All about hyperpigmentation

What is hyperpigmentation?

Hyperpigmentation is a condition that causes dark spots to appear on your skin. These spots are caused by an overproduction of melanin—the pigment that gives skin its color—and can be light brown, dark brown, or even black.

What causes hyperpigmentation?

Hyperpigmentation can be caused by several factors:

• Inflammation. Dark marks can be caused by inflammation (like acne) or trauma (like wounds) on the skin. 
• Hormonal changes or imbalances. Hormonal changes can cause your body to produce more melanin. This is why many women experience hyperpigmentation during pregnancy (a.k.a. chloasma and linea nigra) or when they go through menopause—and the same goes for polycystic ovarian syndrome (PCOS) and hormone replacement therapy (HRT).
• Sun exposure. Prolonged exposure to UV rays can cause hyperpigmentation and accelerated skin aging.
• Age. As you age, your skin becomes less elastic and is more susceptible to damage from environmental stressors, especially UV rays—leading to solar lentigines (a.k.a. sun spots, age spots, or liver spots).
• Medications. Certain medications can increase your skin’s sensitivity to light and cause hyperpigmentation as a side effect. These include tetracycline, birth control pills, and other hormonal treatments.

What are the different types of hyperpigmentation?

Post-inflammatory hyperpigmentation (PIH) (a.k.a. dark acne marks) is a type of dark skin discoloration that can occur after an injury to the skin—typically acne. When inflammation occurs within the dermis, melanocytes produce excess melanin.

Solar lentigines (a.k.a. sun spots, age spots, or liver spots) are a form of freckles that appear as spots or splotches on the face. They’re caused by sun exposure and are especially prominent in middle-aged adults with fair skin—although people with darker complexions can also develop them.

Melasma is a skin condition that causes brown or grayish-brown patches on the face. The patches are usually symmetrical, meaning they occur on both sides of your face, and usually appear on the cheeks, forehead, chin and even the upper lip. Melasma can affect men and women of all ethnicities, but it’s most common in women who have medium to dark skin tones and often begins during pregnancy or after taking birth control pills.

How to treat hyperpigmentation

Topical treatments

Many topical treatments can be used for lightening hyperpigmentation, including but not limited to:

• Depigmenting agents like:

  • Hydroquinone
  • Vitamin C
  • Arbutin
  • Kojic acid
  • Niacinamide
• Retinoids
• Glycolic acid
• Azelaic acid

—which can be prescribed to you by your dermatologist, either individually or in combination.

Oral treatments

Oral medications may include:

• Tranexamic acid
• Melatonin
• Glutathione

—which inhibit the body’s melanin production. These treatments are available over-the-counter and through your dermatologist’s prescription and can be used in conjunction with topical treatments.

In-clinic treatments

In-clinic treatments like:

• Chemical peels
• Laser therapy

—can be prescribed in addition to other topical medications by your dermatologist to treat unwanted hyperpigmentation more effectively.