Hyperpigmentation


Are you concern with dark spots and how to treat hyperpigmentation? 

What Causes Dark Spots?

Skin pigmentation refers to how much melanin the body generates, and it determines the color of the skin. Melanin is produced by cells called melanocytes, found in the deep basal layer of the epidermis. When your skin is exposed to UV-B rays, melanocytes kick into overdrive and produce higher levels of melanin which causes hyperpigmentation.

Hyperpigmentation, also called dark spots, is a common condition that causes some areas of the skin to be darker or a different color than others.1 Hyperpigmentation means the deposit of extra melanin, the brown skin pigment that normally colors the skin. Hyperpigmentation can be caused by things like sun exposure, hormonal changes, or an underlying medical condition.2

hyperpigmentation

The Mechanism of Hyperpigmentation from Sun Exposure

  1. Reactive oxygen in the epidermis is generated by exposure of UV-B rays from the sun
  2. With the reactive oxygen, melanin is excessively produced by melanocytes
  3. Skin hyperpigmentations are generated

Hyperpigmentation Types

There are three types of hyperpigmentation—melasma, sunspots (solar lentigo), and post-inflammatory hyperpigmentation.2

  1. Melasma is a benign disorder characterized by hyperpigmentation of the skin, believed to be caused by hormones. It is common in pregnant women and usually occurs on the face or stomach.3
  2. Sunspots on the skin develop over time with exposure to the sun. They are common in areas that are most exposed to the sun like the shoulders, hands, and face. Sun-damage spots, photodamage, and age spots are common names for sunspots.
  3. Post-inflammatory hyperpigmentation is common after an injury or condition that causes skin inflammation, like acne.

dark spots on face

At-Home Hyperpigmentation Treatments

At-home treatments to reduce the appearance of pigmented skin include natural remedies, prescription medications, and over-the-counter creams and serums.

Natural Remedies For Pigmented Skin


There are several do-it-yourself remedies for skin lightening. There is not much scientific evidence that these natural remedies work, but some anecdotal reports suggest some of these methods might be worth a try.

  • Apple cider vinegar may lighten pigmentation because it contains acetic acid.4
  • Aloe vera has long been used for moisturizing. A compound called aloin may also help reduce hyperpigmentation.5
  • Green and black tea may help to lighten dark spots. Green tea extract is a popular ingredient in over-the-counter creams and lotions. Green tea bags can also be placed directly on dark spots.6 Black tea water applied to the skin twice a day may lighten hyperpigmentation.7

Brightening Creams And Serums


When it comes to brightening creams and serums, there are many prescription and over-the-counter options.8 These products take time to work and require consistent use to see results. Check for the following active ingredients in your chosen product to help brighten skin and reduce the appearance of dark spots.9

Medications that help to encourage cell turnover to reveal newer, healthier skin include retinoids and azelaic acid. Retinoids are available over the counter as retinol and as prescription tretinoin.8 Azelaic acid may also help to suppress melanin production.10 It is available in prescription and over-the-counter strengths.

Vitamin C and niacinamide are popular ingredients in brightening creams and serums because they can block melanin production.11,12

Hydroquinone bleaches the skin by decreasing the number of cells that make melanin. It usually takes three to six months to see improvement.13 Hydroquinone is only available as a prescription product, Tri-Luma, in the United States. Some people have experienced serious side effects using hydroquinone, such as rashes, facial swelling, and skin discoloration.14

In-office Skin Pigmentation Treatments

There are several treatments available to improve the look of dark spots and pigmented skin that can be done in the office.

Professional Chemical Peels


Chemical peels are applied to the area of skin you want to improve, like areas of dark pigmentation on the face. A chemical solution is applied to the face that removes the dead skin cells in the outer layer of the skin, called exfoliation. After the outer layer of skin peels off, new skin underneath will appear smoother and less damaged.15

Chemical peels offered in a professional setting will penetrate to deeper levels of the skin than at-home chemical peels.

Light Therapy For Dark Spots


IPL (Intense Pulsed Light) uses pulses of light to penetrate the lower layers of skin and target melanin. The light is converted into heat, which destroys the pigment particles. Most IPL systems will refine the light output with filters to enhance skin penetration and targeting.16

IPL treatments are non-invasive, and most people do not need any downtime. The results of IPL treatment are long-lasting but can take up to five sessions to reach the desired outcome.17 Candela’s Selective Waveband Technology (SWT®) IPL on the Nordlys system targets the excess melanin with narrow wavelengths of lights (less heat in the skin) to improve the pigmented lesions. The Nordlys is FDA, CE, and TGA cleared, and is a non-invasive treatment for dark spots and other skin pigmented lesions.

Laser Treatments For Skin Pigmentation


Laser treatments use a single wavelength to target melanin in the skin. Depending on the different causes and conditions of hyperpigmentation, lasers can be used as effective treatments for melasma, dark spots and age spots.

The PicoWay® picosecond ultra short pulse laser targets the excess melanin in the skin and shatters it into tiny pigment particles that are metabolized out of the body. Instead of using a photothermal effect that causes the skin to heat up, the PicoWay laser system uses a photoacoustic effect. This means that people usually have little to no downtime after their treatments.18 The PicoWay is FDA, CE, and TGA cleared.

