If you’re bothered by dark spots due to hyperpigmentation on your skin, today there are more options for erasing discolouration than ever before.
What exactly is hyperpigmentation? It’s any patch of skin that looks darker than your natural skin tone because the brown pigment melanin is being overproduced. Hyperpigmentation can present in liver spots (or age spots) and sunspots.
FACTORS THAT CAN CAUSE HYPERPIGMENTATION
According to the Cleveland Clinic, below are the most common causes of hyperpigmentation, and they can affect people of all skin tones to varying degrees.
Skin trauma such as acne, eczema, bug bites, cuts, scrapes, even scratching or friction from, say, vigorous rubbing, can all set off inflammation. Inflammation, in turn, can send pigment-producing cells into high gear, leaving behind a dark spot after the injury has healed. When inflammation is the cause of discolouration it is often referred to as post-inflammatory hyperpigmentation.
2. Sun Exposure
According to the Mayo Clinic, the sun’s UV rays trigger extra melanin production as a way to defend your skin from damage. That extra melanin is what gives you a tan. But when sun exposure is frequent or excessive it can make dark sunspots appear. Although sunspots are not cancerous, according to the American Society for Dermatologic Surgery, sun-exposed skin may develop pre-cancerous blemishes that look similar to sunspots. For this reason, it’s important to have your skin checked yearly by a dermatologist.
Often referred to as the “mask of pregnancy,” melasma is characterised by brown patches that commonly form in women with fluctuating hormone levels, such as during pregnancy. This type of hyperpigmentation most often occurs in women, but can also occur in men. It is thought to be triggered by a combination of sun exposure, genetics, and hormonal changes, since it has also been linked to the use of oral contraceptives, per experts at the American Osteopathic College of Dermatology (AOCD). Additionally, according to the Cleveland Clinic, other hormonal medications used for birth control and menopause symptoms may cause melasma, as well as other certain medications.
4. Medical Conditions or Medication
Hyperpigmentation can be caused by Addison’s disease, an adrenal gland disorder that can increase melanin production. Certain drugs, including antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and anti-malarials may all increase the risk of hyperpigmentation, according to a book published by StatPearls in July 2022. Some chemotherapy drugs can also cause temporary hyperpigmentation, per the advocacy group Cancer Connect. In the case of chemotherapy drugs, associated dark spots usually resolve 10 to 12 weeks after treatment ends as new skin cells replace dead ones.
THE BEST WAYS TO TREAT AND PREVENT FUTURE HYPERPIGMENTATION
Today, there are plenty of dark-spot correctors to choose from, but it’s just as essential to tackle them preventively. The following scientifically proven steps can help.
1. Keep Skin Moist to Boost Cell Turnover
While your primary goal with hyperpigmentation is to lighten the dark spots, an effective over-the-counter (OTC) moisturiser should contain ingredients that benefit the skin in other ways. “In addition to addressing the pigment issues, a good product will have moisturising agents like glycerin or hyaluronic acid, and maybe even a retinol to boost cell turnover,” says Doris J. Day, MD, a clinical assistant professor of dermatology at NYU Medical School in New York City and the author of Beyond Beautiful: Using the Power of Your Mind and Aesthetic Breakthroughs to Look Naturally Young and Radiant. “These inactive ingredients allow the active brighteners to work more effectively.”
A good moisturiser can also restore the skin’s lipid or fat barrier, helping new skin cells stay healthy as they rise to the surface in place of old ones, notes the University of Tennessee Medical Center.
2. Keep Hands Off Bites, Blackheads, and Other Injuries
As tempting as it may be to scratch a mosquito bite or squeeze a stubborn blackhead, remember your mother’s words – “Don’t pick!” – and follow that advice. “Scratching and picking at a spot will only increase the inflammation that’s responsible for skin discolouration,” says Jeanine Downie, MD, a dermatologist and the director of Image Dermatology in Montclair, New Jersey. “The more you mess with it now, the worse it’ll look later.”
3. Explore OTC Whitening Options
The sooner you treat hyperpigmentation, the easier it will be to erase. “The pigment in brown spots can move deeper into the skin over time,” Dr. Downie explains.
Spot-eradicating ingredients to look for in OTC treatments include azelaic and glycolic acids, vitamin C, and retinoids, says the American Academy of Dermatology Association (AAD).
“Treatments containing ingredients like vitamin C, licorice root, and kojic acid further help reduce hyperpigmentation by inhibiting tyrosinase, an enzyme responsible for the formation of skin-darkening melanin,” says Ni’Kita Wilson, a cosmetic chemist in New York City. Research published in 2017 in the Journal of Enzyme Inhibition and Medicinal Chemistry supports Wilson’s advice, noting that the knowledge of the link between tyrosinase and excess melanin development has led to the rise of multiple OTC products with the aforementioned ingredients.
While many of these OTC ingredients have “bleaching” effects on dark spots, the AAD strongly cautions against applying liquid bleach to your skin.
Consider an Rx for Stubborn Skin Discoloration
If OTC remedies aren’t helping, it’s time to call in the pros. Dermatologists consider products with hydroquinone, alone or combined with other lighteners, to be the gold standard for fading dark spots because it slows the production of pigment. These are available by prescription, per the U.S. Food and Drug Administration (FDA). “It’s our go-to,” says Downie, “because unlike many of the ingredients in OTC products, it almost always works at eliminating hyperpigmentation.” However have your dermatologist closely monitor hydroquinone treatment, she adds, because in high concentrations hydroquinone can cause sun sensitivity and may bleach the skin.
In addition to hydroquinone, the AOCD notes that your dermatologist may prescribe other treatments, such as topical cortisone cream or tretinoin, a type of synthetic vitamin A.
Protect Your Skin From the Sun
The most effective way to prevent sun-induced discolouration is to diligently apply a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or greater, every day, even on cloudy or cool days. “UV rays just send the pigment into overdrive, turning dark spots darker,” says Dr. Day. “You must wear sunblock daily on exposed areas.”
SPF refers to protection from UVB short-wave rays only. To also protect against UVA long-wave rays, the Centers for Disease Control and Prevention (CDC) advises choosing a product that contains Mexoryl, Parsol 1789, titanium dioxide, zinc oxide, or avobenzone.
Additionally, the AAD recommends avoiding the outdoors between 10 a.m. and 2 p.m., when the sun is strongest. You can also wear a wide-brimmed hat to protect your head, as well as your face, ears, and neck.
Ask a Dermatologist About High-Tech Options
If topical solutions aren’t fixing the problem, you may want to talk to your dermatologist about more aggressive ways to banish discolouration, such as chemical peels, microdermabrasion, or dermabrasion, or per the International Association for Physicians in Aesthetic Medicine, a laser resurfacing procedure. (Important note: If you have melasma, lasers are considered third-line treatments, as they have not been found to get rid of excess melanin production, according to a review published in March 2017 in the International Journal of Women’s Dermatology.
Other Steps to Prevent or Minimise Future Damage
Besides treatment and sun protection, there are other preventive measures you can take to minimise the onset of future dark spots. Stick to gentle skin-care products that don’t sting or burn, as irritation can worsen or trigger hyperpigmentation. Also, protect yourself against other common skin-darkening triggers by using acne medication to fight off pimples, as well as sprays to prevent bites.