty etc for weight reduction & cellulite reduction. Dr. Rinky Kapoor is trained at the iconic National Skin Centre, Singapore and completed her Fellowship in Cosmetic Dermatology & Lasers at the world renowned Stanford University, USA.