The Gentle® laser devices deliver high-energy long pulses that penetrate deep into the skin to destroy the excess pigment. This laser system features a protective cooling burst of cryogen via a dynamic cooling device (DCD), in the treatment area right before and after each laser pulse. This cooling spray protects the skin's surface against a burning sensation and keeps the patient comfortable during the treatment. The Gentle is FDA, CE, and TGA cleared.

Hyperpigmentation Before and After Photos

PicoWay Pigmentation treatment for Asian - P1
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Photos courtesy of: Candela
PicoWay
PicoWay Pigmentation treatment
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PicoWay Pigmentation treatment for Asian - P3
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PicoWay Pigmentation treatment for Asian - P4
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PicoWay Pigmentation treatment for Asian - P5
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PicoWay Pigmentation treatment - P6
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PicoWay Pigmentation treatment for Asian - P7
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nordlys-pigmentation-Guillermo-Simón-MD-P2
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Photos courtesy of: Guillermo Simón, MD
Nordlys
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Photos courtesy of: Candela Institute for Excellence
Gentle Pro Series
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Gentle Pro Series
FAQs
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Skin pigmentation, also called hyperpigmentation, is a common condition that causes some areas of the skin to be darker or a different color than others.1

Pigmentation is caused by deposits of melanin, the brown skin pigment that normally colors the skin. Melanin is produced by cells called melanocytes. Hyperpigmentation can be caused by things like sun exposure, hormonal changes, or an underlying medical condition.2

Depending on the type of hyperpigmentation, you may see results after just one session. Usually, multiple sessions are needed.18

The simplest way to prevent hyperpigmentation and dark spots is to avoid the sun and wear a broad spectrum sunscreen daily. If hyperpigmentation is caused by an underlying condition, treating the underlying condition can improve symptoms.2

References
1. Cleveland Clinic. Hyperpigmentation. October 7, 2021. Access from: https://my.clevelandclinic.org/health/diseases/21885-hyperpigmentation#:~:text=Hyperpigmentation%20is%20a%20common%20condition,%2C%20gray%2C%20red%20or%20pink.
2. Healthline. What You Should Know About Hyperpigmentation. March 7, 2022. Accessed from: https://www.healthline.com/health/hyperpigmentation
3. Healthline. Melasma. March 7, 2019. Accessed from: https://www.healthline.com/health/melasma
4. Kapuścińska A, Nowak I. [Use of Organic Acids in Acne and Skin Discolorations Therapy]. Postepy Hig Med Dosw (Online). 2015 Mar 22;69:374-83.
5. Ali SA, Galgut JM, Choudhary RK. On the Novel Action of Melanolysis by a Leaf Extract of Aloe Vera and its Active Ingredient Aloin, Potent Skin Depigmenting Agents. Planta Med. 2012.;78(8):767-71.
6. Sarkar R, Arora P, Garg KV. Cosmeceuticals for Hyperpigmentation: What is Available? J Cutan Aesthet Surg. 2013 ;6(1):4-11.
7. Choi SY, Kim YC. Whitening Effect of Black Tea Water Extract on Brown Guinea Pig Skin. Toxicol Res. 2011;27(3):153-60.
8. Insider. The Best Ingredients to Treat Hyperpigmentation and Brighten Your Complexion, According to Dermatologists. November 1, 2020. Accessed from: https://www.insider.com/guides/beauty/best-ingredients-for-hyperpigmentation
9. Medical News Today. What To Know About Hyperpigmentation. May 30, 2022. Accessed from: https://www.medicalnewstoday.com/articles/323808
10. Schulte BC, Wu W, Rosen T. Azelaic Acid: Evidence-based Update on Mechanism of Action and Clinical Application. J Drugs Dermatol. 2015;14(9):964-8.
11. Sanadi RM, Deshmukh RS. The Effect of Vitamin C on Melanin Pigmentation - A Systematic Review. J Oral Maxillofac Pathol. 2020;24(2):374-382.
12. Sarkar R, Arora P, Garg KV. Cosmeceuticals for Hyperpigmentation: What is Available? J Cutan Aesthet Surg. 2013;6(1):4-11.
13. Healthline. Everything You Need to Know About Hydroquinone. February 15, 2022. Accessed from: https://www.healthline.com/health/beauty-skin-care/hydroquinone
14. US Food and Drug Administration. FDA Works To Protect Consumers From Potentially Harmful OTC Skin Lightening Products. May 10, 2022. Accessed from: https://www.fda.gov/drugs/drug-safety-and-availability/fda-works-protect-consumers-potentially-harmful-otc-skin-lightening-products
15. Healthline. What You Should Know About Chemical Peels. September 18, 2018. Accessed from: https://www.healthline.com/health/chemical-peels
16. DermNet NA. Intense Pulsed Light Therapy. 2005. Accessed from: https://dermnetnz.org/topics/intense-pulsed-light-therapy
17. Sadick NS, Weiss R, Kilmer S, Bitter P. Photorejuvenation With Intense Pulsed Light: Results of a Multi-Center Study. J Drugs Dermatol. 2004;3(1):41-9.
18. Dermatology Times. A Review of Lasers for Hyperpigmentation. April 17, 2019. Accessed from: https://www.dermatologytimes.com/view/review-lasers-hyperpigmentation

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