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Image of a woman in a hijab to represent hyperpigmentation

Hyperpigmentation - symptoms, causes and treatment options

If you’ve noticed the odd dark patch appear on your skin, it could be hyperpigmentation – a common and mostly harmless condition.

This can affect the skin of people of all ethnicities, genders, and ages, but is especially prevalent during pregnancy – with around 90 per cent of pregnant women experiencing it.

But what causes the condition, and what hyperpigmentation treatments are available?

What is hyperpigmentation?

Hyperpigmentation is a skin condition that occurs when melanin – the pigment that gives skin its colour – is over produced. If your body starts making more of it than usual, spots and patches that are darker than the surrounding skin can appear.

Dark spots of hyperpigmentation can appear in small patches, across large areas, or all over your body.

What causes hyperpigmentation?

Genetics

The colour of your skin is based on your parents’ genes with more than 125 genes affecting your skin pigmentation. In some cases, acquired and inherited syndromes can be the reason behind hyperpigmentation. These can include:

  • Dowling-Degos disease.
  • Griscelli syndrome.
  • Incontinentia pigmenti.
  • Legius syndrome.
  • Piebaldism syndrome.

Age

Anyone over the age of 40 may be more at risk. As we mature, the number of melanin-producing cells (melanocytes) in our bodies starts to fall. Those that remain can grow in size but become more focused, leading to an increase in dark spots for some people.

Older adults often develop age spots – a type of hyperpigmentation (sometimes known as sun or liver spots). These dark patches usually occur on the hands, face or other areas of skin frequently exposed to the sun.

Lifestyle and other possible causes

Some lifestyle changes can also sometimes cause hyperpigmentation to appear:

  • Sun exposure – may cause your body to produce extra melanin.

  • Pregnancy – for some pregnant women, the change in hormone levels can affect melanin production levels.

  • Injuries – cuts, burns, acne and inflammation to skin may lead to the condition developing.

  • Addison’s disease – a rare endocrine disease that affects your hormones and may also impact melanin levels.

Two women's faces to represent hyperpigmentation

Hyperpigmentation treatments

Seek advice from your doctor first if you are concerned about your skin in anyway. They can recommend a relevant course of action, which could include treating it personally, outside of the healthcare system.

Some of the best non-medical treatments include:

Creams

Topical creams and gels are over-the-counter options that work to help lighten the skin. You typically have to apply them once or twice a day to the affected area and over time the skin tone starts to lighten. Creams can work best for flat spots and patches.

Retinoids

Retinoids are a common ingredient in many types of skin cream and gel. They work to reduce pigmentation, cell damage and boost repair. You can find combination creams that include skin lighteners and retinoids to tackle hyperpigmentation even more effectively.

Retinoids are safe for all skin tones, but if you’ve got darker skin and aim to use them for a long time, check with your doctor or dermatologist first on what strength to use.

Lifestyle changes

Simply staying out of the sun and protecting your skin with plenty of SPF is a good start. This may help prevent hyperpigmentation from developing in the first place and can support any other pigmentation treatment you try.

Chemical peels

A chemical peel for hyperpigmentation works to remove dead skin cells, revealing fresher and lighter skin. You can get over-the-counter chemical peels; however, professional treatment will always yield better results.

Microdermabrasion

This treatment can remove pigmentation blemishes across any skin tone. It gently removes the epidermis (outer three layers of skin) to help sun-damaged skin heal and repair, returning to its original colour.

IPL therapy

A kind of laser treatment for pigmentation, intense pulsed light (IPL) therapy breaks down damaged cells with broad wavelength light and removes the pigment. You may need five or six sessions for the full results to show.

Laser skin resurfacing

Also known as a laser peel, laser treatment for pigmentation can often remove pigment without scarring. There are two types of laser pigmentation removal:

  • Ablative – removes the top layers of skin.
  • Non-ablative – promotes collagen growth.

Both destroy damaged skin cells to encourage growth of new cells that match the surrounding skin tone.

As well as laser peels, there are a plethora of other laser treatments for pigmentation. This includes:

  • Carbon peels – activated liquid or powdered carbon is applied to the face before a low-energy laser is manoeuvred over the treatment area. This exfoliates the skin, promoting collagen production and tightening pores.
  • Thulium lasers – often referred to as Fraxel treatments, thulium lasers can potentially target thousands of tiny areas through the epidermis. These are known as ‘microscopic treatment zones’, meaning you can treat particular areas of the skin rather than the entire surface.
  • Laser toning – with no downtime and a low risk of complications, laser toning uses a gentle laser to rejuvenate skin cells and reduce the appearance of pigmentation.
  • Pico toning – Pico toning uses laser technology to improve the appearance of sun damage, brown spots, and hyperpigmentation. This laser is gentle on the skin, so there is little downtime; however, you’ll often need three to six treatments to get the best results possible.

Hyperpigmentation facts

  • Even when you’re sat inside, you can be exposed to things that cause hyperpigmentation. According to the Journal of Investigative Dermatology, exposure to blue light (from your computer, TV etc) can cause the condition in people with medium to dark skin tone.
  • Liquorice could be a hyperpigmentation treatment, as it’s thought that it can restore patches of skin to a lighter colour when applied to a darkened area.
  • Alcohol-based perfume products can increase skin pigment production when exposed to the sun.

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