The 4 Step Hyperpigmentation Treatment Plan

By Lela Lankerani, MD February 12, 2014 38 Comments

hyperpigmentation full image

What is Hyperpigmentation?

Skin coloration irregularities are relatively common. Pigmentation disorders like hyperpigmentation can make the skin appear lighter or darker, or blotchy in places and can occur affect people of all races.

Skin pigmentation is determined by melanin, a substance produced by melanocyte cells in the skin. Melanin absorbs UV light, thus protecting the body from its harmful effects. However, it is quite common for melanin to be excessively produced by the body leading to Skin pigmentation irregularities. These fall into one of three categories:

  • Actinic lentigines, also known as sun spots
  • Post-inflammatory hyperpigmentation
  • Melasma

Actinic Lentigines

Actinic lentigines (AKA age spots or sun spots) are brown spots that develop as a result of the cumulative effects of sun damage inflicted on our skin, throughout the years. The spots are pale brown or gray in color and have a clearly defined edge. They typically develop on the areas of the skin most frequently exposed to the sun, such as the face and back of the hands. The number of sunspots become more visible as we age.

Actinic lentigines are particularly common in places like Austin, where the weather is hot and sunny and the residents like to spend lots of time outdoors.

lentigines 2

Actinic lentigines on the upper back (Photo Credit: http://www.aocd.org)

Post-inflammatory Hyperpigmentation

Post-inflammatory hyperpigmentation is the result of inflammation in the skin caused by acne, burn, rash or traumatic injury.

It appears as irregular shaped patches of brown skin. They are caused when an injury, illness, or infection triggers an inflammatory response within the skin. This causes the melanocyte cells to increase their rate of melanin production, and the melanin leaks out and upwards towards the surface of the skin.

post inflammatory hyperpigmentation case

Post-inflammatory hyperpigmentation before and after (Photo Credit: HealthFox.com)

Melasma

Melasma shows up as larger patches on the cheeks, forehead, upper lip and jaw line. It is caused when the female hormones estrogen and progesterone stimulate the melanocyte cells to produce excessive amounts of melanin when exposed to sunlight. Due to this involvement of the female hormones, melasma is much more common in women, particularly pregnant women, and those taking birth control pills. The occurrence of melasma will increase the more the skin is exposed to sunlight.

It is typically the most difficult to treat because the pigment can be deep in the skin and the discoloration tends to recur easily with the slightest sun exposure.

melasma forehead

Meslama on the forehead (Photo Credit: WebMD)

Hyperpigmentation Treatment Options

There are a range of cosmeceuticals and other hyperpigmentation treatment options available to combat any of the above pigmentation issues. The following is a basic road map for effectively treating hyperpigmentation:

Step 1: Sun Protection

The first course of action for any form of hyperpigmentation is to use sun protection to prevent it worsening. UV rays, from sunlight, are the primary cause of hyperpigmentation. You can protect your skin with a high sun protection factor (SPF) sunscreen, SPF clothing, wide brimmed SPF hats and sunglasses.

Our offices carry a variety of excellent broad spectrum sunscreens such as EltaMD, Skin Medica, IS Clinical and Revision Intellishade.

We can help you select one that best suits your skin type and lifestyle.

Step 2: Skin Lightening Skin Care

The next step is using a skin care regimen that utilizes skin lightening ingredients such as Lytera by Skin Medica, EvenTone by Skinbetter, Skinceuticals Advanced Pigment Corrector or IS Clinical’s White Lightening. This should be an individualized regimen tailored to your skin’s specific needs. You can schedule an appointment with one of our licensed medical aestheticians who will design a skin care regimen that will address not only the pigmentation issues, but any other concerns you may have or want to prevent.

Step 3: Skin Lightening Mask

For moderate to severe hyperpigmentation or melasma that is unresponsive to the treatments outlined above, there’s the option of using Cosmelan Mask by Mesoestetic. Cosmelan works by peeling surface pigment away to lighten any hyperpigmentation. It also blocks the enzyme involved in the melanin formation process to prevent any further pigmentation in the skin. This non-invasive skin lightening treatment rejuvenates the skin and brightens the complexion. It’s safe to use on all skin types and is highly effective on all types of hyperpigmentation, including melasma, sun spots, or hyperpigmentation caused by acne scarring.

Step 4: Light and Laser Treatments

If the hyperpigmenation is resistant to the Cosmelan Mask, we offer a variety of light and laser treatments, Photofacial, Clear & Brilliant, and Fraxel.

During the treatment laser energy is delivered to the target area in a series of short pulses. This energy is more efficiently absorbed by the dark cells containing the most pigment, and the energy causes the pigment to break down. The treatment may need to be completed over a course of sessions, depending on the extent of hyperpigmentation.

In addition to lightening brown spots, these laser treatments can also reduce redness while improving skin texture, fine lines and wrinkles.

Recurrence

None of these treatments can completely prevent pigmentation problems from returning. You can minimize the possibility of pigmentation problems by limiting your skin’s exposure to the Sun’s UV rays.

