Hyperpigmentation is one of the most frustrating skin conditions to deal with, in large part due to its persistent nature and chronic, unavoidable exposure to two of its main causes: the sun and hormones. Depending on your budget and motivation, treatment plans involve over-the-counter skin care products, prescribed topicals, and in-office treatments. According to Dr. Riyaz, a certified dermatologist and Docent medical advisor, the treatment plan should address the excess production of melanin while reducing inflammation.
What are the different types of hyperpigmentation?
There is hyperpigmentation induced by exposure to UV rays (think freckles and dark spots). Then there’s melasma, a skin condition that can be triggered by hormonal changes that appear on your face in the form of mottled brown spots. It’s also important to keep in mind that melasma, which is also made worse by sun exposure and heat, can be treated and managed but never completely eradicated.
There is also post-inflammatory hyperpigmentation (PIH) and post-inflammatory erythema (PIE), which usually occur following an acne breakout. “When acne heals, it can leave a discoloration that ranges from pink, red, purple, brown or black,” says Dr. Christine Choi, a certified dermatologist. “Although melasma and PIH are different conditions, my treatment approach is similar to both,” explains Dr. Choi.
What ingredients help fade dark spots?
This means that you need to include ingredients like vitamin C and kojic acid in order to slow down the production of melanin-producing cells in the skin. Adding products containing these ingredients to a skin care routine that includes exfoliators like retinol or tranexamic acid can also help remove dead skin cells, leaving skin more even. The last part of the routine is sunscreen. “Protecting your skin from the sun is the most important action you can take to prevent sun-related dark spots,” says certified dermatologist Dr. Hadley King. Exposure to UV rays can also increase the production of melanin-producing cells, making your dark spots worse.
According to all of the experts we spoke to, when building a routine to fight hyperpigmentation, you need to include an SPF of at least 30, along with antioxidants. Beyond that, however, your individual diet should be personalized to suit your skin. It may take several tries to find your preferred combination of products for long-term use, but experts recommend looking for products that contain at least one of the following ingredients:
This antioxidant protects your skin against environmental aggressors that can make inflammation worse. In addition, according to clean cosmetic chemist and founder of KKT Consultants Krupa Koestline, by reducing the production of melanin, a cause of dark spots, while helping to smooth fine lines and wrinkles.
Tranexamic acid not only slows the excess production of melanin, says Dr. King, but it increases the brightness of your skin while improving the appearance of discoloration.
This ingredient, which is a form of vitamin B3, helps balance your sebum production to soothe rashes and prevent excess melanin from reaching your skin surface, Koestline explains. Plus, niacinamide reduces redness, strengthens the skin barrier, and has anti-inflammatory benefits, says Dr. King.
Kojic acid works to prevent dark spots by interfering with your skin’s melanin production, reducing discoloration, and preventing new spots from reaching your skin surface.
This herbal antioxidant protects against sun damage while evening out your skin tone, says Dr. King. “It acts like an exfoliant,” says Dr. King, “and blocks the synthesis of melanin without being an acid exfoliator.”
Retinoids do two main things: stimulate collagen production and increase cell turnover for brighter, plumper, and smoother skin, says Dr. Riyaz.
Dr. Riyaz finds azelaic acid to be especially helpful for people with dark skin and for those with hypersensitive or acne-prone skin.
Mandelic acid is oil soluble, says Dr Riyaz, so it can penetrate the skin deeper without irritating the skin. If your skin is having a hard time tolerating other acids, you might want to consider this one.
What treatments help fade dark spots?
When it comes to in-office treatments, which can range from chemical peels to lasers, your treatment plan should be tailored to your skin tone as well as the type of hyperpigmentation you are experiencing (more on that later). According to Dr. King, because olive and dark skin tones contain more melanin-producing cells, certain treatments can trigger even more dark spots. Also, if you are pregnant or breastfeeding, you want to consult your doctor before trying any of the products or treatments mentioned in this article.
According to renowned esthetician and nurse dermatologist Natalie Aguilar, it’s important to follow a consistent skincare routine before trying any treatment. “It’s important to start with the right skin care products to see if they work,” says Aguilar. “If they don’t meet your goals, you’ve at least prepared the skin for other treatments and worked to prevent the risk of burns.”
If hyperpigmentation is your main concern, consider Intense Pulsed Light (IPL) and Broadband Light (BBL), says Dr. Amy Chang, board certified plastic surgeon. While these treatments don’t affect the texture or firmness of your skin, they work like magic on dark spots. During the healing process, you will notice that your spots may become a bit darker, but don’t worry, they will rise to the surface before they flake off. IPL and BBL treatments should not be used on melasma as it can be exacerbated by heat. People with darker skin should also avoid it.
Consider a laser treatment like Fraxel, or layer your treatments with microneedling or other procedures for more intensive results.
Picosure is the only FDA-approved laser treatment for melasma, says certified dermatologist Dr. Corey L. Hartman. “It works like a hammer, breaking concrete to explode the pigment into smaller and smaller pieces until it’s so small that it is washed away by the lymphatic drainage,” says Dr. Hartman. “It breaks down stubborn pigments that are nestled deep in the skin and more difficult to process.” To see results, you will need to perform three to six Picosure treatments.
Chemical peels are another popular option for treating unwanted pigmentation. “Peels are available in different strengths and formulations,” Aguilar explains. “They could be a single ingredient peel, like a glycolic acid peel, or they could contain a combination of acids, like a Cosmelan peel.” Cosmelan peel contains hydroquinone, retinoic acid, azelaic acid, kojic acid, arbutin, phytic acid and ascorbic acid, and it is known for its before-after results transformers.
For deep skin tones, Dr Riyaz prefers lactic acid and mandelic acid. “They offer exfoliating and moisturizing benefits while safely reducing hyperpigmentation on darker skin tone.”
Another commonly prescribed treatment for hyperpigmentation is tretinoin, or prescription retinol. “It evens out pigmentation by exfoliating and stimulating cell renewal, reducing inflammation and removing excess melanin from your cells,” says Dr. Riyaz.
How often should I apply SPF?
Never underestimate the importance of regularly applying broad-spectrum sunscreen and reapplying it every two to three hours awake. “No dark spot regimen is complete without a broad spectrum sunscreen with a high SPF. It is important to diligently use sun protection to prevent the development of additional pigmentation,” says Dr. Riyaz. “And this is especially critical when using hydroquinone, tretinoin, and exfoliating acids, as it reduces the chances of sensitivity.”
Since inflammation can contribute to the formation of unwanted pigments, especially in cases of PIH and PIE, it is also important to include anti-inflammatory products in your diet. They help alleviate breakouts and lingering marks after breakouts in a consistent and preventative way.