Hyperpigmentations

Overview

Hyperpigmentation is a term that describes a condition where the skin appears darker in small patches, covering large areas or even covering the whole body. Although hyperpigmentation is not harmful, it can cause significant cosmetic disfigurement and become a psychosocial burden on the patient.

There are several types of hyperpigmentations, the most common ones that we deal with in Medical spas are:

• Sunspots or solar lentigines. These are very common and directly related to excess sun exposure. Sunspots are found in sun-exposed areas only like the face and neck, upper chest, hands, and arms. They are very prominent in white people especially after a long summer on the beach.
• Melasma. This condition is the most difficult and annoying form of hyperpigmentation. Presenting as tanned or brown patches mostly on the face. Melasma commonly starts after pregnancy or hormonal treatment. Melasma can go after pregnancy but commonly women who developed it during pregnancy are more prone to develop it later without pregnancy. However, men can develop melasma too!
• Post-inflammatory hyperpigmentations. This is the darkening of the skin after an injury, surgery, or infection due to increased melanin production.

Causes of Hyperpigmentations

• Genetic/hereditary.
• Sun exposure – UVL effect.
• Hormonal – Hormone replacement therapy, pregnancy, etc.
• Underlying diseases: autoimmune diseases, Addison disease, etc.
• Medications: some Antibiotics, antimalarial, antiarrhythmic, or oral contraceptives.

How to prevent hyperpigmentations?

Try to limit sun exposure especially during the peak hours of sunlight (11:00 am – 4:00 pm). Wear a broad-brimmed hat or a biking mask if going out for a run!. Wear sunscreen with SPF 30 or above, and look for zinc oxide, iron oxide or titanium dioxide to block daylight’s UVA rays that worsen hyperpigmentation.

Consult your doctor before trying to treat the condition on your own!.

Avoid over-the-counter skin treatments to cure your skin pigmentations. Some of those could make your pigmentation worse or rebound to a worse condition once you stop using them.

Avoid any sun exposure after any minimally invasive cosmetic procedure. For instance, laser resurfacing, micro-needling, Vampire Facial, Profound, Sublative treatment, etc. 

How to treat Hyperpigmentation? 

Treatment of hyperpigmentation is challenging because of its relapsing and persistent nature. There are several methods to cure pigmentation on the face.

Cosmetic Camouflage. To avoid pigmentation, use physical-blocking opaque sunscreens, especially the ones with zinc oxide or iron oxide. These have the dual benefit of camouflaging hyperpigmentation and preventing photo-induced darkening. In addition, the use of make-up can help to even skin tone. Several brands are available that can provide heavy coverage, including Dermablend, Cover FX, and Covermark/CM beauty.

Topical treatments. With Hydroquinone, retinoids such as tretinoin, azelaic acid, corticosteroids, Kojic acid, and Vitamin C, has shown to significantly improve the complexion of the skin. Also, improve the appearance of hyperpigmented lesions in the epidermis including the melasma. ZO medical-grade skincare products have a variety of options to cure all pigmentation face conditions. 

Oral treatment. Some studies have discussed the benefits of Tranexamic acid in the treatment of melasma in combination with local treatments. These studies are underway, but results seem promising!.

Laser & IPL. Also, known as photo facial treatment has been very effective in the treatment of hyperpigmentations especially caused by sunspots. And although it’s very helpful in the treatment of melasma, we commonly do a test spot before using it for that indication. These methods are commonly helpful for disorders associated with the deposition of melanin in the dermis. 

Microneedling. The concept of micro-needling involves enhancing internal healing properties in the skin by making the skin believe that it has been injured. This leads to the shedding of the external layer of the skin (which is commonly involved in the pigmentation) and replacement with healthier-looking skin. This is a wonderful procedure for those patients who were deemed not good candidates for laser therapy.

Chemical Peels. ZO skincare has a variety of skin peels like the 3 step peel that treats hyperpigmentation and discoloration by removing the damaged surface layer of the skin. These are quick and easy and have very minimal downtime. Commonly 5-6 sessions are needed at 2-4 weeks intervals. In darker skin tone patients, superficial to medium-depth peels are most typically used to reduce the risk of dyspigmentation.