What is Hyperpigmentation?
Hyperpigmentation (HP) is another word for dark blotches on the skin. Age spots are one example, and these dark places can appear because of sun damage, acne or skin injury. A skin pigment called melanin creates the spots, and they often show up on the face, chest, arms and the back of the hands since these areas are most often exposed to the sun.
Heat and inflammation caused by the sun prompt special cells in your skin called melanocytes to become active. They protect your skin from the sun's ultraviolet radiation by spreading it out and absorbing some of it. Even when you're wearing sunscreen, the heat causes inflammation that activates these cells. Some of the active melanocytes start to multiply, and this can lead to a dark area on your skin.
Age, genetic factors and sun exposure are all implicated in the tendency to develop hyperpigmentation spots. Hormone treatments and certain medications can also trigger the increased melanin production that causes excess pigmentation. Hormones produced during pregnancy sometimes cause pregnant women to develop chloasma, a pattern of darker skin on the face. Vitamin deficiencies, illness, disease and metabolic disorders can also cause HP spots.
One type of skin darkening, post-inflammatory hyperpigmentation (PIH) can be caused by extreme cases of acne. Part of the process of healing a scrape, wound or acne lesion is activity by melanocytes. It's an immune response to injury since melanin is an antioxidant that improves the body's ability to fight bacteria.
Unfortunately, this also involves the release of enough melanin to darken the affected area. HP spots on your skin are evidence of previous lesions or of your body's melanin having provided protection from sun damage and changes to DNA that could cause skin cancer.
Eczema, dermatitis and psoriasis are conditions that irritate the skin and often leave behind darker spots after a severe rash. It's important to treat inflamed areas right away with the appropriate medications in order to minimize the symptoms. The spots can wear away on their own eventually because of cell turnover; as layers of skin die and slough off, the new skin has less pigmentation. People with more natural melanin in their skin are more prone to PIH, and it may take longer for their spots to fade.
Many times, hyperpigmentation occurs as a direct result of time spent in the sun. It can take decades for the melanin reaction to occur, and that's why people who were sun worshipers in their twenties might not start seeing dark areas on their skin until they're in their thirties or forties. Elderly people have a higher incidence of dark skin patches because of the cumulative effects of sun exposure over time.
What Does Hyperpigmentation Look Like?
These dark spots left behind after inflammation, injury or sun damage are flat and usually have irregular edges. They can range from light pink to purple, brown or even black. The affected area isn't considered a scar because the tissue doesn't get eroded or puckered. The excess melanin is the only residual effect of the wound healing or UV protection that has taken place.
Can You Prevent It?
The best way to prevent hyperpigmentation is to limit exposure to the sun. Using a sunscreen whenever you're in the sun is vital, and those that contain zinc oxide block the ultraviolet rays more effectively. Most people think of sunscreen use as being limited to the pool or the beach. But keep in mind that going for a walk, working in the yard, and even driving can be opportunities for the sun's rays to reach your skin.
Another common cause of HP is excess melanin from healed acne lesions. Keeping acne under control is the best way to prevent new dark spots from forming. Some acne medications have properties that lighten hyperpigmentation spots as they treat the acne.
What is the Treatment for Hyperpigmentation?
Over time, an HP spot will naturally lighten, but the degree of fading depends on how dark it is. It can take up to two years for an over-pigmented patch on the skin to fade, and some places will never completely go away. There are over-the-counter treatments that can cause less severe spots to lighten, and a dermatologist can recommend a prescription treatment that's effective on darker ones. Some cosmetic procedures can also minimize dark places on the skin.
Glycolic Acid has small molecules that penetrate the skin easily and help it shed dead skin cells. It's less irritating than some other exfoliating skin treatments, but it can take time for it to work. Glycolic acid also stimulates collagen production, making it a useful everyday treatment for slowly fading existing brown spots and inhibiting new ones from forming,
Niacinamide is a form of vitamin B-3 that has fewer side effects than prescription-strength lighteners like hydroquinone or tretinoin. It has anti-inflammatory properties and works as a gentle exfoliant with few side effects. Like glycolic acid, it will slowly fade existing HP patches and inhibit new ones.
Hydroquinone inhibits the production of melanin in the skin. Over-the-counter strength hydroquinone creams often contain additional lightening ingredients like kojic acid, glycolic acid, tretinoin and other retinoids, or vitamin C. These combination creams can give you better results than using hydroquinone alone. Side effects can include dry, peeling skin, redness and irritation.
Vitamin B-12 is crucial for many cell functions including the prevention of lesions. Taking oral supplements of B-12 can lead to a marked lightening of melanin spots in people who previously had a deficiency. It's a highly recommended supplement for preventing anemia, supporting nerves, and maintaining healthy blood cells as well.
Vitamin C can be applied directly to the skin via vitamin C serum. This vitamin inhibits the production of melanin in your skin by suppressing the enzyme tyrosinase. It will fade the darker spots without making the rest of your skin any lighter. The antioxidant, anti-inflammatory and anti-aging properties of vitamin C make it a necessity for healthy skin, and the melanin-lightening properties are a bonus.
