An Introduction to Hyperpigmentation Treatments

Published August 4th, 2021 by Emily Wagner
Fact Checked by
Chris Riley
Medically Reviewed:
Erik Rivera

Many people with dark patches or brown spots on their skin look for treatments to get rid of them. These spots are areas of hyperpigmentation, and you are not alone in dealing with them. 

Fortunately, there are several treatment options to get rid of these troublesome areas, including topicals, chemical peels, laser treatments, and more.

What Is Hyperpigmentation?

Hyperpigmentation is defined by the American Osteopathic College of Dermatology as, “a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin.” Melanin is a brown pigment that is responsible for determining a person’s skin color. Hyperpigmentation occurs when there is more melanin in some skin cells than others, which creates dark spots.

Types of Hyperpigmentation

There are several types of hyperpigmentation, each with a different cause. These can include environmental factors, aging, and more. Knowing the type of hyperpigmentation can help your dermatologist recommend what treatments may work best for you. 

Age Spots

Age spots are an extremely common type of hyperpigmentation that is caused by sun exposure over time. With this, they mainly develop in people ages 50 and older; however, they can occur in younger people who are in the sun a lot. Other names for age spots include liver spots, sunspots, or solar lentigines. 

Post-Inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) is darkening of the skin in areas where there was inflamed acne, psoriasis, or other skin damage. PIH can develop in anyone, but it is more common in people with darker skin tones.  

Melasma

Melasma, also known as chloasma, is a hyperpigmentation condition that can develop for a number of reasons. A common name for the condition is the “mask of pregnancy,” because it can occur on the face and affects 15 to 50 percent of pregnant women.

Men can also be affected by melasma, although 90 percent of cases develop in women. Other causes for the condition include family history, taking certain medications, and using certain skin care products.

Treatments for Hyperpigmentation

Most cases of hyperpigmentation are chronic, meaning that they last for three months or longer. Fortunately, there are a number of treatments that can be used to treat the condition. 

Skin Acids

Skin acids, or face acids, are safe chemicals that are used to clear away dead skin cells to make room for new ones. Examples of skin acids include:

  • Kojic acid: lightens the skin by stopping skin cells from making melanin
  • Azelaic Acid: used to treat redness and swelling from acne, can also be combined with other skin acids to treat hyperpigmentation
  • Alpha hydroxy acids (AHAs): includes citric, lactic, glycolic, and tartaric acids 
  • Salicylic acid: reduces inflammation and is effective in treating PIH

Skin acid products are available as creams, oils, and lotions. The Food and Drug Administration (FDA) recommends using products with 10 percent or less AHA. If you are using products with AHA, be sure to apply sunscreen as well to prevent sunburns. 

Chemical Peels

Chemical peels use higher concentrations of skin acids on specific parts of the skin to target hyperpigmentation. These peels work by removing layers with the dark patches of skin. The outer layer of the skin, known as the epidermis, is typically removed. In some cases, the next layer down, known as the dermis, may also be removed. 

Chemical peels can be strong, and it may be best to seek the help of a dermatologist. There are products available over-the-counter (OTC) as well. However, if you have sensitive skin, they may not be the best option.

Chemical peels can also make the skin sensitive to sunlight. Be sure to apply sunscreen before going outside after a chemical peel, or your hyperpigmentation may become worse. 

Laser Treatments

Laser treatments use intense beams of light to treat hyperpigmentation. There are two types of lasers used, ablative lasers and nonablative lasers.

Ablative lasers are similar to chemical peels because they also remove the outer layer of the skin. They also heat the deeper layers of the skin, causing them to make collagen. This removes the darker patches of skin while making it smoother and tighter.

Nonablative lasers do not remove any layers of skin. Instead, they help skin cells make more collagen, which can make the skin smoother and improve tone. One type of nonablative laser treatment is intense pulse light (IPL) therapy, which can work well for treating hyperpigmentation.

Retinoids

Retinoids are compounds that come from vitamin A. They are extremely useful when treating hyperpigmentation, because they stop skin cells from making melanin. Retinoids also help skin cells rejuvenate and get rid of old, dead cells.

Retinoids are available OTC or as a prescription from your dermatologist.

Lightening Creams

Lightening creams contain ingredients that help lighten the skin. Hydroquinone, for example, reduces the number of skin cells that make melanin (known as melanocytes). This has a bleaching effect on the skin, making it lighter over time.

Other ingredients, like licorice extract and niacinamide (from vitamin B3), help even out skin tone by stopping skin cells from making melanin. It can also stop hyperpigmentation from developing after exposure to ultraviolet B (UVB) rays, which come from the sun. 

Dermabrasion

A dermabrasion uses a device with an abrasive brush or wheel that removes the top layers and middle layers of the skin. A microdermabrasion works on just the top layers of skin to remove areas of hyperpigmentation.

Once the skin has healed, it is much smoother and the dark patches of skin are gone. It may take a few sessions of dermabrasion to see the effects, especially if the hyperpigmentation is over a large area or it is deep in the skin.

References

  1. Hyperpigmentation – American Osteopathic College of Dermatology
  2. Age spots (liver spots) – Mayo Clinic
  3. Postinflammatory Hyperpigmentation – StatPearls [Internet]
  4. Postinflammatory Hyperpigmentation – The Journal of Clinical and Aesthetic Dermatology
  5. Melasma – Cleveland Clinic
  6. Cosmeceuticals for Hyperpigmentation: What is Available? – Journal of Cutaneous and Aesthetic Surgery
  7. Azelaic Acid Topical – MedlinePlus
  8. Dual Effects of Alpha-Hydroxy Acids on the Skin – Molecules
  9. Comparative Study for 35% Glycolic Acid, 20% Salicylic Acid–10% Mandelic Acid, and Phytic Acid Combination Peels in the Treatment of Active Acne and Postacne Pigmentation
  10. Alpha Hydroxy Acids – Food and Drug Administration
  11. Chemical peel – Mayo Clinic
  12. Laser resurfacing – Mayo Clinic
  13. Topical Retinoids for Pigmented Skin – Journal of Drugs in Dermatology
  14. Dermabrasion – Mayo Clinic

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