Hyperpigmentation is a common skin condition that we all deal with at some point in our lives. For some of us, treatment is quick and easy while for others – it can be a constant battle. Hyperpigmentation occurs when surrounding tissue on the face or body darkens, showing an uneven tone to the skin or a tan. That darkening occurs when the melanocytes (melanin – the skin’s pigment) are overstimulated, causing their production and multiplication. Hyperpigmentation can be triggered by excess sun exposure, sun damage, skin injuries, skin inflammation, due to acne scars, as well as vasodilation. Some skin conditions are highly sensitive to melanin production like Melasma, which is a chronic skin condition requiring life-long treatment and protection.
Depending on the patients’ skin, some hyperpigmentation treatments can be quick and effective, while others can be quite complex. Depending on the patient’s photo type, it may take numerous treatments to help lighten the skin or eliminate the discoloration all together. With darker photo types, typically Fitzpatrick IV-VI, require more careful treatment plans and will require pre-treatment protocols to ensure a low risk of PIH (post-inflammatory hyperpigmentation). Post-inflammatory hyperpigmentation occurs when the skin is overheated, or the inflammation of the skin causes the melanocytes to overreact. This can result in long-term hyperpigmentation issues and can potentially damage the skin.
In order to avoid PIH, treatment selection, skin care products, and maintenance therapies are essential to ensure a safe and effective outcome. Treatment options like Chemical Peels, Oxygeneo facials, IPL Photo facials, and Carbon Peels are quick and easy treatments that will provide overall brighter glowing skin. Treatments like the Nd:Yag laser, Q-Switch laser, and Picosure laser provide lightening and brightening effects to the skin, specifically for darker skin tones. More intense treatments such as Fraxel, Erbium laser, and CO2 laser are extremely effective at eliminating hyperpigmentation, however these treatments are ablative, are not meant for all skin tones and do required downtime.
As treatments are important when correcting and eliminating hyperpigmentation, skin care is also just as important to help prepare the skin before intense treatments, and to help maintain glowing results post treatment. Pre-treating with skin care requires a specific brightening protocol as well as an exfoliation regime to make sure the skin is prepped. Products that include AHA’s, BHA’s, Retinol, Arbutin, Vitamin C, (etc.) will provide necessary exfoliation and brightening effects to the skin. This process is extremely important for darker skin tones to begin roughly 1-month prior to treatments as it will lower the risk of PIH and will allow for overall better results.
In order to determine the best course of action and long-term plan for the patient’s skin, a consultation is required to determine which treatments are best suited in order to achieve their clearest complexion. For older patients, if the hyperpigmentation has been left untreated for a long period of time, it may require several treatment series to safely and effectively lift the hyperpigmentation. Patients with photo types IV-VI will need to be realistic and patient when trying to treat their hyperpigmentation – as it will be a marathon rather than a sprint to the finish line.
With all of this being said, the most important note to remember is to protect your skin daily with a medical grade sunscreen to prevent further hyperpigmentation from forming. When undergoing treatments, sun exposure is not allowed, and if exposed could potentially cause irreversible damage. Medical grade sunscreen will protect the skin by shielding the sun, using an SPF minimum of 30%. Patients need to always remain aware of their exposure, and always take precautionary measures to protect themselves first!