Hyperpigmentation: The best treatments

It's more common to have an uneven skin tone than to not. Regardless of skin colour, dark spots and patches can appear on any part of the face and body that's been regularly exposed to the sun, or been scarred for whatever reason. This is what's referred to as hyperpigmentation, and it's totally normal – despite some of us finding it problematic.

"Hyperpigmentation is a general term that describes an excessive production of the natural pigment, melanin,” aesthetic doctor Dr David Jack tells Bazaar. “Hyperpigmentation presents as brown irregular patches on the skin with little surface change,” adds Dr Vanita Rattan, doctor and cosmetic formulator specifically for skin of colour.

Broadly, there are three main types of hyperpigmentation, as Dr Jack explains.

Sun damage hyperpigmentation (also known as sunspots or solar lentigines): “Over time as our skin is exposed to UV, and even blue light from the sun and other sources, it is less able to regulate the production of melanin. As a result, an overproduction of melanin can create distinct pigmented patches on the skin. These are commonly found on the face, hands and chest, and can be seen in all skin types.”

Post-inflammatory hyperpigmentation (PIH): “This occurs in response to inflammation in the skin and is particularly common in darker skin types. It is often the result of acne and scarring, and often happens after facial treatments such as laser, particularly in darker skin types.”

Post-inflammatory hyperpigmentation (PIH): “This occurs in response to inflammation in the skin and is particularly common in darker skin types. It is often the result of acne and scarring, and often happens after facial treatments such as laser, particularly in darker skin types.”

Melasma: “Melasma or chloasma is a condition where brown or greyish patches of pigmentation develop often as a result of internal body triggers, such as hormone changes like pregnancy and thyroid conditions. Melasma is often worsened by sun exposure in the summer and can improve in wintertime.”

How to prevent hyperpigmentation worsening 

points out, “prevention is better and cheaper than the cure, so I advise everyone from a young age to protect their skin from harmful UVA and UVB light with a full spectrum sunscreen”.

Dr Rattan concurs. “The most important tip is to wear SPF50 in the morning even if you are staying indoors, as UV rays penetrate through glass and will encourage hyperpigmentation”. So, before you do anything about your skin tone be sure you're applying SPF.

Treatment options for hyperpigmentation

When it comes to hyperpigmentation treatment, Dr Jacks favours a stepladder process, “starting with the simplest solutions first, testing if they work”. If they don’t, you can gradually ascend to more advanced options.

Step 1: Daily skincare products

He explains that “topical solutions for hyperpigmentation typically work to interrupt the pathways where pigment is produced in the melanocyte cells – they mostly inhibit an enzyme called tyrosinase, which can limit the production of melanin”. Many skincare ingredients have tyrosinase-inhibiting effects, including some of the commonly used 'actives' you’re likely to own, such as vitamin C and retinol. Some are stronger and are available on prescription.

Regardless, while topical skincare can have noticeable effects, they often require at least three months of consistent use to do so. These are the key ingredients to look for in your skincare:

Vitamin C works as Dr Jack explains above to limit the production of melanin. In addition, “vitamin C together with vitamin E also has strong antioxidant actions that can help reduce and protect the cells of the skin against future UV damage”.

Retinoids (vitamin A) too work in a number of ways to reduce the production of melanin, Dr Jack confirms. Retinoids come in various strengths, so newcomers should try something gentle. "Retinyl palmitate is great for people that are concerned about redness or peeling with stronger retinoids,” he suggests. While Dr Rattan too recommends retinoids, she says to avoid retinoic acid or Retin A if you have darker skin: “This speeds up cell turnover but makes brown skin very sun sensitive which can worsen pigmentation.”

Alpha hydroxy acids (AHAs) “such as mandelic acid, glycolic acid, lactic acid and citric acid all have beneficial actions on existing pigmentation and can reduce melanin production with repeated use,” adds Dr Jack. The favourite of Dr Rattan is mandelic acid. “This is a safe and effective chemical peel especially for Asian, Arabic and African skin types.”

AHAs also have exfoliating effects, meaning “they can help improve the penetration of other skincare products into the skin,” adds Dr Jack.

Kojic acid, ferulic acid, azelaic acid, niacinamide (vitamin B3) and N-acetylglucosamine (NAG) perform in a similar way to vitamin C. “These tyrosinase inhibitors reduce over-production of melanin,” adds Dr Rattan.

Alpha-arbutin and beta-arbutin are molecules derived from hydroquinone, which is available in prescription-only pigmentation treatments in the UK. “Hydroquinone, alpha- and beta-arbutin all work by inhibiting the enzyme tyrosinase,” explains Dr Jack.

Botanical and plant extracts – from liquorice to green tea and mulberry extract – are shown to be effective in the reduction of pigmentation. “Most of these are believed to work in similar ways to the ingredients listed above,” Dr Jack adds.MZ Skin Pigmentation Correcting Ampoules

Step 2: At-home skin treatments

If use of home skincare shows no results after more than three months of consistent use, or you feel that they’re starting to work but want to up the ante, this is when Dr Jack might recommend home treatments such as a gentle peel or mask. “Home peels generally work by exfoliating the skin (to improve penetration of any products) and can have pigment-reduction benefits,” he says. “Most home peels generally use higher concentrations of active ingredients than regular skincare, but lower than those used in professional treatments.” A vast number of options are available for home peeling – from AHAs to retinoids and botanical peels – but approach all with caution. Heed the advice of Dr Rattan regarding AHAs above, especially if you have a dark complexion. 

Reference: Harpers Bazaar:  Bridget March