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Hyperpigmentation back: Darkened Upper Back – Simply Better Skin


How to Get Rid of Hyperpigmentation Based on Your Skin Tone |


How to Get Rid of Hyperpigmentation Based on Your Skin Tone

What is Hyperpigmentation

Hyperpigmentation is the name of the patches of skin on your body that are darker than your natural skin tone. The darkened skin patches are caused by the overproduction of the brown pigment, melanin, in your body. Too much melanin production leads to any of these four main types of hyperpigmentation: melasma, post-inflammatory hyperpigmentation, sun damage, and medical conditions.

Melasma is a condition most commonly found in women who take oral contraceptives or who are pregnant. Skin pigmentation or those brown patches that present on the skin are typically found on the cheeks, forehead, nose, upper lip, and chin.

Post-inflammatory hyperpigmentation is the most temporary form of the condition and occurs as a reaction to certain traumas that your skin experiences. These “traumas” that trigger hyperpigmentation include acne, infection, waxing, laser treatments, and chemical peels. Typically, these hyperpigmentation spots go away on their own within a couple of months.

Sun damage is exactly what it sounds like. Dark spots that occur from overexposure to the sun’s UV rays. Typically, sunspots appear on the face, chest, and hands and are more common as one ages due to more sun exposure throughout the years.

The last type of hyperpigmentation can occur due to a medical condition called Addison’s disease. This disease is a disorder in one’s adrenal gland that causes an overproduction of melanin resulting in dark spots or darker skin tones.


Best Ways to Get Rid of Hyperpigmentation

The good news is that there are quite a few options that work to neutralize melanin production and get rid of hyperpigmentation. All types of hyperpigmentation can be lightened back to your natural skin tone.

The first option to even out your skin is to use an over-the-counter lightening product. When considering this purchase, be sure to choose a product that contains moisturizing agents in it to avoid dry skin as well as to encourage cell turnover. Ingredients like hyaluronic acid or glycerin will boost the growth of skin cells and can also restore the lipid barrier in your skin to protect it from sun rays.

The second step to take in healing hyperpigmentation is to avoid picking, touching, and pulling at your skin. Picking at your skin will only damage and inflame the discolored patch even more. The more you touch it, the deeper the pigmentation spots will move into your skin making it more difficult to get rid of.

If over-the-counter creams are not doing the trick, consider reaching out to your dermatologist for a dermatology medication. Prescription-strength hydroquinone is the most commonly used product as it works to slow the production of pigmentation and fade dark spots. Be sure to follow your doctor’s orders with hydroquinone because overuse of it can result in increased sun sensitivity or the bleaching of the skin.


Sometimes, topical creams might not work as well or as quickly as expected. In this case, turning to dermatological procedures will work as the fastest way to get rid of hyperpigmentation. Chemical peels, laser therapy, microdermabrasion, or dermabrasion are all options that work similarly to rid skin of hyperpigmentation. These procedures work to gently remove the top layer of your skin where the dark spots lie. After recovery, dark spots will be lightened, and you will have a more even skin tone.


Lastly, and arguably most importantly, you must take steps to prevent future damage from hyperpigmentation. Using sunscreen with SPF 30 daily is the best way to avoid any type of sun damage or worsening of dark spots. When completing your skincare routine, be sure to use skincare products that do not sting, as these can further irritate the condition. Finally, if you struggle with an acne skin condition, use a medication that prevents breakouts and acne scars to avoid discoloration from these as well.


To conclude, although hyperpigmentation poses no immediate threat to your skin’s health, it can be frustrating to have an uneven skin tone. By treating your skin spots correctly through proper hyperpigmentation treatment, the discoloration will go away and you will regain confidence with an even and glowing complexion.


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Hyperpigmentation – Dermatologic Disorders – Merck Manuals Professional Edition

Because melasma risk increases with increasing sun exposure, the mechanism probably involves overproduction of melanin by hyperfunctional melanocytes. Other than sun exposure, aggravating factors include

  • Autoimmune thyroid disorders

In women, melasma fades slowly and incompletely after childbirth or cessation of hormone use. In men, melasma rarely fades.

Triple topical therapy is first-line treatment that is often effective and consists of a combination of

Hydroquinone depigments the skin by blocking the enzymatic oxidation of tyrosine 3,4-dihydroxyphenylalanine (DOPA) and inhibiting melanocyte metabolic processes. Hydroquinone should be tested behind one ear or on a small patch on the forearm for 1 week before use on the face because it may cause irritation or an allergic reaction. Tretinoin promotes keratinocyte turnover and can exfoliate skin that contains epidermal pigment. Corticosteroids help block synthesis and secretion of melanin. Two promising technologies being tried in conjunction with triple topical therapy are the Q-switched Nd:YAG (1064 nm) laser and nonablative fractional resurfacing.

If triple topical therapy is not available, then hydroquinone 3 to 4% applied twice daily for up to 8 weeks at a time (chronic continuous use can theoretically increase the risk of exogenous ochronosis, which is a permanent form of hyperpigmentation) may be considered; 2% hydroquinone is useful as maintenance.

Azelaic acid 15 to 20% cream can be used in place of or with hydroquinone and/or tretinoin. Azelaic acid is a tyrosinase inhibitor that reduces melanin production (and is considered safe for use during pregnancy). In addition, topical kojic acid has been increasingly used; it is a chelating agent that blocks tyrosine conversion to melanin.

