Ask a Dermatologist: How Can I Treat Hyperpigmentation?

But if you think these spots will disappear as effortlessly as they seemed to materialize, get ready for a rude awakening: Hyperpigmentation treatment is going to take a little bit of effort. While some types of hyperpigmentation, like the sort that comes after you've popped a rather big pimple, will slowly fade, this can still take months. And there are other types (like the kind produced by UV exposure) that will take a little coaxing for it ever to fade.

This topic is one that is definitely best discussed with experts, so we turned to dermatologists Anita Sturnham, GP, Rachel Nazarian, MD, and Scott Wells, MD, who walked us through the options. Keep reading for what they had to say.

Meet the Expert

• Anita Sturnham is a general practitioner and the founder of Nuriss Skincare & Wellness Clinics.
• Rachel Nazarian, MD, is a board-certified dermatologist specializing in cosmetic treatments, skin cancer, and dermatologic surgery.
• Dr. Scott Wells, MD, is a New York-based plastic surgeon and skincare expert with a focus on facial rejuvenation. He has more than 20 years of professional experience.

What Is Hyperpigmentation?

"Hyperpigmentation is a common skin condition that can affect all skin types and all ages," explains Sturnham. If you have it, you'll start to notice patches on the skin that don't seem to match your normal skin color. It'll often show up as brown patches, not too dissimilar to large freckles. There are two classifications, Sturnham adds, "localized or diffuse, meaning it appears in small patches on the skin or as a larger area of altered pigmentation."

What Causes Hyperpigmentation?

"Most cases of diffuse hyperpigmentation are caused by systemic conditions," reveals Sturnham. These conditions can include Addison's disease, hyperthyroidism, or hemochromatosis. Diffuse hyperpigmentation may also occur because of a medication side effect.

On the other hand, localized hyperpigmentation tends to represent a direct injury or inflammation to the skin, and is the more common type seen in dermatology clinics. "Anything that causes inflammation in the skin can potentially send a signal to our melanocytes, the cells that produce brown melanin pigment as part of an immune response," she explains. "This inflammation can be caused by UV damage, acne spots and breakouts, harsh chemicals on the skin, and even hormonal fluctuations, such as those in pregnancy or when taking the contraceptive pill."

Are Some People More Susceptible to Hyperpigmentation Than Others?

Unfortunately, the answer is yes. "Melanocyte instability is the main reason we develop hyperpigmentation. These pigment-producing cells that live at the dermo-epidermal junction and basal layers of our skin can become hyperactive if triggered and start overproducing melanin, leading to hyperpigmentation and sunspots," Sturnham breaks it down for us. "The more baseline melanin you have in your skin (i.e., the darker your skin tone), the more risk you have of developing hyperpigmentation in the first place."

Can You Avoid Getting Hyperpigmentation?

As with most skincare concerns, prevention is better than cure. First up: Nip any potential problem areas in the bud by caring for wounds as soon as they appear. “Wound care is important because areas of healing, such as a scratched bug bite or a picked pimple, are prone to infection and inflammation—making hyperpigmentation of the skin more likely,” says Nazarian. “That also means cleaning the skin with a gentle cleanser and not picking at the leftovers (scabs or old pimple scars) or scrubbing with a harsh cleanser.”

You'll definitely want to make sure you're taking proper sun care precautions (regardless of whether or not you have any recent wounds). “Sun exposure is one of the most controllable factors," says Wells. "Patients prone to hyperpigmentation must avoid direct exposure, wear hats and other occlusive clothing, and always wear a sunblock of SPF 30 or higher. My overall favorite types of sunblock are mineral blocks containing micronized zinc and titanium dioxides”

Sturnham also suggests you avoid retinol during the day—as UV rays destabilize skincare ingredients and increase your risk of photosensitivity—and use skincare that includes pigment-stabilizing ingredients, so they'll be less likely to overproduce melanin and leave you with pigment spots (whether the trigger is UV damage, hormones, or outbreaks).

How Can Hyperpigmentation Be Treated?

"Hyperpigmentation is multifactorial: There may be genetic, metabolic, hormonal and environmental factors, all acting as triggers," warns Sturnham, reminding us that there is no single therapy available that will completely cure hyperpigmentation. But with a more holistic, multitherapy approach, you can get great results. "Using a combination of at-home and in-clinic based procedures, we can generally achieve adequate reduction and even complete resolution in many patients," she promises.

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