Hydroquinone (prescription-strength) is a chemical that inhibits production of melanin in the skin by inhibiting melanin-producing tyrosinase. However, it also breaks down the melanin in existing melanocytes. Prescription-strength hydroquinone can cause skin to become red and irritable with heightened sensitivity to the sun.Prescription Hydroquinone Cautions
Spending time in the sun when using it can cause damage to your skin. Neither over-the-counter nor prescription-strength hydroquinone is safe to use during pregnancy. Prolonged use at high concentrations can actually causehyperpigmentation, and a doctor's supervision is necessary when using hydroquinone.
Azelaic Acid is an antioxidant and anti-inflammatory that limits the free fatty acids in the skin, making it a barren environment for fungi and bacteria. It's derived from wheat and barley, and it heals the skin at the same time that it lightens pigmentation. Side effects can be a stinging sensation on the skin, redness and dryness. While it's an effective treatment for acne, only the prescription strength has an appreciable effect on hyperpigmentation.Azelaic Acid Cautions
Some people are allergic to azelaic acid, so a skin patch test should be done before using it to rule out itching or an allergic reaction. It's important to replace the moisture lost by treatment with azelaic acid to prevent premature aging of the skin.
Tretinoin is a vitamin A derivative also known as retinol. It encourages cell turnover/exfoliation and stimulates the growth of new cells. It also keeps pores from being blocked, making it a useful treatment for acne as well as hyperpigmentation. The well-known brand name for prescription tretinoin is Retin-A. The combination of tretinoin and azelaic acid may work best for lightening skin while minimizing the side effects of each treatment.Retinoid Cautions
The use of retinoids can lead to dry skin and a heightened risk of sunburn, so moisturizer and sunscreen are vital elements of this treatment. If your skin becomes extremely red or irritated, let your doctor know. Never exceed the amount of retinol cream prescribed by your dermatologist, because it is toxic in high doses. Here are warning signs of excessive retinol intake:
- Intestinal cramping
- Blurred vision
Dermabrasion lightens dark patches of skin by removing the top layer of cells, basically by sanding the top layer of skin away. If you choose this route, do your homework and check out the various practitioners. Make sure that a licensed esthetician performs the procedure because overexposure to the treatment can actually cause more hyperpigmentation.
Chemical peels use acids to remove pigment from the skin. The top layer of skin peels off, exposing fresh skin cells that don't have the discoloration. This procedure is only suitable for those who don't have sensitive skin. Dark spots on the surface of the skin can be removed by freezing them with liquid nitrogen. Laser therapy is a targeted treatment that can shatter pigment deposits under the skin.
Hyperpigmentation Treatment and Acne
Dark spots caused by healed acne lesions are treated the same way as HP caused by sun damage, aging or injury. For skin-lightening to be effective, however, the acne should be under control first. If it's not being successfully treated, the dark spots will continue to form even as they're eliminated.
Some treatments, such as tretinoin (brand name Retin-A) and azelaic acid, are acne treatments as well as hyperpigmentation medications. Tretinoin causes cell turnover that fades discolorations, and azelaic acid inhibits the formation of melanocytes.
These medications can cause peeling, red and irritated skin and make your skin more sensitive to the sun. Stay indoors as much as possible, and use sunscreen when you're outside because the sun can darken existing spots. There are sunscreens for people of every skin type, including those with dry or oily skin and those with acne.
Emotional Effects of Hyperpigmentation
One good piece of news is that hyperpigmentation doesn't negatively affect your health, and physicians aren't concerned about it. The main problem with these dark splotches on the skin is the way they make people feel. Most of us will end up with a few spots here and there that are nothing more than a nuisance.
When HP becomes excessive, though, it can lead to self-consciousness and anxiety in some people. Spots in noticeable places, such as the face, can lead to a lack of self-esteem. Treatments to diminish heavily pigmented areas can help alleviate these feelings.
Anti Hyperpigmentation Diet
Foods that contain a lot of vitamin B-12 will help your skin be less susceptible to hyperpigmentation and lesions of all kinds. This vitamin isn't made by the body and is only present in animal foods or supplements. You can take it in a pill form, and it's present in most multi-vitamins. Some foods are fortified with B-12 and, for those who are deficient, shots can be prescribed by a physician. Here are some of the best food sources of vitamin B-12.
- Cottage cheese
Besides ensuring that your diet includes sufficient vitamin B-12, eating foods that are high in antioxidants will protect your skin. Here are some of the top foods you can eat to get that antioxidant boost.
5 Natural Skin Care Tips to Prevent Hyperpigmentation
1. The number one tip for preventing new dark splotches and keeping existing ones from darkening is to use a 30-SPF sunscreen when outdoors.
2. Make sure that the pigment-lightening products you use contain collagen to strengthen your skin.
3. Encourage cell turnover with non-prescription exfoliating products like glycolic acid and vitamin C.
4. Give your skin the nutrients and moisture it needs every day.
5. Eat well for your skin's health, including getting enough vitamin B-12 daily.