What is hyperpigmentation?
Hyperpigmentation is a descriptive term used to describe changes in a persons skin tone. Hyperpigmentation is caused by excess secretion of melanin, the hormone secreted by our melanocyte cells, causing a 'staining' on the skin. Melanocytes gives skin it's colour. People with darker skin tones have a greater level of melanocytes than those with fairer skin types, and are therefore more at risk of developing hyperpigmentation. That said, fairer skin types are still at risk, especially those who 'sun-worship' without using adequate protective SPF.
What causes hyperpigmentation?
Firstly, the Sun! Sun causes 80% of ageing, which includes hyperpigmentation. Did you know that the UK has the highest levels of skin cancer? Even higher than Australia - 'the sunshine state'. Why? Because we're not sun savvy and fail to protect ourselves from the harmful UV rays. A good point to remember (and one which I tell all my clients) is that when the sun comes up it is day, when the moon comes up it is night. Therefore, as long as it's day - put on your SPF! Regardless of whether it is boiling hot or not! The sun is up and the harmful UV rays are there. Other causes of hyperpigmentation include hormones, structural damage (such as too strong peels or lasers) and inflammation of the tissues.
Knowing what type of hyperpigmentation I have.
In order to treat hyperpigmentation, it is important to find out the cause of it. The three most common causes are post-inflammatory hyperpigmentation (PIH), melasma and solar lentigines.
Post-Inflammatory Hyperpigmentation - is generally caused when the skin is damaged or irritated. This can be due to conditions such as eczema, acne or burns (such as those found when using incorrect strength peels or lasers). This trauma stimulates the melanocytes to over-produce melanin (part of a natural inflammatory response by the body), resulting in PIH to the effected area. Depending whereabouts in the layers of the skin this excess melanin is created will depend how dark in colour and how deep the hyperpigmentation will be. The darker and the deeper it is, the harder it will be to 'pull through' and completely remove. Areas that are hyperpigmented will also darken with sun exposure, especially if no or a 'not-strong-enough' SPF is used. Therefore, it is so important that if you suffer with hyperpigmentation, and especially if you are being treated to remove it, that a 50+ SPF is used daily to protect these areas.
Melasma - due to its occurrence generally because of hormone changes, melasma is more commonly found in women. Birth control and HRT can cause melasma, as well as high incidents found during pregnancy. Melasma generally appears on the forehead, cheeks, nose and chin and will worsen in the sun.
Solar lentigines - are more commonly known as age spots, liver spots or sun spots and generally appear on sun-exposed areas of the skin such as the hands (most common) head and face, neck and chest. They wont go away on their own accord and will need treating.
How to treat hyperpigmentation
As discussed, being sun-savvy, using SPF, covering up as much as possible in the sun, wearing hats and staying out of the sun during the hottest parts of the day are a must, regardless of whether you have hyperpigmentation or not, but especially if you do. Sunbeds are also a no-no, not only because of the harm they do to the skin but they also are responsible for ageing us prematurely.
If the cause of the hyperpigmentation is a skin condition such as acne or eczema, then we can offer advice and treatments options to improve the skin barrier and support skin health which in turn will reduce these conditions and then we can treat the PIH.
Skincare products are high on the agenda as a way of both treating and preventing further damage to the skin. Cosmeceutical (see my blog pro-ageing-embracing-the-ageing-process-by-using-the-correct-skin-care-products) product ingredients to choose when treating low-severity hyperpigmentation include the following:
Vitamin C: This is a tyrosinase inhibitor. Tyrosinase is the enzyme that the body uses to produce melanin, therefore anything that is a tyrosinase inhibitor will reduce the production of melanin and therefore, hyperpigmentation. Vitamin C is also an antioxidant, therefore it protects the skin against pollutant damage and free-radicals.
Kojic Acid: another tyrosinase inhibitor and antioxidant.
Retinol (Vitamin A): encourages new skin to the surface whilst exfoliating and encouraging the shedding of older, darker, damaged skin cells.
Niacinamide (B3): helps interrupt the process of cell pigmentation, thus brightening the skin. It is also very protective and healing for certain skin conditions (such as acne) and therefore helps prevent future hyperpigmentation.
Azelaic Acid: has anti-inflammatory properties and can supress melanin production. This skincare additive is suitable for use in pregnancy so can help in the battle of pregnancy-induced melasma.
Mandelic Acid: is an alpha-hydroxy acid that helps supress melanin production and exfoliates the skin.
Arbutin: is considered a natural form of hydroquinone, a chemical that bleaches the skin, so can be a preferred method of treatment to help tackle hyperpigmentation.
Your skincare specialist may also recommend a course of chemical peels to help resurface the skin. With any treatment plan, your skincare specialist ought to be advising a skin preparation phase (getting your skin ready for the peels) the treatment phase (in-clinic) and the maintenance phase (the vitally important cosmeceutical homecare products and a face SPF 50+). (See my blog HERE all about acids and why they are so phenomenal in skincare procedures). A combined treatment plan of peels and homecare are advised for those of darker skin colour, to avoid further hyperpigmentation and gain the best overall results.
Finally, hyperpigmentation concerns are no solely focused on the face. Hyperpigmentation can occur on other parts of the body, such as the bony prominences, areas where skin has friction, such as the inner thighs, and also can be found in the intimate areas of the body. All can be treated effectively by following both in-clinic recommended treatments and good homecare products that contain tyrosinase inhibitors, provide antioxidant properties and help heal and nurture the skin.
If you are concerned about hyperpigmentation and would like to know how it can be treated, please contact DermalEssence Aesthetics Clinic for a skin consultation and analysis, in-clinic treatment and a starter pack of cosmeceuticals.