Hyperpigmentation is a darkening of the skin due to an overproduction of melanin. It can be brought on by various injuries to the skin, acne vulgaris, sun damage, and inflammation. It is most common in people with darker skin tones who spend a lot of time in the sun, although anyone with any type of skin tone may develop it. Examples of hyperpigmentation include liver spots, sun spots, age spots, melasma (mask of pregnancy), and freckles.
There are three types of hyperpigmentation:
Light brown spots, not as dense as dermal.
Deep brown spots on the skin, some may appear ashen-grey and quite dense and solid.
A mixture of epidermal and dermal, presenting as dark brown spots.
Darkened areas on your skin are the sole symptom of hyperpigmentation. These areas may be localized on your face or hands, or may even cover your entire body.
Who is Affected
Even though anyone of any race or color can be affected by hyperpigmentation, genetically those with darker skin tones as well as Asians and those of Asian descent, are at increased risk. People who spend excessive amounts of time in the sun put themselves at more risk of developing hyperpigmentation because UV rays stimulate melanocytes into becoming hyperactive, and these are the cells that produce pigment (melanin).
An individual’s natural skin tone will determine the kind of hyperpigmentation that occurs. People with more melanin (or darker skinned people) will likely develop hyperpigmentation from scars and irritations. People with less melanin (or fairer skinned people) are more likely to develop hyperpigmentation due to sun damage.
While hyperpigmentation is usually caused by an excessive production of melanin, there are many different reasons behind why the body starts overproducing melanin. Generally, when the skin is damaged in some way, hyperpigmentation is your body’s defense reaction. Various causes include:
- Sun exposure (the most common cause of hyperpigmentation)
- Chemotherapy side effect
- Certain medications
- Changes in hormone levels
- Endocrine diseases
- Skin treatment side effects
- Various metabolic disorders
- Surgical procedures
- Chicken Pox
- Severe sunburn
- Razor bumps
- Insect bites
- Birth control pills
How to Diagnose Hyperpigmentation
What is most important when diagnosing hyperpigmentation is not the darker skin spots themselves but the reason behind why they have appeared. Generally, hyperpigmentation is strongly linked and most commonly associated with overexposure to sunlight, however, there are a number of other possibilities behind why hyperpigmentation has presented, and a doctor will need to delve into your medical history and current medical status to make a diagnosis.
A Wood Lamp is used to analyze the areas of your skin that have developed hyperpigmentation. A Wood Lamp emits black light that allows the doctor to see any fluorescence—a sign of hyperpigmentation.
Types of Hyperpigmentation include:
- Solar lentigines: these spots are harmless and usually affect people over the age of 40. They are caused by excessive exposure to UV rays which then cause a proliferation of melanocytes and an accumulation of melanin in your skin cells.
- The mask of pregnancy: this usually occurs in women (but can develop in men too). Melasma is caused by hormonal changes in your body, as well as excessive sun exposure.
- Post-inflammatory hyperpigmentation: this happens when there is an injury to your skin such as a lesion, wound, insect bite, acne scar, chicken pox scar, etc. that leads to excess pigmentation.
How to Treat Hyperpigmentation
Topical prescription medications such as 4% hydroquinone are often used to treat hyperpigmentation. This medication bleaches your skin, though it may take several months for the affected areas to lighten.
Other medications include:
- Tretinoin cream
- Glycolic Acid (GA)
- Azelaic Acid
- Trichloroacetic Acid
- Gentle cryotherapy w/ liquid nitrogen (used only with extreme caution)
- Pigmented creams: can be used to mask dark spots as a cosmetic solution
- Over the counter brightening products that contain licorice root, kojic acid, pine tree bark extract, and vitamin c, vitamin e, proanthocyanidin from wine, genistein from soybeans, ferulic acid, polyphenols from green tea, and resveratrol from wine
- Photofacial (PL) treatment: involves intense pulsed light to treat the affected areas
These medications may be used alone, or in combination. Also, a doctor might recommend chemical peels in addition to topical ointments for significant lightening of your skin.
It is also important to keep in mind that these treatments are effective only for epidermal hyperpigmentation, as dermal pigmentation cannot be treated from the surface of your skin. Instead, it must be treated with lasers or even invasive surgery (as a last resort) to penetrate the top layer of skin (epidermis) down to the dermal layer. If you have been using brightening creams to treat your hyperpigmentation and, after weeks or months of use, don’t see a difference, you likely have dermal pigmentation and will need to seek treatment from a doctor or dermatologist.
You may also have a combination of epidermal and dermal hyperpigmentation and as such may need to use multiple treatment methods.
Hereditary freckles, on the other hand, cannot be treated.
How to Prevent Hyperpigmentation
Most hyperpigmentation is caused by excessive sun exposure, which means the most important prevention technique is to limit sun exposure, wear sunscreen lotion, and use protective clothing when you are in the sun. There is also an oral sun protectant available called Sunsafe Rx that is made with natural ingredients that have been shown to help prevent hyperpigmentation.
