Hyperpigmentation: what it is

Hyperpigmentation can cause significant distress as the dark spots tend to appear on the face, hands, and other highly visible body parts that have been exposed to the sun, and can be difficult to hide.

WHAT IS HYPERPIGMENTATION? AND WHY DOES IT OCCUR?

Hyperpigmentation occurs when melanin is overproduced in certain spots on the skin.

Hyperpigmentation results in flat, darkened patches of skin that are light brown to black in colour, and can vary in size and shape.

There are many types of hyperpigmentation, but the following are the most common:

How melanin overproduction leads to hyperpigmentation. — Hyperpigmentation results in flat, darkened patches of skin that can vary in size and colour.

Pigment spots such as age spots are caused by sun exposure. For this reason, they appear mainly on body parts that are frequently exposed, such as the face, hands and arms. They tend to be small, darkened patches of skin.

Melasma or chloasma is often referred to as “the mask of pregnancy”, as it affects 90% of pregnant women. It occurs as a result of hormonal influences such as pregnancy and birth control pills, and causes dark and irregularly shaped areas on the face or arms that can be quite large.

Freckles often appear on the face. — Freckles are caused by sun exposure, and commonly appear on the face.

Post-inflammatory hyperpigmentation occurs when a skin injury or trauma heals and leaves a flat area of discolouration behind. It’s commonly found among acne sufferers, and can also be caused by cosmetic procedures such as dermabrasion, laser treatment and chemical peels.

There are other factors that can cause patches of skin to become darker – such as scarring, birthmarks, solar or actinic keratoses and skin cancers – but these aren’t considered to be forms of hyperpigmentation.

WHAT MAKES HYPERPIGMENTATION AND DARK SPOTS APPEAR?

Hyperpigmentation is caused by an overproduction of melanin – the pigment that gives our skin, hair and eyes its natural colour – in patches of the skin. This overproduction is triggered by a variety of factors, but the main ones can be linked back to sun exposure, genetic factors, age, hormonal influences, and skin injuries or inflammation. Learn more about the causes of hyperpigmentation.

THE MAIN CONTRIBUTING FACTORS

Sun exposure is the number one cause of hyperpigmentation, as it’s sunlight that triggers the production of melanin in the first place. Melanin acts as your skin’s natural sunscreen by protecting you from harmful UV rays, which is why people tan in the sun. But excessive sun exposure can disrupt this process, leading to hyperpigmentation.

Once dark spots have developed, sun exposure can also exacerbate dark spots by making freckles, age spots, melasma and post-inflammatory hyperpigmentation spots even darker.

Sun exposure is a major cause of hyperpigmentation. — Sunlight triggers melanin production, making it the number one cause of hyperpigmentation.

Limiting the time you spend in the sun, wearing protective clothing, and using a broad-spectrum sunscreen with a high SPF can help reduce your risk of developing hyperpigmentation, and stop existing dark spots from getting worse.

Hormonal influences are the main cause of a particular kind of hyperpigmentation known as melasma or chloasma. It’s particularly common among women, as it’s thought to occur when the female sex hormones oestrogen and progesterone stimulate the overproduction of melanin when skin is exposed to the sun.

Close up of upper lip with hyperpigmentation — Hyperpigmentation on the upper lip can occur due to hormonal changes.

Melasma is primarily due to female hormones. It affects so many pregnant women that it is also known as “the mask of pregnancy”. It’s more prevalent among people with darker skin.

Hyperpigmentation is also symptomatic of certain illnesses, such as some autoimmune and gastrointestinal diseases, metabolic disorders and vitamin deficiencies. Hyperpigmentation is also a side effect of certain hormone treatments, chemotherapy drugs, antibiotics, antimalarials, anti-seizure drugs, and other medications.

Melasma – a form of hormone-induced hyperpigmentation – affects around 90% of pregnant women.

Photocontact dermatitis caused by henna dyes or tattooing can result in residual hyperpigmentation.

