The human skin contains cells that produce melanin, the chemical
responsible for skin coloration. When the cells produce too much melanin, the
skin becomes excessively pigmented (hyper pigmented). Hyperpigmentation is
characterized by darkened areas of the skin, such as age spots and freckles.
It
can affect men and women of all ethnic groups and is common from middle age and
beyond, though younger people may also experience it. It is caused by sun exposure,
skin trauma and as a side effect of certain drugs, but may also be a symptom of
certain illnesses. Even though hyperpigmentation does not cause serious health
concerns, it can cause grave cosmetic implications and even depression and
anxiety.
So what is the best approach to pigmentation
treatment? For successful
eradication of skin pigmentation, the treatment should be approached in three
stages: (a) determining the cause of hyperpigmentation (b) treating the
pigmentation and (c) preventing further hyperpigmentation.
A. Determining the Cause of Hyperpigmentation
To determine the cause of hyperpigmentation, you need to know the
various types of skin hyperpigmentation and what causes them. The three most
common types are:
(i) Melasma: Skin pigmentation resulting from hormonal fluctuations. It is
caused by thyroid dysfunction, hormonal therapy, pregnancy or as side effect of
birth control pills. It is very difficult to treat.
(ii) Post-inflammatory hyperpigmentation (PIH): Caused by skin injuries such as burns,
psoriasis, acne and adverse effects of skin care treatments. It goes away when
the skin regenerates and heals.
(iii) Lentigines: Also called age spots or liver spots, this type
of hyperpigmentation occurs in more than 90% of people of the age 60 years and
above. It is caused by exposure to UV rays.
For effective identification of the type of hyperpigmentation you
have, it is wise to consult a dermatologist for examination and
recommendations.
There are various pigmentation treatment methods. Here are the
options you can consider:
(i) Prescribed topical medication: Topical applications containing retinoids and
alpha hydroxy acids (AHAs) will exfoliate and rejuvenate your skin and help you
treat any type of hyperpigmentation. Some of the topical products used in pigmentation
treatment are hydroquinone (FDA
approved skin lightening treatment), kojic acid, Azelaic acid and Mandelic
acid.
(ii) Non-ablative professional procedures: When topical applications fail to yield
desirable results, your dermatologist may recommend a procedure that can target
and remove hyperpigmentation. The most common non-ablative procedures are skin
peels (use of salicylic acid to treat the darkened areas), intense pulsed light
(IPL) therapy, and laser skin resurfacing.
(iii) Microdermabrasion therapy: Microdermabrasion is a very popular option for
eradicating hyperpigmentation, but you should choose an experienced
practitioner who can abrade the skin without causing skin irritation.
(iv) Over-the-counter medications: Pigmentation treatment can be achieved with
certain over-the-counter medications. For example, skin lightening creams
containing soy milk, kojic acid, azelaic acid, arbutin, cucumber or
hydroquinone can slow down melanin production and remove existing melanin
pigments from the skin. Similarly, there are over-the-counter topical
treatments containing alpha-hydroxy acids or Retin-A.
(v) Home remedies: Pigmentation treatment can also be achieved by
using home-made topical applications such as aloe vera, lemon juice, rose hip
oil, and cucumber juice.
C. Preventing Further Hyperpigmentation
Whether you are still treating or have recovered from
hyperpigmentation, you need to take measures to prevent further pigmentation.
Here are the most effective ways of preventing hyperpigmentation:
(i) Reduced exposure to UV rays: Sun exposure is one of the most common causes
of hyperpigmentation and you will most likely experience further pigmentation
if you show a nonchalant attitude towards sun exposure. And even though
reducing exposure to UV rays will not treat the pigmentation you already have,
it will help to prevent further discoloration. Therefore, make sure to reduce
your exposure to the sun by wearing sunscreen routinely (and a hat and long
sleeves when you are in strong and direct sunlight), avoiding tanning beds,
limiting your time outside, and avoiding sunbathing.
(ii) Changing your medications: If your hyperpigmentation is caused by a
certain birth control pill or other medication containing hormones, you can
prevent further hyperpigmentation by switching to a new drug or ceasing to take
the medications when there are no better options.
(iii) Careful use of skin treatments: Hyperpigmentation is sometimes caused by trauma
to the skin as a result of skin treatment or plastic surgery. Therefore, make
sure to conduct thorough research before using any skin treatment or plastic
surgery, and to choose a highly experienced practitioner for your cosmetic
surgery procedures.
