Hyperpigmentation – Current Treatments Overview

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Dark patches on facial skin often develop throughout a person’s life as a response to environmental, hormonal, and hereditary factors. Melasma is a specific type of hyperpigmentation that occurs as a result of pregnancy. Hyperpigmentation can also have many other causes including UV exposure, autoimmune disorders, or drugs that cause increased light sensitivity.

Areas of excessive pigment are sometimes temporary. However, they may still last for several months or years before fading. Hyperpigmentation may also become progressively more noticeable and widespread with age. Women who are self conscious about areas of uneven skin tone may choose to wear makeup every day as camouflage. The constant use of concealer can contribute to other persistent skin problems such as acne in individuals with sensitive skin.

In many cases, skin that is blemished with dark marks may impact a person’s quality of life by adversely affecting their appearance and self esteem. According to recent research published in the Journal of Cosmetic Dermatology, almost 1 out of 4 of patients with pigmentation disorders report that it affects their life activities. Dermatologists offer patients a number of treatment options to diminish the appearance of hyperpigmentation and reduce the need for heavy makeup. The treatments below may be used alone or in combination depending on the severity of the condition and on the patient’s skin type. With each of the treatments listed below, protecting the skin from sun exposure is critical for achieving the desired outcome.

Topical Applications

There are a number of active ingredients used in facial creams for lightening dark areas of skin. Common ingredients include tretinoin or retinoic acid (Vitamin A compounds), hydroquinone, and azelaic acid. Some formulas also include corticosteroids such as fluocinolone acetonide to help reduce inflammation. Many of the substances found in these creams are also used in higher concentrations for chemical peels. Glycolic acid may also be recommended to treat hyperpigmentation. Topical creams are generally applied by the patient at home while chemical peels are performed in a dermatologist’s office on an outpatient basis.

Advanced Treatment Options

Dark patches of facial skin may also be treated with more aggressive therapies such as microdermabrasion and fractional laser procedures. If the cells displaying increased pigment are trapped in the surface layers of skin, this old skin can be exfoliated using microdermabrasion to reveal unblemished skin underneath. This type of treatment tends to work best for age spots caused by sun exposure. Fractional lasers penetrate into the deeper layers of the skin for further rejuvenation. This laser option is avoided by some dermatologists since there is a risk of actually making the problem worse. The patient’s skin type and the underlying cause of the increased pigmentation determine whether laser resurfacing is a viable option.

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