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Hyper-Pigmentation - The Cause/Triggers, Treatments & When It's Time To See a Dermatologist


What is Hyper-Pigmentation: 

There are various types of hyper-pigmentation, the triggers associated and also the treatments available. Hyper-pigmentation can occur when the skin produces an excessive amount of melanin (the pigment that gives skin its colour) within the layers of the skin. This can create spots/marks on the skin that appear darker than surrounding areas.

The Causes:

The most common forms of hyperpigmentation are:
Age/Sunspots - are brown, tan, or black spots that appear on the skin with sun overexposure. Commonly they appear on the face, neck, and hands, and other areas exposed to the sun.

Post Inflammatory - this creates spots/ patches of darkened skin that appear after an inflammatory skin condition, such as acne, eczema. The treatment for this tends to be a difficult and prolonged process (often takes 6-12 months to achieve the desired results. Each topical treatment options may improve the epidermal layer, but not the underlying dermal layer.

Melasma - Now this bitch is a real, well bitch. It usually covers larger areas of skin than other types of hyperpigmentation,  usually appears on the face. It commonly affects women. Melasma is more common in people with darker skin and may have a bent link. There is a lot of uncertainty as to what causes it. Generally it's thought hormones can sometimes trigger it, but it's also tied to the vascular system. 

Pregnancy and taking birth control can both be triggers. When a person is no longer pregnant it usually fades. If trigger by birth control it can linger after use has been discontinued on occasions. Sometimes it can disappear on its own, but for some people without treatment, it may not. The good news is it can be reduced in the same ways as other types of hyper-pigmentation it just may require longer care or varied approaches like topical combined with other treatments like some mentioned below,
 
Medical conditions - Eg. Reaction to medications, rarer cases are Addison's disease or Hemochromatosis

How do I Treat Mild - Moderate Hyper-Pigmentation?:

I’ve put a list of topical products I personally would consider the more effective topical options. Each of the below ingredients are effective on their own for mild/superficial hyper-pigmentation. For more moderate-severe cases a combination of 1-2 brightening agents with an AHA or Retinoid can dramatically boost results.

Hydroquinone - Considered the gold standard to treat pigmentation. This is a synthetic lightening agent that is effective at inhibiting the production of melanocytes which results in more even tone over time. This best suited to treat fairer skin tones. Unfortunately there are a few side effects associated with sensitivity/irritation, hyper-pigmentation (yup), and on rare occasions has caused a condition called ochronosis (papules and bluish-black pigmentation). This usually occurs after prolonged daily use which is why products containing this shouldn’t be used for extended periods. Sensitive prone skin generally don't tolerate this well, or at all.

Arbutin - There are two forms of Arbutin, Alpha/Beta Arbutin. Studies have shown that Alpha Arbutin is more stable/effective than its beta form. It has a similar function to Hydroquinone but is naturally derived agent extracted from bearberry, cranberries, blueberries, wheat, and pears. Arbutin is broken down into glucose and a natural form of hydroquinone. it’s also less irritating to skin than directly applied synthetic hydroquinone.

Kogic Acid - is a product that can be easily overlooked but is similar to other chemical exfoliants. it’s a natural byproduct created during fermentation of sake. It also can inhibit melanin production. It’s also a powerful antioxidant with anti-aging and collagen-protective effects and can be used safely by any skin type.

Tranexamic Acid - A more uncommon ingredient that’s an amino acid (you may be familiar with its other name Lysine).It functions similarly to Arbutin, can be used by all skin types and is one of the few ingredients recommended for melasma. 

Retinoids - can assist but is generally more effective when paired with one of the above brightening agents.

AHA (Alpha Hydroxy Acids) and BHA’s (Beta Hydroxy Acids) - can also be used. will speed up cell turnover in different ways to force pigmentation in the layers to shift forward.
Licorice Extract - has shown to be effective in inhibiting the production of melanin and brightening skin. Vitamin C and Niacinamide have shown some mild brightening effects but are better combined with other actives to produce significant results for deeper pigment issues.

I will provide a list of products in a separate post as there are quite a few effective options available depending on your pigmentation issue, price range and location, as I know some products are not always accessible (Feel free to reach out to me if that's the case for yourself). I'll link that into this post very soon.

For more serious types of pigmentation its important to have an experienced dermatologist/ doctor analyze your skin as they can correctly diagnose the type you have and recommend bespoke treatments ranging from topical creams,  chemical peel,  IPL, and Photo Dynamic Therapy through to more specific PicoWay and Diolite laser treatments that designed to target pigment (usually works better on fairer skin types for this reason).

Unfortunately hyper-pigmentation is not easily faded. It depends on the depth and how your skin responds to certain products. For sun-related hyper-pigmentation factor in the time it took to accumulate. I understand that feeling of just wanting it gone as quickly as possible (I remember the first time I saw any pigmentation on my face and initially thought I'll try almost anything to get rid of it). However after researching this in more detail all indications were the more gentle the approach, the less chance you have of causing new issues like hypo-pigmentation or scarring. Like many say it's a marathon not a sprint. But there is light at the end of the tunnel. 

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