Opinion

All about hyperpigmentation – PART 2 Treatment options

Hyperpigmentation can be a very frustrating issue, and if you have it, you’re probably a little bit desperate already, and see no hope ahead of you. Don’t worry, the battle is not lost yet!
There is no universal therapy out there that can simply cure all hyperpigmentation cases, however there are quite a few treatment options that have proven to be effective. You just need to find the right one for your specific case. 
 
As mentioned in the first part of “All you need to know about hyperpigmentation” in our July-August issue, fighting hyperpigmentation without a decent photoprotection, is simply a lost cause. So let’s start with photoprotection, as well as eliminating other provoking factors, as part of any treatment. This might be especially tricky for those with melasma, since you should balance hormonal levels first in order to control it. But once this is taken care of, we can now think of active pigment reduction strategies. So what are the options?
 
Most common approaches include the use of topical formulations, laser therapy, dermabrasion and chemical peels. 
 
Although physical approaches – like lasers, dermabrasion and chemical peels – may be effective, they bring with them a high risk of post inflammatory hyperpigmentation. There is a chance that in place of getting rid of dark spots on your face, you will get some new ones. That’s why physical approaches should be performed only by very experienced professionals, and should only be considered as an option after topical formulations have failed to help.
 
So let’s focus on topical formulations.
 
When using a topical cream, don’t consider it a failure if you see no improvements after just a month or so of use, since you usually need a few months of everyday use for the product to show results. If, after a few months, you still see no results, it is possible that you simply picked the wrong cream or gel.
 
As I mentioned in Part 1, excess melanin production and redistribution is to blame for the dark spots and patches on our skin. If your cream or gel fails, it is possibly because the active ingredient in it isn’t strong enough to tackle all parts of your melanin production/redistribution process. A good approach in such a situation is to try another formulation (i.e. another product) with a combination of two or three active ingredients that target more than one mechanism of melanin production or redistribution.
 
But what ingredients are we talking about? Let’s look at some well-known topical actives that can help you get a radiant, even complexion.
 
For many years, the ingredient of reference for skin lightening was hydroquinone. Now however, several places like Japan and Europe are questioning it’s safety, so don’t be surprised if you can’t find it anywhere anymore. Thankfully, there are quite a few good replacements for hydroquinone, with the same action mechanism.
 
You should look for ingredients like arbutin, azelaic acid (appropriate even for people suffering from roseaca), deoxyarbutin, glycolic acid, liquorice extract, mequinol (works well together with tretinoin, a form of retinol), N‐acetylglucosamine and N‐Acetyl‐4‐S‐cysteaminylphenol.
 
Another group of ingredients that you should keep an eye out for include: niacinamide (works great paired with N‐Acetylglucosamine, from the previous list), soybean trypsin inhibitor and retinoids. Other ingredients include ascorbic acid (a form of vitamin C) and kojic acid (produces modest results by itself, and is better if used in combination with glycolic acid, for example). These are just some of the most well-known actives, that have proven results.
 
Although very effective, ingredients like retinoids may sometimes provoke serious skin irritation, which is why some people tend to quit their treatment after a short period of time. Thankfully, researchers keep doing good work and often bring us new, effective ingredients with less side effects. One of my personal favorites is a natural active called Bakuchiol. It acts as retinoids but without the unwanted skin irritation. It is definitely worth trying. 
 
As you can see, there’s a wide range of solutions available for hyperpigmentation, and as long as you are persistent and patient, it is possible for you to achieve a more even complexion. Remember however, that even if you get rid of existing spots and patches, new ones can still appear. That is why it is important for you to concentrate not only on fighting existing spots, but also on preventing new ones from forming. 
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