We get a lot of questions about hyperpigmentation, that is, the discolouration and dark spots on certain areas of your face, or your hands. Let’s make a distinction, however, between hyperpigmentation and freckles. Freckles are very appealing and are a genetically based skin characteristic, so we won't attempt to 'fix' freckles!
Let’s look at the underlying causes of hyperpigmentation and also some preventative measures to help you with this fairly common skin phenomenon.
Hyperpigmentation is relatively harmless. Some patches of skin become darker in colour due to excess production of melanin. Melanin is the brown pigment that causes the various shades of our skin colour. Some people are more prone to it than others but its development can be the result of years of exposure to the sun. The discolouration can start appearing over time or it can appear in a relatively short period of time.
Some underlying reasons for hyperpigmentation are as follows:
Hormonal change - This is known as Melasma or Chloasma. These usually consist of larger areas of darkened skin. Pregnancy, for example, can trigger overproduction of melanin that causes the 'mask of pregnancy' on the face. Women who take birth control pills can also develop hyperpigmentation because their bodies undergo a similar kind of hormonal change. If you are bothered by the pigment, then consider alternatives to taking birth control pills.
Environmental and Lifestyle factors – Excessive exposure to sun without sunscreen is a key cause of the issue.
Acne or injuries to skin – Skin problems such as acne can leave dark spots after the condition clears.
Age spots or liver spots – These are also due to sun damage, which is why they are also called solar lentigos. These small, darkened patches are usually found on the hands and face or other areas frequently exposed to the sun.
So how do we get rid of them? Pigmentation can respond well to a combination of topicals, peels, skin or oral medications (in case of Melasma- VEGF-1 Modulators), IPL or lasers.
Here are some possible solutions in order of the severity of treatment.
- The easiest answer is wearing a broad spectrum sunscreen that blocks both UVA and UVB rays. This helps avoid the condition in the first place, but if hyperpigmentation already exists then the horse has already bolted, so read on.
- Use products that contain ingredients like kojic acid, AHAs, ascorbic acid (vitamin C), licorice extract (natural Tyrosinase inhibitor), botanicals including bearberry, blueberry and other berries, tranexamic acid, and Retinol + Retinoids; all of which can reduce hyperpigmentation.
- Use prescription creams. They usually contain hydroquinone (2-6/8%) which lightens and fades darkened skin patches by slowing the production of melanin, allowing those dark spots to gradually fade to match one's normal skin colour. In more resistant cases the percentage of hydroquinone can be increased and/or tretinoin or kojic acid (1-3%) may be compounded into the prescription medication. The downside of hydroquinone and these sorts of medications is that they can be irritating to sensitive skin and usually take three to six months to show improvement.
- IPL (Intense Pulsed Light) produces very shallow wounds in the skin that stimulate skin renewal and removes superficial damage, skin imperfections, and excess skin pigmentation.
- Intense exfoliation such as a chemical peel. This is where a chemical agent is applied on the skin to cause controlled shedding of the entire epidermis. This results in the regeneration of new skin and deeper tissues. Peels are also used for the treatment of melasma. They remove unwanted melanin by causing a controlled chemical burn to the skin. If you are a regular reader of our blogs then you already know how we feel about this type of aggressive treatment! I personally prefer to use BOA exfoliant for a gentler and more sustained result.
- Undergo laser treatment. The new PiQo4 Laser has the ability to target pigment at different levels of the skin. It uses energy aimed at the brown spot, shattering it rather than transforming it into heat. Too much heat can result in more downtime and occasionally worsens hyperpigmentation, especially on darker skin types.
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