Certain jobs or occupations are also linked to hyperpigmentation due to their associated risk of exposure to sun or chemicals. People known to be at added risk include gardeners, pitch or tar workers, and those who work in perfumeries or bakeries.

As its name suggests, post-inflammatory hyperpigmentation occurs following a skin injury or inflammation, such as a cut, burn, chemical exposure, acne, eczema or Psoriasis. It occurs when the skin is left darkened and discoloured after the wound has healed.

Hyperpigmentation is a known side effect of some medications. — Certain illnesses and medications are known to cause hyperpigmentation.

WHAT CAN YOU DO ABOUT HYPERPIGMENTATION?

Dermatological treatments – anti-pigmentation procedures

Chemical peels involve applying an acidic solution to the face, hands or feet to remove the surface layers of the skin. These chemicals cause the skin to blister and eventually peel off, revealing new and evenly pigmented skin beneath.

Laser therapies have much the same effect, but tend to be more precise, as the dermatologist has more control over the intensity of the treatment. They involve ‘zapping’ the affected areas with high-energy light. The mildest treatments work just on the skin’s epidermis (surface layer), while more intense treatments can penetrate the deepest layers of the skin.

Woman getting a chemical peel — A chemical peel is one way to remove hyperpigmentation and reveal new and evenly pigmented skin.

These dermatological treatments can be very effective against hyperpigmentation but they are expensive and relatively invasive. And because they can irritate, inflame or even burn skin, they can actually cause post-inflammatory hyperpigmentation, especially in people with darker skin.

Woman getting a laser treatment — Laser treatments have a similar effect to chemical peels, but the treatment can be applied more precisely.

Other options

In recent years, a number of skincare products that claim to reduce hyperpigmentation have emerged. Most rely on one of the following active ingredients to decrease melanin production and reduce the appearance of dark spots.

Until recently, hydroquinone or hydrochinone was the most powerful active ingredient for treating hyperpigmentation. It’s still available in some over-the-counter remedies in the US, but only in low concentrations of 2% or less. Hydroquinone can also cause post-inflammatory hyperpigmentation, as it’s a skin irritant.
Arbutin is a natural source of hydroquinone, and is one of the key ingredients used in skin whitening products in Asia. It’s not as strong or effective as industrially produced hydroquinone, but there are also safety concerns.

Kojic acid is a by-product of the fermentation process involved in producing the Japanese rice wine, sake. It is a fairly weak inhibitor of melanin production. It has been banned in many countries.
Vitamin C derivatives have been shown to be relatively effective against hyperpigmentation. They’re often used in conjunction with other active ingredients.
Retinoid acid derivatives have also been shown to be relatively effective as a hyperpigmentation treatment. But they can both irritate skin and make it more sensitive to the sun, which can of course worsen hyperpigmentation. Concerns about the links between retinoids and birth defects also mean they’re not recommended for pregnant or breastfeeding women.
Azelaic acid has also been shown to indirectly affect melanin production and reduce hyperpigmentation. It has little to no effect on freckles and age spots, and can irritate and inflame skin.

A number of skincare products for hyperpigmenation are now available — A number of topical creams for hyperpigmentation have emerged in recent years.

Some skincare products can be applied to dark spots on the body. — Some skincare products for hyperpigmentation can be used on both the face and body.

Tests have shown B-Resorcinol to be highly effective at reducing melanin production.

B-Resorcinol or butyl resorcinol is the main active ingredient in the Eucerin White Therapy Clinical range. It causes little to no skin irritation and is effective against the major kinds of hyperpigmentation, like melasma and age spots.

B-Resorcinol has been clinically proven to start visibly reducing dark spots in four weeks. Regular use can produce even better results. Learn more about B-resorcinol.

There have also been claims that other treatments – such as jojoba oil, lemon juice, or following a sugar-free diet – can also be effective against hyperpigmentation. However, there’s no scientific evidence to support these claims.

Whatever option you choose, make sure you use a broad-spectrum sunscreen every day to prevent further hyperpigmentation. The White Therapy Clinical Day Cream contains a SPF, as well as B-Resorcinol to reduce existing dark spots.