7 Doctor-Approved Treatments for Hyperpigmentation

Hyperpigmentation is caused by an excess of melanin, a brown pigment.

If you’re bothered by dark spots on your skin caused by hyperpigmentation, one thing is certain: there are more options for removing that harmless but vexing discoloration than ever before.

What is hyperpigmentation, exactly? It is any patch of skin that appears darker than your natural skin tone due to an excess of the brown pigment melanin. According to the Cleveland Clinic, hyperpigmentation can be seen in liver spots (or age spots) and sunspots.

4 Factors Contributing to Hyperpigmentation

These are the most common causes of hyperpigmentation, according to the Cleveland Clinic, and they can affect people of all skin tones to varying degrees.

1. Inflammation

Acne, eczema, bug bites, cuts, scrapes, and even scratching or friction from vigorous rubbing can cause inflammation. In turn, inflammation can activate pigment-producing cells, resulting in a dark spot after the injury has healed. Post-inflammatory hyperpigmentation occurs when inflammation is the cause of discoloration.

2. Sun Exposure

According to the Mayo Clinic, UV rays from the sun cause extra melanin production in order to protect your skin from damage. That extra melanin is responsible for your tan. However, excessive or frequent sun exposure can cause dark sunspots to appear. Although sunspots are not cancerous, the American Society for Dermatologic Surgery warns that sun-exposed skin may develop precancerous blemishes that resemble sunspots. As a result, it’s critical to have your skin checked by a dermatologist at least once a year.

3. Melasma

Melasma, also known as the “mask of pregnancy,” is characterized by brown patches that appear in women with fluctuating hormone levels, such as during pregnancy. This type of hyperpigmentation is more common in women, but it can occur in men as well. According to experts at the American Osteopathic College of Dermatology, it is thought to be caused by a combination of sun exposure, genetics, and hormonal changes, and it has also been linked to the use of oral contraceptives (AOCD). Furthermore, other hormonal medications used for birth control and menopause symptoms, as well as other types of medications discussed below, may cause melasma, according to the Cleveland Clinic.

4. Medical Conditions or Medication

Addison’s disease, an adrenal gland disorder that can increase melanin production, can cause hyperpigmentation. According to a book published in July 2022 by StatPearls, certain drugs, including antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and antimalarials, may all increase the risk of hyperpigmentation. According to the advocacy group Cancer Connect, some chemotherapy drugs can also cause temporary hyperpigmentation. In the case of chemotherapy drugs, the associated dark spots usually disappear 10 to 12 weeks after treatment is completed 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 the primary goal of hyperpigmentation treatment is to lighten the dark spots, an effective over-the-counter (OTC) moisturizer should also include ingredients that benefit the skin in other ways. “Aside from addressing pigment issues, a good product will contain moisturizing agents like glycerin or hyaluronic acid, as well as possibly retinol to boost cell turnover,” says Doris J. Day, MD, clinical assistant professor of dermatology at NYU Medical School in New York City and author of Beyond Beautiful: Using the Power of Your Mind and Aesthetic Breakthroughs to Look Naturally Young and Radiant. “By using inactive ingredients, the active brighteners can work more effectively.”

2. Keep Hands Off Bug 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 advice and don’t pick! “Scratching and picking at a spot will only aggravate the inflammation that causes skin discoloration,” says Jeanine Downie, MD, director of Image Dermatology in Montclair, New Jersey. “The more you muck around with it now, the worse it will look later.”

3. Explore OTC Whitening Options


The sooner you treat hyperpigmentation, the easier it will be to remove. “The pigment in brown spots can move deeper into the skin over time,” Dr. Downie explains.

According to the American Academy of Dermatology Association, spot-removing ingredients to look for in over-the-counter treatments include azelaic and glycolic acids, vitamin C, and retinoids (AAD).

“Treatments containing ingredients like vitamin C, licorice root, and kojic acid 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. Wilson’s advice is supported by research published in the Journal of Enzyme Inhibition and Medicinal Chemistry in 2017, which notes that knowledge of the link between tyrosinase and excess melanin development has led to the rise of multiple therapies. Wilson’s advice is supported by research published in the Journal of Enzyme Inhibition and Medicinal Chemistry in 2017, which notes that knowledge of the link between tyrosinase and excess melanin development has led to the rise of numerous OTC products containing the aforementioned ingredients.

While many of these over-the-counter ingredients have “bleaching” effects on dark spots, the American Academy of Dermatology strongly advises against applying liquid bleach to your skin. Because some imported skin lightening products have been found to be contaminated with mercury, steroids, and other harmful ingredients, the group recommends sticking with products made in the United States.

4. Consider an Rx for Stubborn Skin


If over-the-counter remedies aren’t working, it’s time to call in the experts. Dermatologists consider products containing hydroquinone, either alone or in combination with other lighteners, to be the gold standard for fading dark spots because it slows pigment production. According to the US Food and Drug Administration, these are only available by prescription (FDA). “It’s our go-to,” says Downie, “because, unlike many OTC ingredients, it almost always works at removing hyperpigmentation.” She adds that your dermatologist should closely monitor hydroquinone treatment because high concentrations of hydroquinone can cause sun sensitivity and may bleach the skin.

In addition to hydroquinone, the AOCD recommends that your dermatologist prescribe topical cortisone cream or tretinoin, a type of synthetic vitamin A.

5. Protect Your Skin From the Sun


The most effective way to prevent sun-induced discoloration is to use a broad-spectrum sunscreen with an SPF of 30 or higher every day, even on cloudy or cool days. “UV rays simply stimulate the pigment, making dark spots darker,” explains Dr. Day. “You must apply sunscreen to exposed areas on a daily basis.”

SPF only refers to UVB short-wave ray protection. The Centers for Disease Control and Prevention (CDC) recommends using a product that contains Mexoryl, Parsol 1789, titanium dioxide, zinc oxide, or avobenzone to protect against UVA long-wave rays.

Furthermore, the AAD advises against going outside between 10 a.m. and 2 p.m., when the sun is at its brightest. You can also protect your head, face, ears, and neck by wearing a wide-brimmed hat.

6. Ask a Dermatologist About High-Tech Options


If topical solutions aren’t working, talk to your dermatologist about more aggressive ways to remove discoloration, such as chemical peels, microdermabrasion, or dermabrasion, or, according to the International Association of Physicians in Aesthetic Medicine, laser resurfacing. (Important note: If you have melasma, lasers are considered a last resort because they have not been shown to reduce excess melanin production, according to a review published in the International Journal of Women’s Dermatology in March 2017.

7. Other Steps to Prevent or Minimize Future Damage


Aside from treatment and sun protection, there are additional preventive measures you can take to reduce the occurrence of future dark spots. Use gentle skin-care products that do not sting or burn, as irritation can aggravate or trigger hyperpigmentation. Use acne medication to treat pimples and bug spray to prevent bites to protect yourself against other common skin-darkening triggers.

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