 


Lela Lankerani, MD

Lela Lankerani D.O. received her undergraduate degree in Biology at Washington University where she graduated cum laude. Dr. Lankerani has published articles in several scientific journals and has presented at national scholarly meetings including the American Academy of Dermatology and American Osteopathic Academy of Dermatology.


38 Responses to “The 4 Step Hyperpigmentation Treatment Plan”

  1. Stacy says:

    I was wondering if the location of the hyperpigmentation makes a difference in terms of treating it? Is there a difference if its on your face vs. an arm?

    • WD Staff WD Staff says:

      Hi Stacy, the best course of treatment may differ depending on several factors like location and a person’s overall lifestyle. Please feel free to contact us for an individual analysis.

  2. Junisse says:

    Awesome post.

  3. Sarah says:

    Fantastic write up. You have included some great tips! We also just did an article on 3 strange caused of hyperpigmentation. Please check out: https://getridofhyperpigmentationfast.com/three-strange-but-actual-causes-of-hyperpigmentation/

  4. Kathleen says:

    Can these techniques be used on Black skin? Years ago I had a dermabrasion what a mistake! Now I have a hyperpigmentation line on my neck. What can I do?

    • WD Staff WD Staff says:

      Hi Kathleen,

      We’re sorry to hear about your issue. It’s true that there are some treatments that are not suitable for individuals with darker skin tones (in some cases causing damage).

      The good news, however, is that there have been some breakthroughs (particularly in lasers) that provide better results and are safer on darker skin. This is one area where the cosmetics industry has made great strides.

      We recommend contacting us to setup a consultation!

      Thanks for your questions and for reading our blog,

      — WD Staff

  5. Nii says:

    Are there effective treatments available for hyperpigmented lips on coloured people?

    • WD Staff WD Staff says:

      Hi Nii, thanks for the great question and for reading our blog! There are some treatment options for treating that area on individuals with darker skin. Depending on the exact indication there are a couple of great lasers (which are often utilized at a lower frequency to prevent further discoloring the skin).

      Please feel free to give us a call to setup an appointment!

      Thanks,
      WD Staff

  6. Sheryl says:

    I’m an African American woman that lost pigment of my nipples after a breast reduction with free nipple graph. Is there anything to correct this? I’ve tried medical and professional tattooing several times. Color won’t stay

    • WD Staff WD Staff says:

      Hi Sheryl, Thanks for reading out blog and submitting this great question. Sometimes the color fades early because of the color composition of the ink. Sometimes small areas of hypo pigmentation can be surgically excised.

      If you have further questions please feel free to give us a call to setup an appointment. Seeing you in person would help us determine the best course of treatment.

      Thanks again,

      WD Staff

  7. robbi768 says:

    DO NOT USE LASER for hyperpigmentation!! Its too strong and will make it worse!! These treatments are very expensive.

    Since we have sensitive skin anyway, what works is using products with glycolic acid as that is gentler and will take away the hyperpigmentation over time without BURNING it off (which wil leave scars). I use two creams for my hyperpigmentation and I have seen results in one month of daily use. (1) the Made from Earth Pure Aloe Vera – I use this on my body, and (2) the Lady Soma Renewal Serum – I use this on my face.

    Aloe is a safe, gentle and effective method of treating hyperpigmentation, while the Lady Soma Renewal Serum has gentle gycolic and hyaluronic acid that takes the pigment away without the laser burning.

    • WD Staff WD Staff says:

      Hi Robbi, thanks for reading our blog and for your contribution! We completely understand your reservations regarding laser treatments, however we would counter that there are some excellent laser options that use lower power (wavelengths) to address hyperpigmentation without causing any issues. Especially in the hands of an experienced provider, laser treatments are a safe and effective treatment option.

      However, as you stated, there are also other products and treatment options that are effective.

      Thanks,
      WD Staff

    • Preety says:

      I did BBL facial, about 5 treatments, instead of making my skin better, i ended up with Hyperpigmentation. I am brown skin. Whenever i complained during procedure, the lady responded, that it is pulling all the pigmentation out, but now i am left with bad skin. I didnt have all the dark marks on my skin (patches)I do not recommend any laser treatment for brown skin people. I am going to order these two products. Now this lady is talking me to get a peel, i tried one before didnt help. Hydroquinonone, didnt help either (made it worst)

  8. Fatima says:

    Hi, I have hyperpigmentation on my breast. My dermatologist recommend me retain A , I think I receive rashes and darken my chest areas using Retain A. Should I get laser treatment?

    • WD Staff WD Staff says:

      Hi Fatima, Thanks for reading our post and submitting your question. We would encourage you to visit your dermatologist and discuss your reaction to the Retin A before trying any new treatments. That being said, there are many great laser treatments that can treat hyperpigmentation. Please let us know if you would want to schedule a consultation, we can discuss several new potential treatment options.

      Thanks,
      WD Staff

  9. Kelly says:

    Hey there! I’ve been following your site for some time now and finally got the courage to go ahead and give you a shout out from Humble Texas! Just wanted to mention keep up the fantastic work!

