Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Why Is Hyperpigmentation So Hard To Get Rid Of? June 23, 2016

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One of the more difficult skincare problems to solve is hyperpigmentation or dark spots on your skin.  This is also a very prevalent skincare issue that affects people of all skin tones.   Just where do these frustrating spots come from and how can you get rid of them for good? In this post I want to give you some insight into what causes hyperpigmentation in the first place and how to combat it effectively.

How Does Hyperpigmentation Form?

There are a few different types of hyperpigmentation or dark (brown) spots that can form on the skin.  You can get hyperpigmentation from the sun, from hormones, or as a result of an injury to the skin.  This last type of hyperpigmentation includes the marks that show up on the skin after a pimple heals.  (Please keep in mind that while many people call the red or brown marks that are left on the skin after a breakout heals “acne scars” they are definitely not scars but rather hyperpigmentation)   Certain ethnicities are more prone to hyperpigmentation than others.  Interestingly enough the treatment for hyperpigmentation is the same no matter its source.

I’ve been having an internal debate how technical I should be in explaining how hyperpigmentation forms because it is easy to get very lost among the scientific terms and processes that occur in the skin.  I also feel that such an explanation can be a bit overwhelming for non-science people (I include myself in that category).

I decided to take a middle of the road approach in my explanation.  Here it goes.  Your epidermis (the top layer of your skin) contains melanocytes which produce melanin. Melanin determines your skin color and tone. Everyone has the same number of melanocyctes in their skin; your skin color is determined by the amount of melanin activated in the skin.  Melanin is also the pigment that protects your skin from UV rays.  So when your skin experiences excessive sun exposure or prolonged sun exposure year after year, day after day more melanin is produced in order to protect your skin from the sun’s damaging rays.  A tan is actually a sign of your skin’s “self defense” mechanism kicking into gear.  Sorry to say but with every tan you get you’ve done damage to your skin. Dark spots from the sun can show up in a cluster on one area of your face, perhaps on the side of your face that is exposed to a window in your office or while driving, and can take years to appear after the initial damage has been done to your skin.  Many times as an esthetician I find it hard to convince people to use sunscreen on a daily basis simply because the damage daily sun exposure is doing to their skin is not evident at first.  It can be hard to for people to realize that they need sunscreen everyday when the damage they will see from the sun will only show up 10, 20 years later.  So please remember to apply sunscreen daily in order to prevent hyperpigmentation in the future.

Melasma is the hormonal hyperpigmentation.  Many women develop this type of hyperpigmentation during and after a pregnancy or from using birth control pills.  The hormonal changes that are going on in your body due to pregnancy or the use of birth control pills cause this type of hyperpigmentation to form though exactly what doctors are still not entirely sure.  Sun exposure can make melasma worse. Some lucky women may find that their dark spots fade a bit after giving birth, but for many women this type of hyperpigmentation is an unhappy side effect from a happy life event.

Post inflammatory hyperpigmentation is the red, brown, or even yellow marks that are left on the skin after an injury to the skin or after a breakout has healed. Once again as a defense mechanism, in this case a defense against skin inflammation, the body produces extra melanin.  If there is one positive from this type of hyperpigmentation it is usually the easiest kind to get rid of.

Treatment

First of all it is important to keep something in mind when treating hyperpigmentation – there are no quick fixes for this skin care problem.  You need time, patience, and the daily use of skin care products in order to get rid of hyperpigmentation.  If you have had a dark spot on your face for 6 years you cannot expect it to disappear in just a month.  When I say patience I really mean it.  You need to religiously use the right skin care products at home in order to eventually see results months down the road.  Once hyperpigmentation occurs, with the exception of red marks (and some types of brown marks) left on the skin after breakouts heal, your dark spots have no real desire to go anywhere.  If anyone promises you a miracle cure for hyperpigmentation run in the opposite direction.  Also please don’t put lemon juice all over your face and go out in the sun expecting to fade dark spots.  No matter how many times this skincare hack appears in your Pinterest feed you need to ignore it.  You’ll just end up making your skin more sensitive or even causing burns instead of helping your skin if you follow this “tip”.

One of the reasons hyperpigmentation is so hard to get rid of is because you actually have to treat your skin in two different ways at the same time in order to lighten dark spots.  Though the skincare industry is constantly changing and innovating at the moment the accepted way to treat hyperpigmentation is to shutdown or suppress the production of new melanin, prevent the transfer of new melanin to the melanocyctes, and remove the existing dark spots.  This requires a combination of products to achieve; there is currently no one product on the market that can do all three of these things.  Usually hyperpigmentation is treated with one product that supresses melanin production and another product that brings excess melanin to the surface of the skin and then helps it flake off.

