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Expert Perspectives

Hyperpigmentation: Causes, treatments and prevention

By Dr. Jonathan Levy, MD, FRCPC, DABD, Medical Director, Refine by Medcan

This common skin condition can be easily eradicated with the right treatment for you.

If you haven’t been out in the sun for months yet have noticed a darker patch or spot on your skin, you may be suffering from a common skin condition known as hyperpigmentation. Sunspots, age spots, melasma—they’re all forms of hyperpigmentation, aka “too much pigment”, which results in dark spots or blotches on the surface of the skin. And while these imperfections can be discouraging to see, hyperpigmentation can be easily eliminated with a variety of treatments.

But first, it’s useful to understand what causes each type of hyperpigmentation. Lentigines—or sunspots—are the result of cumulative sun exposure. Unlike a freckle, this flat spot doesn’t fade in winter. Sunspots most commonly appear on the face, backs of hands or the chest—areas most often exposed to the sun for extended periods of time. Post-inflammatory hyperpigmentation occurs as the result of another skin condition, such as acne, eczema, a rash, a scrape, or other injury. As the body heals, it produces more melanin, which causes this hyperpigmentation. And melasma can be the result of multiple factors and is often due to increased hormone levels in the body that stimulate the skin to produce pigment. Melasma appears as blotchy patches, typically on the face, including cheeks, forehead, nose, and upper lip. Birth control pills, pregnancy and hormone therapy can all trigger melasma because they increase hormone levels.

While hyperpigmentation can be disheartening to see, it may fade on its own, and can also be easily treated in a variety of ways or combinations of treatments—most of which require a total of four treatments spaced out every few weeks. Lasers, intense pulsed light and cryotherapy work well to target specific spots, while chemical peels or a prescription combination of hydroquinone (a bleaching agent), retinol (vitamin A, which increases the cell turnover rate) and a weak cortisone (to soothe irritation caused by the other two ingredients) are ideal to treat melasma, since it’s often spread over a larger area.

Once hyperpigmentation is eliminated, it generally won’t recur unless the source of the problem recurs. If you’ve treated sunspots but continue to spend significant amounts of time in the sun unprotected, you may see more sunspots appear. Likewise, if your melasma is hormone-induced and you start taking birth control or become pregnant, the melasma may return. So it’s important to treat the source of the problem first. Prevention plays a big role, so wearing sunscreen with SPF 50 year-round is one of the best things you can do for your skin. Even if hyperpigmentation isn’t a result of sun exposure, the sun worsens any type of hyperpigmentation—so the more you can protect your skin, even in the dark days of winter—the better.

Curious about how Refine by Medcan can help you achieve your skincare goals? Contact us at 416.977.6502 or refine@medcan.com to set up a consultation.

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