Hyperpigmentation or uneven skin is a common skin problem that a large number of people face. Dark spots, known as age spots or sunspots, often appear on the face, hands, or other parts of the body exposed to the sun.
Hyperpigmentation is a term that describes areas of uneven pigmentation on the skin.
Hyperpigmentation appears in the form of dark spots that make the skin uneven. Areas of uneven skin are known as age spots or sunspots. People with dark skin are usually more affected by hyperpigmentation than those with light skin. The reason for it is because the skin’s pigmentation is stronger in dark skin.
Hyperpigmentation occurs due to excessive production of melanin. Melanin’s a natural pigment that gives our skin, hair, and eyes their natural color. Several factors can affect melanin overproduction. But it’s mostly associated with sun exposure, genetics, hormonal influences, and injuries or inflammation to the skin.
Excessive sun exposure is a major cause of hyperpigmentation, as the sunlight stimulates melanin production. Melanin acts as a natural protection for the skin from the sun by protecting it from harmful UV radiation. Due to this, we get tanned. However, excessive sun exposure can disrupt this process and cause hyperpigmentation.
Hormones are the main cause of a special type of hyperpigmentation known as melasma or chloasma. It’s particularly common in women. It is thought to occur when the female sex hormones estrogen and progesterone stimulate excessive melanin production after exposing the skin to the sun. Hyperpigmentation can also occur as a side effect of some hormone therapies.
Progressive hyperpigmentation occurs after an injury or inflammation of the skin, such as cuts, burns, exposure to chemicals, acne, atopic dermatitis, or psoriasis. It appears after the wound has healed after the skin has darkened and lost color.
As skin ages, the number of melanin-producing cells (known as melanocytes) decreases, but the remaining ones increase in size, and their redistribution changes. These physiological changes explain the increase in age spots in people over 40 years of age.
Hyperpigmentation is also a symptom of some diseases. For example: autoimmune diseases and diseases of the digestive system, metabolic disorders, and vitamin deficiency. It can also occur as a side effect of some hormone therapies, chemotherapy, antibiotics, antimalarial drugs, antiepileptics, and other drugs.
Gradual hyperpigmentation is caused by the healing of an injury or a blow to the skin, after which a shallow spot or discoloration remains. It’s mainly found in patients being treated for acne, but can also be caused by cosmetic procedures such as dermabrasion, laser treatment, and chemical peels.
Also known as chloasma, melasma is a condition in which large areas of hyperpigmentation appear most commonly on the face. Although it can occur in both men and women, melasma is more common in women because it can be caused by changes in hormone levels. Melasma affects 10-15% of pregnant women. It also affects 10-25% of women who take oral contraceptives and is often known as a “pregnancy mask”.
Patches of skin, such as age spots (also known as pigmentation spots or sunspots), are caused by sun exposure, so they mostly occur on the parts of the body that are most commonly exposed. This includes the face, palms, and hands. These are mostly small and dark parts of the skin.
Post inflammatory hyperpigmentation
Post inflammatory hyperpigmentation (PIH) is an acquired hypermelanosis occurring after cutaneous inflammation or injury that can arise in all skin types, but more frequently affects skin-of-color patients, including African Americans, Hispanics/Latinos, Asians, Native Americans or Pacific Islanders.
Sun protection is the most important step you can take to prevent hyperpigmentation. It’s important to remember that the sun’s rays affect the skin even during cloudy days. It’s essential to provide the skin with the daily protection it needs. Limited exposure of the skin to the sun will reduce the appearance of hyperpigmentation. Try to stay out of direct sunlight at the time when the sun’s most intense. Wear protective clothing including sunglasses and headgear whenever possible. When your skin’s exposed to the sun, apply and renew the sun protection product regularly with the corresponding SPF factor which is specially formulated for the needs of your skin. Except all other factors, pigmentation trait is also a risk factor for skin cancer. So take as much skin care as you can.
Dermatological treatments such as chemical peels or laser therapy can help treat hyperpigmentation.
Chemical peels involve applying an acidic solution (such as glycolic acid) to the affected areas to encourage peeling of the skin (removal of dead cells) and stimulate the development of new undamaged cells.
Laser therapy has a similar effect. It provides greater precision because the dermatologist purposefully uses high-energy light on the affected areas of the skin. The mildest treatments act on the epidermis of the skin (surface layer), while more intensive treatments can penetrate the deepest layers of the skin.
Dermatologists may also prescribe and/or use hydroquinone. It is still considered the most effective topical agent to reduce hyperpigmentation. However, it can only be used for a limited time because, like other forms of chemical peels and laser therapy, it can cause skin irritation and cause gradual hyperpigmentation, especially in people with dark skin.
Before treatment, the skin should be thoroughly cleansed with cleansing milk and tonic to remove make-up, creams, self-tanning products and more. The area where you will receive treatment must not be in a sunny location so that the laser can distinguish dark spots from the rest of the skin during the treatment.
Laser treatment to remove hyperpigmentation and other pigment changes isn’t complicated and is done on an outpatient basis without local anesthesia. Once the area to be treated is cleaned, goggles are put on the eyes and treatment can begin. The laser is applied to the skin and the area where the pigmented spot is located is crossed. A light pulse is released which the client feels like a slight burning sensation. The laser beam absorbs light energy when it penetrates the skin. By the thermal effect of short light strokes, melanin is abruptly heated and separated from the dermis.At the end of the treatment, it’s normal for the skin to turn red, and scabs can form that disappear in a few days. The client can undergo the next treatment, if necessary, after 4 to 6 weeks.
Immediately after treatment, the area exposed to the laser will be slightly red. You can apply a cold compress to the treated area to make it more comfortable and to speed up your recovery. For most clients, the skin calms down completely overnight and they can use standard skincare and make-up products the very next day. It’s important to avoid direct exposure to the sun and solarium for a month after treatment until the skin has fully recovered. After that, it’s recommended to use protective creams with SPF 50+ so that the stains don’t reappear.
Hyperpigmentation can be bad for your skin, so educate about your skin type and take care of your skin while your skin condition is good!