  10. lakh says:

    My esthetician gave me Tattoo removal treatment and it actually helped with my hyperpigmtation as well. i had tried almost everything before this but this is best.

  11. Summer says:

    I have bad acne, and the other day I got a pimple and I poped and picked at it. ( I know I am not suppose to) Anyway now the spot where the pimple was has a scab color but it is not a scab it is my skin. I don’t know what to do.

    I don’t know any thing about the different kinds of acne or what I have. I don’t know how long it will take to heal, or if I should see a doctor. Can you please help me?

  12. Natasha says:

    Yes, you are right. Hyper-pigmentation can be avoided and treated using best quality pigmentation skin care products which we can buy online or offline from any retailer. I have been using the skin care an beauty products of famous brands. One can buy online pigmentation cream of various reliable brands like Aspect, Cosmedix, PCA Skin etc.

  13. Does laser put an end to hyperpigmentation for once and all? says:

    Does laser help to remove hyperpigmentation forever?

    • WD Staff WD Staff says:

      Hello, thanks for reading our post and submitting your question. Laser treatments are great for addressing pigmentation issues. Treatments can be tailored to treat the specific type and degree of hyperpigmentation on a patient to patient basis. Please give us a call if you would like to learn more!

  14. dervesh says:

    Hi I have PIH spot on my face for over 2 years ..i used many creams and stuff but it just came back after getting better..2 weeks back i had laser treatment…Short bursts …my doc said it will take 4-5 weeks ..but my question is it looks even darker now than before?? wats wrong is it getting worse after the laser or wat?
    Male .Skin ( Brown/Tan)

    • WD Staff WD Staff says:

      Hi Dervesh, thanks for reading our post and I’m sorry for your issue. Post-treatment darkening after laser therapy can be common, especially for individuals with darker skin tones. In fact, treating hyperpigmentation in darker Fitzpatrick scales can be difficult in general. Your physician may be correct in that it could take some time clear.

      However, if the issue persists we would recommend seeing your doctor to try a different treatment!

  15. Jackie says:

    Hi, I had laser resurfacing treatment nearly a month ago. I started seeing hyper pigmentation about a week or so ago and now I am seeing more. How long after a treatment can it show up? I have a lot of areas on my face that are turning brown. I had beautiful skin before but I wanted to get rid of fine lines. I’m so disappointed and scared that these brown spots will just continue to show up

    • WD Staff WD Staff says:

      Hi Jackie, It sounds like you may have developed some post-inflammatory hyperpigmentation after the laser treatment. The good news as it should be easily treatable. We would encourage you to contact your provider to be assessed in person and discuss options.

      Thanks,
      WD Staff

  16. Preeti says:

    I read a lot of reviews about Hiperpigmentation and it sounds to me like treating the problem on brown skinned people could be difficult so could you please provide me with options take work for asian Indian skin tone.

    • WD Staff WD Staff says:

      Hi Preeti, Thanks for reading our post and submitting your question. You are very correct: treating individuals with darker skin tones can be difficult as there is the potential for unwanted discoloration issues when done improperly.

      Because of those issues, the best advice we can give is for your to see a licensed dermatologist in your area for assessment. It would be impossible for us to recommend a “full proof” treatment without assessing you in person.

      Thanks,
      WD Staff

  17. Runaize says:

    I have a hyper pigmentation on my cheek bone. Can i get rid off it ?

    • WD Staff WD Staff says:

      Hi Runaize, there are lots of great treatments that can take care of that hyperpigmentation. If you are in the Austin area, please give us a call to schedule an appointment! We will find the best treatment option given the specific characteristics of your skin.

  18. Marzena says:

    I have dark spots on my cheeks, forehead, chin and above my upper lip, and after 2 months of dermalmd lightening serum use, they have nearly vanished. I highly recommend dermalmd serum! Be sure to wear sunscreen everyday to keep the dark spots from coming back.

  19. Claudia says:

    I suffer from hyperpigmentation, leaving dark spots on my skin. Used dermalmd lightening serum for 30 days, 2x a day. I was really surprised by the results. I’ve tried every product. Either it didn’t work at all or irritated my skin. Dermalmd serum tingled the first few times I used it, but that went away and no redness.

  20. Patricia says:

    Lies! Dermalmd lightening serum ruined my face! I wanted to get rid of some acne scars but instead I’m left with huge brown spots. I wish I could turn back time. You’ve been warned!

    • Kennedy says:

      How bad was your hyperpigmentation and what colored skin are you because people said it was different for other skin tones but I am thinking about it and I want to hear the negatives

  21. Ashley says:

    Thanks for your tip to keep your skin safe with sunscreen, clothes, and hats. I like how you said that you should also look into masks for treatment as well. My sister is considering getting skin pigmentation treatment, and we are looking into health from medical professionals; thanks for the tips.

  22. Audrey says:

    Thanks for this article! I think when you’re looking at something as laser treatment you have to talk to a doctor. At-home remedies are good to start, but they won’t give you extremely noticeable results. In-office treatments, on the other hand, can definitely give you a better idea of what the laser treatments can do for you.

  23. Ahmad says:

    very helpful thanks for sharing 🙂

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