Pigmentation is the natural colour of a person’s skin. Hyperpigmentation is characterized by the increased production and accumulation of pigment (melanin), which causes a darkened appearance to the skin in small or large areas.
The three most common types of hyperpigmentation are photodamage, melasma and post-inflammatory hyperpigmentation (PIH). Photodamage is ultraviolet (UV) induced and shows in the form of freckles, age spots and uneven skin tone. Melasma describes brown to gray-brown patches, most commonly seen on the cheeks, nasal bridge, forehead, chin, and above the upper lip. Melasma is sometimes referred to as the “mask of pregnancy” and can last years afterwards.
Other common causes include oral contraceptives, menopause and hormone replacement therapy. Post-inflammatory hyperpigmentation (PIH) can be found in areas of the skin that have been subjected to inflammation due to trauma, irritation or acne.
Multiple in-clinic treatments and skin lightening products are available to treat hyperpigmentation. In-clinic treatments include photofacials where light targets the brown spots and chemical peels that enhance the exfoliation of pigment.
Many of the commonly used product ingredients block tyrosinase, which is the main enzyme used in melanin production. Examples include hydroquinone, kojic acid and arbutin. Other ingredients, like niacinamide, exert their lightening effect by reducing the transfer of melanin from melanocytes (pigment-making cells) to keratinocytes (skin cells). Substances, which increase cell turnover such as alpha hydroxy acids and retinoids, are also commonly used to lift hyperpigmentation. Other ingredients with novel mechanisms of action are also available.
Finally and without a doubt, the most important product to prevent hyperpigmentation is sunscreen. A broad-spectrum mineral sunscreen with an SPF of at least 30 should be worn 365 days per year to prevent future sun damage.