A look at hyperpigmentation, age spots, sun damage, melasma, and treatment options


Everyone has pigmentation in the skin. Pigmentation refers to the color of a person’s skin. Skin color is determined by the amount of melanin in a person’s skin. Darker skin has more melanin and lighter skin has less. The skin can produce excess melanin in response to an “injury” such as a tan, trauma, or inflammation, and this is when darker patches may appear on the skin. Melanin can also be influenced by hormone levels, birth control pills, and pregnancy (the “pregnancy mask” usually appears as darker spots in the cheek area). Dermatologists and skin care specialists refer to a large area of ​​skin discoloration as melasma. Melasma can occur in the epidermal layers, closer to the surface of the skin, or in the dermal layers, deeper within the layers of the skin. Epidermal hyperpigmentation is more easily treated due to the location.

This article will talk more about treating epidermal hyperpigmentation than about dermal pigmentation, which can still be treated, but can be more stubborn. A dermatologist or skin care specialist can determine your level of hyperpigmentation using a Wood’s lamp, a dermatological diagnostic tool, which uses ultraviolet light to look at the skin.

Before talking about hyperpigmentation treatment options, an important note to make is that prevention is the key to keeping your skin an even tone and free from unwanted sun damage. Daily use of sunscreen with an SPF of 30 or higher can make a big difference to your skin in the long run. There are so many types of sunblocks and sunblocks available these days, but what specialists recommend are those that provide physical blockage from the sun. These physical sunblocks contain titanium dioxide and / or zinc oxide to reflect the sun’s rays away from your skin. Chemical sunscreens, on the other hand, provide protection but absorb the rays and can heat the skin. If you do not have access to a physical sunscreen, it is recommended to use a chemical sunscreen rather than not using any type of sunscreen. If you are in a hot and sunny location, a hat also provides an excellent additional barrier, especially if you are going to be in sunlight for extended periods of time.

Hyperpigmentation can be treated in a number of ways through home care or with various treatments in a doctor’s office, usually a dermatologist or cosmetic surgeon.

Lately there has been an influx of “bleach” type products on the market, at the drugstore or at the makeup counter. While some of these may help lighten your blemishes, you may not necessarily get the result you are trying to achieve, mainly because these OTC products are not as strong as they need to be to provide optimal results. There are skin care products that are only sold through a doctor and that will be more effective. Most of these products contain hydroquinone, a lightening agent, and are often combined with a retinoid, a product that increases cell turnover. Products containing alpha hydroxy acids (AHAs) and fruit amino acids also accelerate the removal of dead skin cells and the production of new ones, keeping skin looking vibrant and healthy.

Exfoliating the skin, which encourages faster cell turnover, is also another way to speed up the shedding process of hyperpigmented skin. Medical grade chemical peels, performed under the supervision of a physician, create a “controlled” lesion on the skin that causes exfoliation. Often times, a chemical peel can be done in conjunction with another type of treatment, such as an intense pulsed light therapy procedure.

An intense pulsed light facial can significantly improve skin texture and reduce rosacea redness, age spots, sun damage, spider veins, and uneven pigmentation. This therapy works on many different levels, literally, because the broad spectrum of light is absorbed at different levels in the skin. The downtime for a treatment like this is minimal.

Another treatment for melasma and hyperpigmentation is fractional rejuvenation. Instead of using light, this therapy uses radiofrequency to reach deep into the layers of the skin, inducing a “controlled” injury under the top layer of the skin to maximize collagen production. This not only improves brown spots and texture irregularities, it also works well to treat mild to moderate wrinkles.

The most intense treatment for hyperpigmentation would be to have chemoabrasion performed by a plastic surgeon or dermatologist. This is done under anesthesia and combines a middermal peel with dermabrasion. This is a much more aggressive treatment with a defined downtime for proper healing. Most people who have mild melasma or hyperpigmentation spots can find other treatment options that are less expensive than chemoabrasion and provide very acceptable results.

Hyperpigmentation, while not generally life-threatening, is a popular concern because people like to show their “best” face. The good news is that pigmentation correction is possible, but it takes time. Many of the procedures mentioned above generally need to be done in a series over a span of weeks or months. There is no “quick fix” (other than covering makeup) to treating hyperpigmentation, but if you have the patience and resources, there are therapies that will give you long-lasting results.