TREATMENTS FOR HYPERPIGMENTATION
If you start to see spots or patches of darker skin on your face or elsewhere on the body, chances are it's hyperpigmentation. But, don't worry. The condition is not contagious or life-threatening. It's not even a disease. It's just your skin making more pigment than it should.
If you feel that these areas of darker patches are making you less self conscious, there are effective solutions out there. Start with this article to learn about the basics of hyperpigmentation and the best available treatments.
What is hyperpigmentation?
Hyperpigmentation is a common name for several skin disorders that cause the appearance of skin patches darker than the surrounding skin. These patches can differ in size, location, and origin.
The best examples of hyperpigmentation are sunspots, dark circles around the eyes, dark scars, and melasma.
Hyperpigmentation is not uncommon in the general population. It affects all skin types. The cause of dark patches is the overproduction of melanin (pigment) in that area of the skin. There can be many reasons for the increase in melanin production. The most common ones include:
Top Nine Hyperpigmentation Treatments
Topical skincare products and some minimally invasive aesthetic procedures are the best treatment options for hyperpigmentation. Since the condition is harmless, the indications for treatment are usually cosmetic, with a low tolerance for side effects and complications.
Following that criteria, we made this list of the nine best hyperpigmentation treatments:
Laser Skin Resurfacing
Laser skin resurfacing is a peeling procedure that strips off superficial layers of the skin. It removes dead skin cells and enables new ones to take their place. That boosts the skin's natural regenerative power.
The “new” skin that forms on the surface is free of minor imperfections, such as fine lines, sun spots, blemishes, and shallow scars.
There are two types of lasers in use, ablative and non-ablative.
Non-ablative lasers are gentler. They target only the top layer of the skin, the epidermis.
Ablative lasers are aggressive. Their effect is profound, but the risk of complications is significantly higher. 
Intense Pulsed Light (IPL) devices work similarly to non-ablative lasers. They use light energy to target and destroy melanin inside the skin.
IPL therapy usually works better on fair skin. Although, new technologies, such as radiofrequency, are making it possible to use IPL devices on dark skin.
For best results in treating hyperpigmentation, several IPL sessions are usually necessary. Flat blemishes and dark spots tend to react the best to this type of therapy.
Chemical peels may be effective against hyperpigmentation issues, such as melasma, sun spots, and blotchy skin. However, it's the more aggressive ones that work best. These carry a risk of complications, such as infections, scars, and burns. So, it's best to get them from a professional, such as a dermatologist.
Depending on the type of acid and its concentration, chemical peels penetrate different layers of the skin. Some of them are safe to apply at home, but they require multiple sessions for visible results.
Sun exposure and chemical peels do not mix well. So, avoid this type of hyperpigmentation treatment if you live in an area with lots of sunlight. Also, use plenty of SPF (30 or higher).
Lightening creams are an at-home solution for hyperpigmentation issues. They require more patience but can produce satisfying results.
Many of these products are free to purchase over the counter. However, the ones with higher concentrations of active ingredients usually require a doctor’s prescription.
The common ingredients of lightening creams include:
- Niacinamide (vitamin B3)
- Licorice extract
Retinoids are a group of topical products with long-standing use in skincare. They are a derivation of retinol, a type of vitamin A.
The effectiveness of retinoids in anti-aging is well-proven. However, treating hyperpigmentation is not their number one purpose.
Much like lightening creams, prescription versions of retinoids (tretinoin) may be more successful in treating hyperpigmentation.
Face acids are topical exfoliating products that help unlock the skin’s natural regenerative potential. They exfoliate the top layer of the skin, remove dead skin cells, and allow new cells to emerge. That forms a layer of youthful-looking skin with less visible imperfections of all kinds.
There are different kinds of face acids available on the market. The most popular ones are:
- Salicylic acid
- L-ascorbic acid (vitamin C)
- Azelaic acid
- Kojic acid
- AHA’s (Alpha-hydroxy acids)
Microdermabrasion is a mechanical skin exfoliating technique. The procedure takes place in the doctor's office or a procedure room.
The goal is to remove the top layer of the skin and facilitate natural rejuvenation. So, the principle is the same as in the case of laser skin resurfacing or chemical peels, but the method is different.
The dermatologist uses a tool with an abrasive attachment. They move it gently over the surface of the skin, removing parts of the epidermis. One session is usually not enough.
The procedure causes micro trauma to the skin, kick-starting its regenerative response.
Dermabrasion is a similar procedure. The method of application is the same as with microdermabrasion. However, the treatment reaches deeper into the skin and removes a part of the dermis too.
That effectively improves the appearance of scars, age spots, sun damage, and wrinkles.
Photodynamic therapy uses a combination of light energy and chemicals to treat various skin issues. It improves the appearance of acne, scars, fine lines, wrinkles, large pores, rosacea, age spots, and precancerous lesions.
The procedure stimulates collagen production and the creation of new skin cells. It is safe, in general. However, patients should avoid sun exposure for at least 48 hours after treatment.
The Final Word
Hyperpigmentation is usually a benign condition that does not affect the health and functioning of the skin. However, it can be aesthetically unappealing. In certain people, it may trigger mental issues, such as depression and anxiety.
Rarely, indications for hyperpigmentation treatment are more than cosmetic. In such cases, other symptoms are usually present as well. That's why it is essential to let a dermatologist or an aesthetic medicine specialist determine the best course of action.
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- Plensdorf S, Livieratos M, Dada N. Pigmentation Disorders: Diagnosis and Management. Am Fam Physician. 2017 Dec 15;96(12):797-804. PMID: 29431372.
- Trivedi MK, Yang FC, Cho BK. A review of laser and light therapy in melasma. Int J Womens Dermatol. 2017 Mar 21;3(1):11-20. doi: 10.1016/j.ijwd.2017.01.004. PMID: 28492049; PMCID: PMC5418955.
- Sofen B, Prado G, Emer J. Melasma and Post Inflammatory Hyperpigmentation: Management Update and Expert Opinion. Skin Therapy Lett. 2016 Jan;21(1):1-7. PMID: 27224897.
- Rivas S, Pandya AG. Treatment of melasma with topical agents, peels and lasers: an evidence-based review. Am J Clin Dermatol. 2013 Oct;14(5):359-76. doi: 10.1007/s40257-013-0038-4. PMID: 23881551.
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