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Hyperpigmentation: Causes, Symptoms, Types, And Treatments

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Hyperpigmentation: Causes, Symptoms, Types, And Treatments September 6, 2018

Most women have pigmentation on their skin, especially in their 30s. This happens because of excess melanin production. But sometimes, the melanin production goes awry, and your skin ends up with uneven dark patches. Also called hyperpigmentation, this skin issue can be very stubborn. Fortunately, it can be controlled. Scroll down to learn everything about hyperpigmentation and ways to treat it.

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What Is Hyperpigmentation? Why Do You Get it?

Hyperpigmentation is the discoloration of the skin, resulting in the development of dark patches or spots. The affected area appears darker than the rest of the skin. This gets worse with sun exposure. Hyperpigmentation is a broad term. Skin discoloration caused by acne blemishes, freckles that have turned into sunspots, or darkening of the skin due to conditions like psoriasis and eczema all come under hyperpigmentation.

All these skin issues boost the production of melanocytes (cells that form melanin), and this, in turn, increases melanin production on your skin. The excessive melanin gets dumped into the deeper levels of your skin, causing hyperpigmentation. These spots, when further exposed to sunlight, flare up and worsen.

Hyperpigmentation may develop due to several reasons and has specific signs and symptoms. Let’s take a look at them.

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Hyperpigmentation: Causes, Types, And Signs To Look For

Hyperpigmentation is divided into three main types, depending on the causes:

1. Melasma

1. Melasma Pinit

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This is a type of hyperpigmentation that is very common in women, especially those with darker skin tones. This skin discoloration usually occurs on different parts of your face like the forehead, nose, cheeks, or just above the lips. And that’s why melasma is a bit difficult to treat. Your body experiences hormonal shifts during pregnancy or when you take oral contraceptives or during hormonal therapies, and this increases when you go out in the sun. Sometimes, it goes away when the hormones are back to normal.

Signs And Symptoms

  • Brown patches on the skin
  • Typically occurs on the face
  • Patches are symmetrical
  • Patches usually appear on the forehead, chin, cheeks, and bridge of the nose
  • May also appear on the forearms and neck

Diagnosing Melasma

The doctor usually conducts:

  • A visual examination
  • Wood’s lamp examination, where the doctor holds a special light against your skin and checks for bacterial or fungal infection to determine how many layers of skin are affected by melasma.
  • A biopsy in case of severe melasma

What Are The Risk Factors Involved?

The exact cause of this condition is yet unknown. However, several factors may put you at the risk of melasma. They include:

  • Your genes. A study found that at least 40% of the patients had a relative who had melasma (1).
  • Excessive exposure to UV rays can cause melasma in people with darker skin tones (2).
  • Anxiety traits and using anxiolytic drugs and antidepressants also increase your risk (3).
  • Apart from pregnant women and those using contraceptives, post-menopausal women who receive progesterone during hormone therapy are also prone to facial melasma (4).

2. Post- Inflammatory Hyperpigmentation (PIH)

2. Post- Inflammatory Hyperpigmentation (PIH) Pinit

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This is a condition that results from trauma or skin inflammation such as psoriasis, eczema, and severe acne. These skin conditions increase the production of pigments, causing dark spots. This type of hyperpigmentation can affect people of any skin type, but it is prevalent in those with darker skin tones.

Signs And Symptoms

  • The pigmented patches usually appear on the area where the skin inflammation occurred.
  • The pigments appear after the inflammation or injury is healed.
  • The lesions are usually black or light brown.
  • When exposed to sunlight, the patches grow darker.

Diagnosing PIH

The skin care specialist diagnoses PIH by:

  • Carefully reviewing your medical history
  • Conducting skin examinations
  • Doing a biopsy of the patch

What Are The Risk Factors Involved?

Your risk of developing PIH increases if:

  • You have a darker skin tone (5), (6).
  • You suffer from any skin condition, such as eczema, psoriasis, and acne.
  • You have excessive exposure to UV rays.

3. Sun Damage Or Sunspots

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Excessive exposure to sun rays is the most common reason people develop hyperpigmentation. If you have developed hyperpigmentation in your early 30s, remember that the process had already begun when you were in your teens.

Sunspots are usually light brown (generally called freckles) and appear mostly on the face, neck, chest, and hands, which are primarily exposed to UV rays. People who have light to medium skin tones develop freckles, and they get darker with continuous sun exposure.

Diagnosing Sunspots

Visual examination of the skin is enough for diagnosing sunspots. However, some sunspots may be a sign of skin cancer (melanoma). In that case, the skin care specialist may conduct several other tests. Primarily, they follow the ABCDE guideline:

  • A – for detecting Asymmetry
  • B – for checking the Border (is it spreading or is notched)
  • C – for the Color
  • D – the Diameter of the spot
  • E – is it Evolving or not?

What Are The Risk Factors Involved?

  • Excessive sun exposure
  • Not using sun protection may increase your risk.
  • Your skin tone. Sunspots are most common in people who have light or medium skin tones.

Don’t worry, most hyperpigmentation responds well to treatment. Since this is one of the most prevalent skin conditions in women, continuous research is going on, and experts are coming up with newer forms of treatment to eliminate these ugly spots. From brightening agents to facial procedures, here are some of the most popular treatment options for hyperpigmentation.