In the United States one of the more prevalent skincare ingredients used to treat hyperpigmentation effectively is hydroquinone.  Hydroquinone is controversial for a few different reasons and has been replaced by a host of other ingredients to brighten dark spots because of the controversy surrounding it.  In order to better understand the controversy about hydroquinone I suggest reading Dr. Leslie Baumann’s article that I have listed below in “sources and further reading”.  There is a lot of misinformation circulating about hydroquinone so be sure to educate yourself on this topic before buying into the anti-hydroquinone hype.

Other skincare ingredients that can help treat hyperpigmentation are:  Vitamin C, kojic acid, licorice, arbutin, and azelaic acid.   A product with one or more of these ingredients is best paired with a retinol (or prescription Retin-A) for best results.  You can also use a product that brightens dark spots in conjunction with an AHA exfoliator though keep in mind a strong exfoliator can actually make hyperpigmentation worse or even cause hyperpigmentation for people with sensitive.  When in doubt see a professional in order to create the perfect skincare regime for your skin.  And above all, apply a generous amount of sunscreen each and everyday!  Use at least SPF 30 and make sure your sunscreen protects from both UVA and UVB rays.  Don’t think that your make-up with SPF is giving you enough sun protection because you’ll never apply enough make-up in order to reach the amount of SPF listed on the product.  So be sure to always apply a sunscreen first and then your moisturizer and make-up.

Other Treatment Options

If you have the money for more expensive in-office treatments getting laser treatments from a dermatologist should produce faster results than using just home care products to treat your hyperpigmentation.  Of course you’ll get the best results from a laser treatment if you take proper care of your skin both before and after the treatment.  Follow the advice the doctor or their esthetician gives you; if they don’t give you any before and after advice go to another office.

You can also see an esthetician or dermatologist for a series of chemical peels that coupled with the correct home care regime can help get rid of hyperpigmentation once again faster than if you were just using products at home.  Just as you need a good home care skincare regime before and after a laser treatment in order to get the best results you need to do the same with a chemical peel.

Sources and Further Reading:

My Related Posts:

 

 

No Mixing Allowed: Skincare Ingredient Combinations to Avoid February 13, 2010

So you’ve researched what skincare products to buy and finally made your purchase.   But did you know that if you use different skincare products at the same time you could actually cancel out the benefits of the very ingredients you purchased the product for?

Don’t mix copper peptides and vitamin C –  using the two together, even if they are in separate products, just cancels out the effects of both.

Don’t mix retinol and benzoyl peroxide – both ingredients are great for fighting acne but if they are used at the same time they simply counteract one another.

Don’t mix retinoids or hydroquinone with glycolic acid – once again if you mix these ingredients they become inactive. 

Hydroquinone and retinoids can only be combined together in specially formulated products like Tri-Luma (which is used to fight hyperpigmentation).

And sometimes too much of certain ingredients is just bad for your skin:

Be alert to signs of redness, irritation, or excessive and prolonged peeling if you use products with AHA (alpha hydroxy acids like lactic, glycolic, malic, etc.), vitamin C, and retinol all at once.  For instance all in one day you may use a cleanser with glycolic acid, a moisturizer with vitamin C, and a retinol cream or serum at night.  You may find that your skin becomes sensitive to the use of so many potent ingredients.  If that is the case cut out one or more of the products with the strong ingredients or stagger the use of the products (skip a day or use a product just once a week).

Source and Further Reading:

 

 

Help for Hyperpigmentation February 11, 2010

Hyperpigmentation, dark spots, blotches, or areas on the skin, occurs when the body over produces pigment.  There are three main kinds of hyperpigmentation caused by three different factors .  No matter what type of hyperpigmentation you have there are many solutions to this skincare problem.

The three main types of hyperpigmentation are melasma, sun (sometimes called age) spots, and post inflammatory hyperpigmentation.  Melasma is caused by hormonal changes in the body; pregnancy and birth control pills can cause melasma.  Sun spots or sun damage is, obviously, caused by sun exposure.  The last type of hyperpigmentation is post-inflammatory hyperpigmentation.  This discoloration of the skin occurs after injury or irritation to the skin or after an acne lesion (pimple) has healed.

As already mentioned there are a number of treatments for hyperpigmentation.  First and foremost you must use a sunscreen, spf 30 or higher, daily and be sure to reapply throughout the day.  Sun exposure will only make your hyperpigmentation worse (i.e. darker) so it is important to protect the skin on a daily basis.  Daily use of sunscreen will also prevent new sun spots from forming.