Other modes of prevention include:
- If you see dark spots of hyperpigmentation developing, immediately begin using brightening products from the drugstore. Look for creams that contain kojic acid, licorice root, pine tree bark extract, or vitamin c as all of these ingredients inhibit the production of tyrosinase: an enzyme that is responsible for the development of melanin.
- Your skin is sensitive, and it will react to picking and scratching. If you notice a pimple, blackhead, or insect bite on your skin, don’t pick at it. Manipulating these spots will increase inflammation and increase the risk of hyperpigmentation.
- Get regular skin checks by a qualified dermatologist. Regardless of whether or not you see dark spots on your skin, scheduling regular skin checks with your dermatologist will help you to quickly curb any skin darkening with a prescription–like hydroquinone.
- If you purchase over the counter agents to lighten your skin, be sure they contain other ingredients that will benefit your skin such as hyaluronic acid, glycerin, and retinol–all of which encourage cell turnover.
- Individuals who are prone to dark spots on their skin should address issues as soon as they arise. Acne should be immediately treated with acne medication, and insect repellent should be used to prevent insect bites. Use sunscreen lotion if needed, but make it a priority to say out of the sun as much as possible.
- When spending time in the sun, wear a hat and clothing with good coverage to limit the exposure of your skin to intense UV rays.
- Take Sunsafe Rx: an antioxidant nutritional supplement that helps prevent sun damage. Just one capsule per day provides natural, healthy, anti-aging protection from UV rays. You can still also use sunscreen lotion when needed, but Sunsafe Rx provides full-body coverage all the time—even when you’re not using sunscreen.
Natural Ingredients That Help Prevent Hyperpigmentation
Hyperpigmentation that includes liver spots, sun spots, age spots, and melasma is a direct result of sun damage. Luckily, there are a number of natural ingredients that have been shown to help prevent skin damage from sun exposure (and thereby help prevent hyperpigmentation). We have written extensively about these ingredients, but they include the ingredients in Sunsafe Rx.
Also, in an article on melasma (a type of hyperpigmentation), we summarized the results from clinical trials on natural ingredients that can help prevent melasma. In particular, polypodium leucotomos, grape seed extract, and other natural ingredients including Vitamin A (from beta-carotene), Vitamin C, and Vitamin E, have all shown good clinical results in patients. A Mediterranean-type diet has also shown positive results. This is important because always avoiding sun exposure can be difficult, and taking natural ingredients that work continuously can be a convenient and effective regimen to help prevent hyperpigmentation.
Prognosis/Outlook for Hyperpigmentation
Fortunately, most cases of hyperpigmentation are not serious. While some hyperpigmentation may be caused by various diseases, the vast majority is caused by other factors such as overexposure to the sun and skin damage.
The two different types of hyperpigmentation are treated differently. Epidermal hyperpigmentation can usually be treated with over the counter medications or prescriptions such as hydroquinone. Dermal hyperpigmentation is rooted deeper in the skin and requires more invasive therapy such as laser treatments and chemical peels.
Some cases of hyperpigmentation have been known to fade away on their own, but most require some whitening agent and require several months to improve. Other spots may never lighten completely, but in this case cosmetic solutions such as pigmented creams can be used to mask the dark patches. Most hyperpigmentation can be prevented by diligently avoiding sun exposure and ingesting natural ingredients to help prevent sun damage when sun exposure on exposed skin can’t be avoided.
Even though all skin types are susceptible to hyperpigmentation, it more commonly affects people with darker skin tones–especially those of Asian descent. Hyperpigmentation usually develops on the face such as under the eyes and on the cheeks. It is also common on the hands and soles of the feet, but may develop anywhere on your body.
Wood lamps are used in diagnosing hyperpigmentation. While usually harmless, hyperpigmentation may sometimes be caused by various diseases including Addison disease, primary biliary cirrhosis, hemochromatosis, and others.
Hyperpigmentation may be treated with over the counter brightening products such as Tretinoin cream, corticosteroids, glycolic acid (GA), and others. Hydroquinone is a commonly prescribed brightening agent for individuals who need a stronger method than over the counter products. These methods work for epidermal hyperpigmentation; however, treating dermal hyperpigmentation requires more intrusive methods such as chemical peels and lasers.
When purchasing over-the-counter brightening creams to treat hyperpigmentation, individuals should search for products that contain vitamin c, kojic acid, licorice root, and pine tree bark extract coupled with an effective moisturizer to soothe the skin.
Preventing hyperpigmentation requires consistent efforts to regulate sun exposure by using sunscreens and clothing that prevents exposing your skin to the sun. Regularly checking your skin, as well as having a physician do it, will allow you to immediately treat any dark spots that are found, as treatment when pigmentation is new yields the best results. Picking and scratching your skin is strongly discouraged.
A safe and effective tool for keeping skin healthy and safe from sun exposure is Sunsafe Rx. This nutritional supplement contains natural antioxidants such as lutein, zeaxanthin, polyphenols from green tea, omega-3 fatty acids, lycopene, and many others that have all been clinically shown to effectively help prevent sun damage.