We might think our skin problems are gone after our teenage years and their accompanying acne. However, when we enter our adult life, most of us encounter a new, persistent skincare issue – hyperpigmentation. We tend to panic a little when we see brownish dots or patches on our faces for the first time. Then we buy some creams and serums, only to panic a bit more when we realise after a month or so that they don’t work as we hoped they would.
Getting rid of hyperpigmentation might be challenging, and not all treatments are appropriate for all kinds of hyperpigmentation. To choose the most appropriate way to tackle this issue, it is crucial to know exactly what we are dealing with. So, what is hyperpigmentation and what causes it?
Hyperpigmentation is the darkening of some parts of the skin caused by increased melanin production (a pigment that helps protect skin from exposure to the sun by reflecting or absorbing harmful ultraviolet rays). It can appear in the form of spots or patches, and is a very common skin condition that can affect people of all skin types.
The four most common types of hyperpigmentation are freckles, dark spots, melasma and post-inflammatory hyperpigmentation.
Freckles
Freckles are small (usually less than 5mm in diameter) flat, light brown spots that can appear all over the body. They can pop up at any age, but often start in childhood. Contrary to common belief, nobody is born with freckles. Have you ever seen a new-born with freckles? Babies can have the freckles gene (MC1R), but the freckles themselves are always triggered by sun exposure. They usually get darker in summer and lighten up when you avoid the sun. Don’t panic, freckles themselves are not a sign of sun damage. However, if you have them, it means that your skin is extra sensitive to ultra-violet light and it’s probably a good idea to make sun screen your best friend (to prevent skin damage and accelerated aging).
Dark spots
Dark spots, age spots, sun spots, liver spots and solar lentigines are all different names for the same phenomenon – brown, black or tan spots that appear on the skin after years of sun exposure. Sounds similar to the description of freckles right? So how can we distinguish them? Easy…while freckles appear in childhood, dark spots tend to appear after years of sun exposure. You can expect them to pop up in your 30s or 40s. While freckles tend to fade away when you avoid the sun, dark spots remain. They are also bigger than freckles, and are pigmented cells clumped together to form dense areas, creating a darker skin tone patch.
Melasma
Melasma is one very frustrating hormonal skin reaction. It can be recognised by the appearance of uneven, dark brown or grey, mask-like patches. According to the American Academy of Dermatology, 90% of people who have melasma are women. Although melasma is also known as the “pregnancy mask”, it can affect not only pregnant women but also women who take birth control hormones, those passing through menopause, or anyone whose hormonal levels become unbalanced for whatever reason. People with a darker complexion are more prone to develop this condition than people with lighter skin.
Post-inflammatory hyperpigmentation (PIH)
As the name suggests this type of hyperpigmentation is a common consequence of skin inflammation such as cuts, burns, acne or in some cases even an insect bite. In rare cases, treatments like dermabrasion, laser therapy or chemical peels might also trigger it. Basically, when there is an injury that causes the skin to become inflamed, this inflammation can trigger excessive melanin (pigment) production, which darkens and discolours the area where the wound was. Anyone can suffer from PIH, however it is most common in people with darker skin tones. It appears as flat spots of pink/red or brown/black shades, depending on skin tone and the depth or discoloration. The good news is that PIH doesn’t provoke scarring and becomes less visible with time.
Now that we’ve identified the different kinds of hyperpigmentation, we can now choose the most appropriate treatment plan to get rid of it. In part 2 of this article, in the next issue of On Skincare, we’ll discuss this in detail.
Meanwhile, don’t forget that even the best treatments on the market are not enough to save you from hyperpigmentation issues once and for all. It’s important to not only focus on tackling already existing spots or patches, but to prevent new ones from forming. And preventing pigment related issues without sunscreen is like pushing a rock uphill – you can try all you want, but without daily protection, new signs of hyperpigmentation will just keep appearing.
