Now You See It, Now You Don’t: Dermatologist’s Guide to Hyperpigmentation

As if we did not have enough to worry about when it comes to our skin, hyperpigmentation, a common usually harmless condition in which patches of skin darken, will affect well over 5 million of us in the US (the number is for melasma, one cause of hyperpigmentation).

In this post, we look at what types of hyperpigmentation exist, how to treat it, what dermatologists advise to do to prevent hyperpigmentation, and what skincare products to invest in as part of the prevention efforts. 

What Is Hyperpigmentation? 

Hyperpigmentation, a common dermatological condition, manifests as darkened patches or spots on the skin, creating an uneven skin tone. Hyperpigmentation occurs when excess melanin, the pigment that gives skin its color, forms deposits in the skin. This can happen due to various factors — from sun exposure to hormonal influences. 

There are several types of hyperpigmentation: 

• Melasma is a common acquired disorder of hyperpigmentation that affects sun-exposed areas of skin, typically on the face. It appears as hyperpigmented irregular patches. Melasma most commonly affects women of reproductive age. It has been linked to sun exposure and estrogen, which explains why many women are more prone to developing melasma during pregnancy or with the use of external estrogen like birth control methods or hormone therapies.
• Post-inflammatory hyperpigmentation follows skin injury or inflammation, such as acne, bug bites, burns or injuries, leaving dark spots at the site. 
• Lentigines, also called sun spots, age spots or “liver” spots, are very commonand usually develop over time resulting from prolonged exposure to ultraviolet (UV) rays. They are most often found on areas frequently exposed to the sun.

Causes of Hyperpigmentation 

Several factors contribute to hyperpigmentation:

• Sun exposure is the biggest contributor to hyperpigmentation. UV rays stimulate melanin production, leading to sun spots and other forms of hyperpigmentation. 
• Hormonal changes, especially in women during pregnancy, or those using hormonal medications, can trigger melasma. 
• Skin injuries or inflammation — acne, wounds, and other skin traumas can result in post-inflammatory hyperpigmentation. 
• Genetics — certain types of hyperpigmentation like freckles and moles are hereditary. 

Dermatologist-Recommended Treatments 

Treatment of hyperpigmentation typically involves a combined approach — including topical treatments and excellent sun protection. There are also in-office devices and treatments that can aid efforts. 

• Topical treatments. Historically treatment options have included prescription creams like hydroquinone (which has questionable toxicity) and over-the-counter skin care products that prevent pigmentation (by direct or indirect inhibition of the process of melanogenesis) or that exfoliate skin. Treating an underlying cause of hyperpigmentation like a chronic rash leading to post-inflammatory hyperpigmentation is important as well. 
• Chemical peels. These involve applying a chemical solution to the skin to remove the top layers, helping to reduce the appearance of hyperpigmentation. 
• In-office treatments. Laser therapies and other in-office treatments can be effective in reducing unwanted discoloration. It is essential to seek an experienced and reputable professional, ideally a board-certified dermatologist, for the safest treatment for this stubborn concern. In-office treatments should always be performed in conjunction with an excellent hyperpigmentation skincare regimen for the best efficacy and to prolong results. 
• Side effects are possible with all treatment methods. 

Preventative Skincare Ingredients 

Certain skincare ingredients are known to be effective at treating hyperpigmentation. Dr. Rose recommends looking for ingredients like tranexamic acid, kojic acid, vitamin C and niacinamide. Below, we briefly summarize how each ingredient works. 

1. Tranexamic Acid 

Tranexamic acid works by inhibiting plasmin, an enzyme involved in melanin synthesis. This reduction in melanin production helps to lighten dark spots and improve overall skin tone. Tranexamic acid is known for its effectiveness and safety, making it a popular choice in topical hyperpigmentation treatments. 

2. Kojic Acid

Kojic acid is an ingredient derived from several species of mushrooms. It reduces and prevents hyperpigmentation by interfering with the process of melanogenesis by inhibiting tyrosinase, a key enzyme in melanin production. By suppressing this enzyme, kojic acid effectively reduces pigment formation, leading to a decrease in hyperpigmentation and skin lightening. It is a skincare ingredient that has proven to be effective at treating sunspots, melasma, and post-inflammatory hyperpigmentation, like tranexamic acid. 

3. Vitamin C (THD ascorbate)  

THD ascorbate, a stable and oil-soluble form of Vitamin C, is known for its skin-brightening and anti-aging properties. Unlike other forms of Vitamin C, THD ascorbate is less irritating, making it more suitable for sensitive skin. It works by slowing down the activity of the pigment-producing enzyme and also addresses any existing discoloration. This dual action not only helps to reduce hyperpigmentation but also promotes a more youthful, radiant complexion. 

4. Niacinamide  

Niacinamide, also known as Vitamin B3, has a number of benefits in skincare. It inhibits the transfer of melanin to skin cells, reducing the appearance of dark spots and uneven skin tone. Additionally, niacinamide strengthens the skin's barrier function, improves texture, and reduces inflammation. Its versatility and gentle nature make it a staple in many skincare products aimed at improving skin health and clarity. Niacinamide is generally well-tolerated in low concentrations but higher concentrations or lower quality niacinamide can be irritating to some including those with rosacea. 

What Does the Doctor Say? 

Dr. Blair Rose has spoken about hyperpigmentation in interviews with CNN, HuffPost, Yahoo, The Zoe Report, and others. The skincare line that she founded — Skincare Junkie — proudly offers the Discoloration Fade Wand to the hypoallergenic, clean and vegan brand. We asked Dr. Rose to share her recommendations for preventing and treating hyperpigmentation: 

• Importance of sun protection. Wear mineral sunscreen with an SPF of 30 or higher daily, irrespective of the weather. Use sunscreens as a standalone product rather than mixed into moisturizers or cosmetics, as this dilutes their effectiveness. Wear wide-brimmed hats and sunglasses for additional protection against UV rays and limit time in the sun, especially during peak hours. 

• Skincare products. To treat and prevent hyperpigmentation, use products containing ingredients like kojic acid, tranexamic acid, cysteamine, vitamin C, and glycolic acid. These skin care ingredients can prevent and treat hyperpigmentation by interfering with melanin synthesis in the skin. Many of these ingredients are also antioxidants that prevent free radical environmental damage. Talk to your board-certified dermatologist about whether vitamin A derivatives like retinol or alpha hydroxy acids (AHAs) may be helpful for you to help brighten. 

• Avoid long-term use of hydroquinone due to the potential side effect of ochronosis that is very difficult to reverse. Skincare Junkie® Discoloration Fade Wand is 100% hydroquinone-free to avoid any risk of ochronosis and the potential toxicity of hydroquinone. 

• In-office treatments. If you struggle with hyperpigmentation, an in-office treatment may be a helpful option in conjunction with a great skincare regimen. 

Now You See It, Now You Don’t! Introducing Skincare Junkie Discoloration Fade Wand 

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The clinically proven formula features a proprietary powerhouse combination of kojic acid, tranexamic acid, and vitamin C in their most penetrable, potent and yet well-tolerated forms. Skin brighteners fade dark spots and reduce stubborn brown patches while soothing antioxidants prevent further damage. Anti-inflammatory ingredients soothe irritated skin. 

Recommended for all skin types, except acne-prone. We’ve just restocked, buy while stocks last, and use as part of your Skincare Junkie routine.