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Hyperpigmentation

Hyperpigmentation is one of the most common skin concerns, bringing people to Leah Nickie Advanced Aesthetics for treatment. What is hyperpigmentation? It is defined as the darkening of certain areas of the skin resulting from the excess production and accumulation of melanin, the pigment that gives color to our skin, hair, and eyes. The various factors and mechanisms that lead to hyperpigmentation can be pretty complex, and its treatment can be frustrating and require a long-term commitment to sun protection and behavior modification. Read on to learn why and how it is treated.

Hyperpigmentation is caused by melanocyte activity. Melanocytes are specialized cells that live in the basal layer of the epidermis. These cells produce melanin through a complex biochemical pathway involving the enzyme tyrosinase. When exposed to stimuli like UV radiation from the sun, inflammation, hormonal changes, or injury, melanocytes can become overactive, leading to increased melanin production. The more melanin your skin has naturally, the more likely you are to experience hyperpigmentation. However, every skin tone is susceptible to various types of hyperpigmentation if it is not protected.

UV exposure is the most common cause of hyperpigmentation. UV light triggers melanocytes to produce more melanin to protect the skin from further damage. This result is a tan or a sunburn. However, the distribution of melanin can become uneven, forming darker patches or spots, such as freckles, age spots, and melasma.

Hormonal fluctuations can also contribute considerably to hyperpigmentation. During pregnancy, many people may develop melasma (sometimes called chloasma or ”the mask of pregnancy”). Melasma presents as darker patches on the face and occasionally the body due to increased levels of estrogen and progesterone stimulating melanocyte activity. Melasma occurs primarily in women but can also occur in men. In addition to pregnancy, oral contraceptives, HRT, and even IUDs containing hormones can trigger melasma. Individuals assigned male at birth who receive gender-affirming hormone therapy may also experience melasma. Heat is often a stimulating factor for melanocytes in those who suffer from melasma, further complicating treatment of this specific type of hyperpigmentation.

Inflammation and injury can also lead to hyperpigmentation. Acne, eczema, and psoriasis can lead to post-inflammatory hyperpigmentation or PIH. When the skin heals after an injury or inflammation, an excess of melanin can accumulate, causing the affected area to appear darker. Some medications and perfumes can also cause hyperpigmentation, although this pathway is rare. Some individuals may also have a genetic predisposition to hyperpigmentation, making their skin more susceptible to certain triggers that stimulate melanocyte activity. Additionally, our melanin production can become less efficient as we age, leading to age-related hyperpigmentation.

Preventing and Treating Hyperpigmentation

The number one way to prevent hyperpigmentation of all types is to protect yourself from excessive sun exposure. Wear a good sunscreen daily. For those with melasma, some research indicates that using sunscreen containing zinc oxide and titanium dioxide may prevent the darkening of pigmentation better than other SPF ingredients. Wearing a hat, sunglasses, and protective clothing is the best way to protect yourself from excessive UV radiation, hyperpigmentation, and skin cancer.

Treating hyperpigmentation generally consists of topical products to protect the skin while lightening existing hyperpigmentation. There are prescription lightening ingredients, such as Hydroquinone (HQ), which do have their place in a treatment regimen. Still, we feel these should be used judiciously because they have side effects and are not indicated for long-term use. Chemical peels, Intense Pulsed Light, and various other laser modalities are often used to treat hyperpigmentation. IPL and laser modalities do carry risks, but in many instances, they result in excellent clearing of hyperpigmentation spots.

Special care must be taken when treating melasma, as it can be highly reactive to heat. It is rare, but possible, not to know you have melasma until you are treated with lasers or IPL. For this reason, at Leah Nickie Advanced Aesthetics, we treat all types of hyperpigmentation with chemical peels, microneedling, and topical products to lighten existing hyperpigmentation and prevent further darkening by using the safest and most advanced ingredients. With melasma, unlike other types of hyperpigmentation, we can never completely clear the patches of darker skin. However, this very frustrating condition can be well controlled with patience, consistency, and behavior modification.

BEST TREATMENTS & PRODUCTS FOR HYPERPIGMENTATION AND MELASMA