Everyone has skin pigmentation. Pigmentation refers to the color of a person’s skin. Skin color is determined by the amount of melanin in a person’s skin. Darker skin has more melanin and lighter skin has less. The skin can produce excess melanin in response to an “injury” such as a suntan, trauma or inflammation, and this is when darker patches of skin can appear. Melanin can also be affected by hormone levels, birth control pills, and pregnancy (the “mask of pregnancy” usually appears as darker patches in the cheek area). Dermatologists and skin care specialists refer to a broad patch of skin discoloration as melasma. Melasma can occur in the epidermal layers, closer to the skin’s surface, or in the dermal layers, deeper within the skin layers. Epidermal hyperpigmentation is more easily treated due to the location.
This article will talk more about treating epidermal hyperpigmentation than dermal pigmentation, which can still be treated but may be more persistent. A dermatologist or skin care specialist can determine your level of hyperpigmentation using a Wood’s lamp, a dermatological diagnostic tool, which uses ultraviolet light to look at the skin.
Before discussing hyperpigmentation treatment options, an important note to keep in mind is that prevention is the key to keeping your skin even and free from unwanted sun damage. Daily use of sunscreen with an SPF of 30 or higher can make a big difference to your skin in the long run. There are so many types of sunscreens and sunblocks available these days, but what specialists recommend are those that provide physical blockage from the sun. These physical sunscreens contain titanium dioxide and/or zinc oxide to reflect the sun’s rays away from the skin. Chemical sunscreens, on the other hand, provide protection but absorb rays and can heat the skin. If you do not have access to physical sunscreen, use of a chemical sunscreen is recommended rather than no sun protection at all. If you are in a hot and sunny place, a hat also provides an excellent additional barrier, especially if you are going to be out in the sunlight for long periods of time.
Hyperpigmentation can be treated in a number of ways through home care or with various treatments in a doctor’s office, usually a dermatologist or cosmetic surgeon.
Lately there has been an influx of “bleaching agent” type products on the market, at the drug store or over the makeup counter. While some of these may help lighten your blemishes, you may not necessarily get the result you’re trying to achieve, mainly because these over-the-counter products aren’t as strong as needed to deliver optimal results. There are skin care products that are only sold through a doctor that will be more effective. Most of these products contain hydroquinone, a lightening agent, and are often combined with a retinoid, a product that increases cell turnover. Products containing alpha hydroxy acids (AHAs) and fruit amino acids also speed up the shedding of dead skin cells and the production of new ones, keeping skin looking vibrant and healthy.
Exfoliating the skin, which encourages faster cell turnover, is also another way to speed up the process of removing hyperpigmented skin. Medical-grade chemical peels, performed under the supervision of a physician, create a “controlled” injury to the skin that causes the peel. Often, a chemical peel can be performed in conjunction with another type of treatment, such as an intense pulsed light therapy procedure.
An intense pulsed light facial can significantly improve skin texture and reduce redness from rosacea, age spots, sun damage, spider veins, and uneven pigmentation. This therapy works on many different levels, literally because the broad spectrum of light is absorbed at different levels in the skin. Downtime for a treatment like this is minimal.
Another treatment for melasma and hyperpigmentation is fractional resurfacing. Instead of using light, this therapy uses radiofrequency to reach deep into the skin layers inducing a “controlled” lesion below the top layer of skin to maximize collagen production. Not only does this improve brown spots and texture irregularities, but it also works well for treating mild to moderate wrinkles.
The most intense treatment of hyperpigmentation would be to have chemoabrasion performed by a plastic surgeon or dermatologist. This is done under anesthesia and combines a mid-dermal peel with a dermabrasion. This is a much more aggressive treatment with definite downtime for proper healing. Most people who have mild melasma or hyperpigmentation spots can find other treatment options that are less expensive than chemoabrasion and provide very acceptable results.
Hyperpigmentation, while not usually life-threatening, is a popular concern because people like to show their “best” side. The good news is that it is possible to correct pigmentation, but it takes time. Many of the procedures listed above usually need to be done in a series over a period of weeks or months. There is no “quick fix” (other than cover-up makeup) to treat hyperpigmentation, but if you have the patience and resources, there are therapies that will provide lasting results.