Everything You Need To Know About Hyperpigmentation

You're washing your face one day — business as usual — and, seemingly out of the blue, you notice a new dark mark. Is it in the same place as that pimple of yesteryear? Did it pop up after a particularly long day in the sun this past weekend? These are all factors to consider before you even start to think about a skin treatment. Not all dark spots are created equal — and, in turn, they should not be treated equally.

From post-inflammatory hyperpigmentation (PIH) to melasma (and every age spot in between), we asked Dr Cara McDonald, dermatologist and co-director of Complete Skin Specialist, for a breakdown of the different kinds of hyperpigmentation, what causes them and how you can treat them ASAP.

According to McDonald, hyperpigmentation is the description given to darkening or discoloured areas on the skin and occurs due to increased melanin production. Melanin is the pigmentation produced by cells in our skin called 'melanocytes' (AKA, the cells responsible for our baseline skin colour).

"The trigger for [hyperpigmentation] varies greatly and is not always fully understood. In many cases, the melanocytes are stimulated by hormonal changes or inflammation and then overreact when exposed to UV light," says McDonald.

"Post-inflammatory hyperpigmentation is a fairly common cause of pigmentation and can persist after acne or other inflammatory skin conditions," explains McDonald. "People with darker skin tend to be more prone to post-inflammatory hyperpigmentation."

PIH can also be a result of instances of trauma, eczema, or rashes on the skin, and usually pops up a few days after the injury in typically small, localised, and dark brown spots.

Melasma appears as brown or grey-brown patches on the cheeks, central forehead, or upper lip area. "We most commonly see melasma in younger to middle-aged women, which is a mottled patchy brown pigment on the face. It commonly affects the cheeks, forehead and upper lip and is exacerbated by sun exposure and hormonal factors such as pregnancy or the oral contraceptive pill," says McDonald.

Age spots (sometimes known as lentigos) are often caused by exposure to the sun (solar lentigos) but can also develop over time as you age. McDonald says they most commonly appear in older, fair-skinned Australians who often present with pigmented lesions caused by excess sun exposure.

"These range from benign freckles to sun damage to lesions called solar keratoses, and even malignant lesions such as melanoma," she says.

Like most skin conditions, McDonald recommends getting a diagnosis from a professional before proceeding with treatment to ensure effectiveness. So many products are formulated to either fade, lighten or brighten the skin, so it's important to know which to pick and use correctly.

She says that strict sun protection and a good skincare regimen is the best starting point for all pigmentation. Wearing a daily SPF has been proven to help in preventing hyperpigmentation (amongst its many other benefits.)

McDonald also says that antioxidants in skincare, such as vitamin C, can help reduce dark spots and help brighten your skin, so incorporating a product like Garnier's Vitamin C Brightening Serum into your morning routine could be a good move.

"Vitamin C is a potent antioxidant and an excellent ingredient to brighten the skin. Retinoids, kojic acid and hydroquinone are all effective at inhibiting pigment production," says McDonald. "Other plant-derived ingredients such as liquorice root extract, mulberry, azelaic acid and arbutin can also be effective, but there is no one size fits all approach."

McDonald also recommends speaking to a professional about using hydroquinone (a prescription-only ingredient at concentrations of greater than 2% concentration in Australia), which is an effective tyrosinase inhibitor that reduces pigment production. She also suggests trying to avoid skin irritation when suffering from hyperpigmentation, as some skincare ingredients available will inhibit the production of pigment and reduce oxidative processes which can exacerbate pigmentation.

Laser treatments have also become a popular way of treating hyperpigmentation, however, in some instances, they can worsen the problem. "In some cases, energy-based devices, such as laser are helpful but often these can worsen pigmentation, so it is important to seek an experienced professional opinion before embarking on any procedures," says McDonald.

She also recommends that in complex cases — like severe acne — seeking professional help early may be easier than treating hyperpigmentation from scarring.

"Unfortunately, there is no quick fix for pigmentation and those who suffer from it know that it is an ongoing battle which can recur at any time. Those who are continuing to struggle should consider seeing an experienced dermatologist for a thorough assessment, accurate diagnosis and discussion of treatment options."