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How To Treat Hyperpigmentation

How To Treat Hyperpigmentation Pinit

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1. Topical Medicine

The dermatologist often suggests topical medicines and chemical ingredients to lighten the spots, such as:

  • Hydroquinone (2%)

This is very effective in reducing hyperpigmentation (especially helpful in melasma) and prevents further discoloration (7). Usually, doctors prescribe skin ointments containing 2% hydroquinone. However, this medicine is not to be used by pregnant women.

  • Chemical Peels

Even in clinical trials, chemical peels have shown promising results in treating hyperpigmentation. Of all the chemical peels, glycolic peels are the safest and most effective in eliminating spots. Even salicylic acid and lactic acid peels work well in treating hyperpigmentation (8).

  • Retinoic Acid (Tretinoin)

Both tretinoin creams and peels act on the dark spots in a similar way. Both disperse the melanin pigments and lighten the spots (8).

  • Kojic Acid 

This bleaching agent is nontoxic (kojic acid derived from palm oil) and gives extremely satisfactory results when it comes to lightening dark spots and preventing further discoloration caused by excess melanin production (9).

  • Dimethylmethoxy Chromanyl Palmitate

This brightening agent is widely used for treating pigmentation and is a safe and effective option for treating pigmentation (10).

2. Other Treatment Options

There are several facial procedures that the dermatologist can perform on your skin to treat hyperpigmentation. Depending on the severity of your spots, you may need multiple sessions. The most common procedures are:

  • Microdermabrasion

This is a procedure in which the topmost layer of your skin is removed (exfoliate and suction them off) by using a device. You will need multiple sessions to get the desired results.

  • Laser Treatment

Also known as laser resurfacing treatment, this procedure uses light beams to remove or peel your skin surface. Laser treatment can be ablative (uses an intense laser to remove skin layers) or non-ablative (boosts collagen development and tightens the skin). Ablative lasers are a bit strong and may cause side effects. Talk to your doctor before considering laser treatment because the type of laser suitable for your skin depends on your skin type and the degree of discoloration.

3. Over-The-Counter Treatments

OTC creams are available to help lighten your pigmentation. However, some creams are a bit stronger, and you will need a doctor’s prescription to get them. But most other creams are usually mild and will not need any prescription. These come in gel or cream form and should be applied on the marks once or twice daily (or as suggested by the doctor or the manufacturer) for noticeable results. The most common OTC creams/gels include:

  • Niacinamide or vitamin B3
  • Licorice extracts
  • N-acetylglucosamine
  • Hydroquinone

You will get these creams easily, and these are affordable as compared to other professional treatments. However, remember that these work extremely slowly, and results may take longer to show up than other treatment options.

Prevention is better than cure – I know you’ve heard this since childhood, but this adage is true in this case. Pigmentation starts early from the deepest layers of your skin and will not show up until it worsens. Here is what you can do to prevent it.

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Ways To Prevent Hyperpigmentation

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  • Never Ever Forget Your Sunscreen 

Always use one that has the highest SPF and offers both UVA and UVB protection. Use it every day before going out into the sun and apply on all exposed parts.

  • Try To Avoid The Sun

You have hats, umbrellas, and sunglasses – wear them to prevent the sun rays from hitting your skin. Stay in the shade when the sun is the strongest (whenever possible).

  • Follow A Good Skin Care Routine

This helps your skin heal the abuse it goes through every day (like pollution and other environmental factors). Also, if you have an inflammatory condition (such as acne or eczema), use anti-inflammatory skin care agents regularly. Most of the times, these conditions initiate pigmentation, which gets worse if not dealt with properly.

Once you have a breakout and it heals, you should immediately follow it up by using brightening agents. Remember, “a stitch in time saves nine,” so you need to act fast. You never know when a seemingly harmless acne spot or pimple mark may flare up and worsen.

If you are battling hyperpigmentation, consult a dermatologist to figure out the extent of your condition and the treatment method that will work best for you. I hope the information provided in the article has helped you gain a better understanding about hyperpigmentation. If you have any doubts, post a comment below.

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References

  1. Melasma: a clinical and epidemiological review”, Anais Brasileiros de Dermatologia, NCBI
  2. Aggravating factors for melasma..”, Journal of The European Academy of Dermatology and Venereology, NCBI
  3. Risk Factor of Facial Melasma..”, The British Journal of Dermatology, NCBI
  4. Epidemiology of Melasma..”, International Journal of Dermatology, NCBI
  5. Incidence of Common..” Cutis, NCBI
  6. Postinflammatory Hyperpigmentation..”, The Journal of Clinical and Aesthetic Dermatology, NCBI
  7. “Hyperpigmentation Therapy: A Review”, The Journal of Clinical and Aesthetic Dermatology, NCBI
  8. “Chemical Peels..”, Journal of Cutaneous and Aesthetic Surgery, NCBI
  9. “Depigmenting Effect..”, Journal of Biomedicine and Biotechnology, NCBI
  10. “Development of a New..”, International Journal of Cosmetic Science, Wiley Online Library
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