There is only one FDA approved agent to reduce hyperpigmentation and this is hydroquinone.  Only products with hydroquinone in them can be legally labeled “lightening” products.  All other products that claim to help lighten hyperpigmentation without hydroquinone are usually labeled “brightening”, “bleaching”, and even “illuminating”.  Please remember that there is no legal definition of or oversight over the words “brightening”, “bleaching”, or “illuminating” found on product labels.  Be sure to turn the product you are looking at around and read the ingredients list. 

 Hydroquinone is a chemical lightening agent that comes in strengths of 1 to 2% in OTC products and 3 to 4% in prescription products like TriLuma.  To use a hydroquinone product you apply the cream, gel, or solution just to your dark marks twice a day for no longer than six months.  Hydroquinone works by inhibiting the tyrosinase enzyme which forms pigment in the skin as well as disrupting the synthesis of the melanin protein in the skin.  Because of its impact on the melanocyte it is thought that hydroquinone disrupts basic cellular processes including DNA and RNA synthesis.  Though hydroquinone has shown to be effective in treating hyperpigmentation it is far from a perfect ingredient and is surrounded by controversy.  For example, its use has been banned in the European Union and in Japan, and as recently as 2006 the FDA reported its intention to ban the use of hydroquinone in non-prescription products.  As of April 9, 2009 the Cosmetic Ingredient Review Board has listed hydroquinone under “ingredients found safe with qualifications” on its website and writes:  “≤1% in aqueous formulations; but only for brief discontinuous use followed by rinsing from skin and hair; and should not be used in any type of leave-on, non-drug cosmetic product”, but as of yet no ban on hydroquinone has gone into effect in the US.  The reason for all this concern about hydroquinone is that the ingredient has both potential mutagenic and cancer causing properties.  In addition to these upsetting issues some people are allergic to hydroquinone or develop contact dermatitis from using this ingredient.  All of these concerns and issues render hydroquinone an effective but unsatisfactory ingredient for some for treating hyperpigmentation.  Personally I feel that when hydroquinone is used for short periods of time, 3 to 6 months, there is no reason to be concerned over its use.  OTC products contain such a small percentage of hydroquinone, 1 to 2%, that I feel there is no need for alarm when you choose to use such a product.  (I have a list of links at the end of this post if you want to read more in-depth about hydroquinone.)

If you do not want to use hydroquinone, many alternatives exist.  Ingredients that are skin brighteners include: kojic acid, arbutin, licorice root, bearberry, soy, mulberry, vitamin C, niacinamide, and azaleic acid.  The current trend in products to treat hyperpigmentation is to combine several of the above mentioned ingredients in one product for better results.

Non-prescription products containing hydroquinone take a long time to work, as do the non-hydroquinone alternatives.  Prescription products usually work much faster.  The more superficial your hyperpigmentation is the easier it will be to remove.  Please also note that people with darker skin tones are more prone to hyperpigmentation, particularly post-inflammatory hyperpigmentation.  If you have darker skin you need to be more gentle when treating your hyperpigmentation so that you do not cause more irritation and/or hyperpigmentation to your skin.

There are other ways to treat hyperpigmentation; regular exfoliation can help get rid of hyperpigmentation.  For example you could use products containing glycolic acid, an alpha hydroxy acid, which works by exfoliating the uppermost layers of the skin.  More superficial dark marks can be removed with this type of  exfoliation.  Glycolic acid can be found in face washes, creams, gels, lotions, and chemical peels.  The form and concentration of the glycolic acid you should use will be determined by the severity of your dark marks and your skin’s reaction to the acid since glycolic acid can cause irritation to some people. 

Another treatment for hyperpigmentation is a series of chemical peels that include ingredients such as glycolic acid, lactic acid, hydroquinone, kojic acid, licorice root, mulberry extract, bearberry extract, azelaic acid, and ascorbic acid (Vitamin C).  The peels will use one or more of the above mentioned ingredients.  A series of chemicals peels can make quite a difference in the appearance of the skin and can definitely improve hyperpigmentation.  Side effects from chemical peels include redness and peeling for a few days after the peel.   To get the best results from your chemical peels it is a good idea to combine the esthetician or doctor administered peels with home products that treat hyperpigmentation.

Another great treatment option for hyperpigmentation are laser treatments.  Lasers such as the Ruby and Q-switched ND:YAG reach the dark spots deep in the skin, converting light to heat, and literally blow up dark spots which then flake off the skin.  Though the procedure only takes a few minutes redness and scabbing can occur; recovery time is about a week.  Intense Pulsed Light (IPL) treatments can also help hyperpigmentation with no downtime.

Just as there are a number of causes and types of hyperpigmentation there are also many different treatments.  Do a little research and give some thought to how your skin reacts to different ingredients before deciding what treatment option is best for you.  Eventually you should have no problem finding the right solution for your hyperpigmentation.

 

Sources and Further Reading:

 

 
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