It's not uncommon to develop areas of increased pigmentation on the skin with age. They're more common on the face and other areas exposed to sunlight. Hyperpigmentation, or dark areas on the skin, is due to an increase in melanin, the pigment that gives skin its color. Certain ethnic groups, including people of Mediterranean, Asian, and African descent are more likely to develop them.
What do these areas of hyperpigmentation look like?
You might notice small areas of pigmentation or larger patches where the skin looks darker. Pigmentation on the surface of the skin is usually light brown. When the pigmentation is in the deeper layers of the skin, it takes on more of a dark brown or gray color. If you have areas of increased pigmentation, it's important to get a proper diagnosis since darkly pigmented areas can also be due to malignant melanoma, a form of skin cancer.
What Causes Hyperpigmentation of the Skin?
Your skin could develop patches of increased melanin for a number of reasons. One of the most common causes is overexposure to the sun. Ultraviolet light from the sun causes damage to the melanocytes, the cells that produce melanin. Hyperpigmentation due to sun exposure can also show up as solar lentigines, known as age or sunspots. People who go out in the sun without sunscreen are at higher risk of developing these annoying dark spots.
Another cause of increased skin pigmentation is pregnancy. Being pregnant causes hormonal changes that cause increased deposits of melanin, a condition known as melasma. In fact, melasma is so common that it's sometimes called the "mask of pregnancy."
By now you're probably wondering what you can do about them if you have them? Fortunately, you do have options!
Topical Lightening Creams
Some topical treatments that you apply directly to the pigmented areas can help lighten the dark areas over time. Creams that contain hydroquinone are formulated specifically to lighten pigmented areas over time. You can buy creams with up to 2% hydroquinone without a prescription. However, higher concentrations are only available in prescription form.
Hydroquinone interferes with the ability of pigment-producing cells called melanocytes to make melanin. Over time, hydroquinone can lighten pigmented areas due to melasma, sun spots, and even freckles. However, it may take 4 to 6 weeks to see visible lightening of pigmented areas.
Skin acids work by exfoliating the top layer of your skin. New skin cells emerge to take place of the old ones that were shed. This process will help even out your skin tone and reveal a smoother one. Products that contain glycolic acid, citric acid, malic acid, lactic acid, or tartaric acid may help. Products containing 10% or less are best to try.
Retinol, which is derived from vitamin A, is sometimes also used to treat hyperpigmentation and is available over the counter. Retinoids are higher in concentration and it’s best to work with a dermatologist to see what would work better for you. Both are applied topically to lighten the skin and reduce the appearance of hyperpigmentation.
Non-Topical Therapies for Hyperpigmentation of the Skin
When topical creams don't have the desired lightening effect, there are other alternatives. A dermatologist can perform a series of chemical peels that, over time, will lighten the pigmented areas. As mentioned, glycolic acid is one example of a chemical used in peels. Others include salicylic acid, lactic acid, and TCA. However, not all are appropriate for all skin types.
Microdermabrasion, a treatment that removes the outer surface of the skin, may also lighten the dark areas over time. However, it will usually take a series of treatments to get results. Laser therapy and intense pulsed light therapy are other procedures a dermatologist or plastic surgeon can perform to lighten darkly pigmented areas.
Sun Protection for Preventing Future Hyperpigmentation
After treating hyperpigmented areas, it's important to keep new ones from appearing. The best way to do that is to wear a sunscreen with at least an SPF 30. Verify that it blocks both UVA and UVB rays from the sun. Most importantly, consult with a dermatologist to find the proper way to treat your specific condition, especially as some treatments are not suited for pregnant or nursing women.