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Hyperpigmentation 101: The Best Dark Spot Treatments

CEO Tinh Phung
Dark spots can be a frustrating skin concern to deal with. Whether you call them uneven pigmentation, age spots, liver spots, melasma, or hyperpigmentation, they can be slow to fade and challenging to conceal. But...

Dark spots can be a frustrating skin concern to deal with. Whether you call them uneven pigmentation, age spots, liver spots, melasma, or hyperpigmentation, they can be slow to fade and challenging to conceal. But fear not, because top skin-care experts are here to share their best tips for treating and defeating those pesky spots.

What Is Hyperpigmentation?

Hyperpigmentation is not a condition in itself, according to San Antonio dermatologist Vivian Bucay, MD. Instead, it is a term used to describe when the skin appears darker than usual. It can occur in small patches, cover large areas, or affect the entire body. Dr. Bucay explains that hyperpigmentation is largely influenced by genetics and is a chronic problem that requires commitment to treat. While there is no magic eraser for hyperpigmentation, there are ways to help the body decrease the amount of pigment it produces.

What Causes Hyperpigmentation?

The excess production of melanin, the pigment responsible for skin color, is the common cause of hyperpigmentation. This can be triggered by various conditions or factors, including changes in hormone levels during pregnancy or menopause. Certain medications and chemotherapy drugs can also contribute to hyperpigmentation. Dark spots are typically found in sun-exposed areas like the face, chest, back, and limbs, and they can become more noticeable as we age and accumulate UV radiation.

Step 1: Prevention

The most effective way to lighten and prevent dark spots is by using a physical sunblock. Dr. Deborah Longwill from Miami recommends using a sunblock that contains zinc oxide and titanium dioxide. She emphasizes that no topical treatment or in-office procedure can fully remove or treat pigmentation without serious UV prevention, such as using physical clothing, sunglasses, an umbrella, and a hat.

Step 2: Topical Treatments

There are many topical treatments available to help decrease melanin production and lighten dark spots. However, it's important to commit to one treatment and maintain it, as results won't occur overnight. Some primary ingredients recommended for lightening dark spots include hydroquinone, retinoids, azelaic acid, glycolic acid, kojic acid, cysteamine, and licorice root extract. These ingredients act as tyrosinase inhibitors, which are key enzymes in the production of melanin.

Hydroquinone is considered the gold standard for lightening dark spots and can decrease tyrosinase activity by about 90 percent. Baton Rouge dermatologist Ann Zedlitz, MD suggests using a stronger formulation of 8 or 12 percent for faster results. However, high concentrations of hydroquinone should only be used for a limited time to avoid skin inflammation and allergic reactions.

Dr. Zedlitz recommends using acids to treat dark spots at home. She suggests using a topical alphahydroxy acid (AHA) product on the entire affected area.

Hyperpigmentation 101: The Best Dark Spot Treatments To lighten the dark spots on this 45-year-old patient’s cheeks, Dr. Zedlitz performed a chemical peel that included mandelic, lactic and salicylic acid, as well as other exfoliating agents and hydroquinone.

Step 3: In-Office Treatments

If the pigment causing the dark spots is deep down in the dermis, an in-office procedure may be necessary to lift it out of the skin. Here are some common in-office treatments:

Chemical Peels: Low-strength glycolic acid and salicylic acid peels can help reduce the appearance of dark spots. Dr. Bucay advises using low concentrations specifically for hyperpigmentation.

Microneedling: Microneedling aids in the absorption of brightening ingredients in topicals and removes specific layers of skin containing melanin, according to Dr. Longwill.

Light and Energy Devices: Intense pulsed light (IPL) and BroadBand Light (BBL) therapy selectively heat up the pigment, leaving the surrounding tissue unharmed. The heated area is then lifted to the surface where it can be removed by the body's natural exfoliation process.

Laser-Resurfacing Treatments: For more severe cases, laser treatments like PicoSure, Fraxel, or Nd:YAG may be recommended. It is crucial to consult with a board-certified dermatologist or plastic surgeon to ensure the proper settings are used for your specific case.

By following these steps and consulting with a skincare professional, you can effectively treat and combat those persistent dark spots. Remember, consistency and commitment are key in the battle against hyperpigmentation.

Would you like to learn more about hyperpigmentation and the best treatment options? Check out this original article for additional information.

Note: The provided images have been included as visual aids to support the content. The captions describe the procedures being performed.