Second-line treatment options for patients with severe melasma unresponsive to topical bleaching agents include chemical peeling with glycolic acid or 30 to 50% trichloroacetic acid. Laser treatments also have been used but are not standard therapy.

Common Hyperpigmentation Disorders in Adults: Part I. Diagnostic Approach, Cafe au Lait Macules, Diffuse Hyperpigmentation, Sun Exposure, and Phototoxic Reactions

1. Crowson AN,
Magro CM.
Recent advances in the pathology of cutaneous drug eruptions. Dermatol Clin.

2. Jimbow K, Quevedo WC Jr, Fitzpatrick TB, Szabó G. Biology of melanocytes. In: Freedberg IM, Fitzpatrick TB, eds. Fitzpatrick’s Dermatology in general medicine. 4th ed. New York: McGraw-Hill, 1993:261–89

3. Landau M,
Krafchik BR.
The diagnostic value of café-au-lait macules. J Am Acad Dermatol.
1999;40(6 pt 1):877–90.

4. Ortonne JP,
Brocard E,
Floret D,
Perrot H,
Thivolet J.
Diagnostic value of café-au-lait spots [in French]. Ann Dermatol Venereol.

5. Eichenfield LF,
Levy ML,
Paller AS,
Riccardi VM.
Guidelines of care for neurofibromatosis type 1. American Academy of Dermatology Guidelines/Outcomes Committee. J Am Acad Dermatol.

6. Friedman JM.
Epidemiology of neurofibromatosis type 1. Am J Med Genet.

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New M,
Maclaren N.
Clinical review 130: Addison’s disease 2001. J Clin Endocrinol Metab.

8. Thiboutot DM.
Clinical review 74: Dermatological manifestations of endocrine disorders. J Clin Endocrinol Metab.

9. Leonhardt JM,
Heymann WR.
Thyroid disease and the skin. Dermatol Clin.

10. Niederau C,
Strohmeyer G,
Stremmel W.
Epidemiology, clinical spectrum and prognosis of hemochromatosis. Adv Exp Med Biol.

11. Ward SK,
Roenigk HH,
Gordon KB.
Dermatologic manifestations of gastrointestinal disorders. Gastroenterol Clin North Am.

12. Brandhagen DJ,
Fairbanks VF,
Baldus W.
Recognition and management of hereditary hemochromatosis. Am Fam Physician.

13. Hyperpigmented lesions. In: Behrman RE, Kliegman R, Jenson HB, eds. Nelson Textbook of pediatrics. 16th ed. Philadelphia: Saunders, 2000:1983–4

14. Boardman LA,
Thibodeau SN,
Schaid DJ,
Lindor NM,
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Increased risk for cancer in patients with the Peutz-Jeghers syndrome. Ann Intern Med.

15. Gould JW,
Mercurio MG,
Elmets CA.
Cutaneous photosensitivity diseases induced by exogenous agents. J Am Acad Dermatol.

16. Friedlander SF.
Contact dermatitis. Pediatr Rev.

17. Pepine M,
Flowers FP,
Ramos-Caro FA.
Extensive cutaneous hyperpigmentation caused by minocycline. J Am Acad Dermatol.
1993;28(2 pt 2):292–5.

18. Kelly AP.
Aesthetic considerations in patients of color. Dermatol Clin.

19. Goroll AH, Mulley AG Jr, eds. Primary care medicine: office evaluation and management of the adult patient. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2000

20. Skin diseases of general importance—part II. In: Cecil RL, Goldman L, Bennett JC. Cecil Textbook of medicine. 21st ed. Philadelphia: Saunders, 2000: 2288–98

Acanthosis Nigricans (for Teens) – Nemours Kidshealth

What Is Acanthosis Nigricans?

Acanthosis nigricans (pronounced: ah-kan-THO-sis NY-gruh-kans) is a skin condition. It causes thicker and darker patches or streaks, usually in skin creases and folds, such as the sides and back of the neck, armpits, elbow pits, and groin. But it can show up anywhere on the body. It may look velvety or warty, or have a dirty appearance.

What Are the Signs & Symptoms of Acanthosis Nigricans?

Acanthosis nigricans appears gradually with dark, velvety patches of skin in body creases and folds, usually in the neck, armpits, or groin. It can be found on other parts of the body, including the face, chest, elbows, knees, and knuckles. It can cause mild itching, but this is uncommon.

What Causes Acanthosis Nigricans?

Acanthosis nigricans is most commonly caused by high blood insulin levels, a condition called insulin resistance. Insulin resistance is seen in people who are overweight or obese, and makes them more likely to develop type 2 diabetes. It is also associated with other endocrine conditions, such as polycystic ovary syndrome (PCOS).

Sometimes, acanthosis nigricans can be hereditary (passed on to a person by their parents) or part of a genetic syndrome. It can be caused by medicines, such as oral contraceptives or steroids.

How Is Acanthosis Nigricans Diagnosed?

Doctors can diagnose acanthosis nigricans by looking at the affected skin.

Acanthosis nigricans itself isn’t harmful or contagious. But it can be a sign that a person is at risk for diabetes. So the doctor may order blood tests to look for diabetes or other conditions associated with it.

How Is Acanthosis Nigricans Treated?

Treating the underlying cause of acanthosis nigricans can make the dark patches of skin fade or even disappear. This can mean stopping any medicine that’s causing the problem or treating diabetes and other health conditions.

Losing weight will help acanthosis nigricans fade. If you’re concerned about your weight, talk to your doctor before going on a diet.

Doctors may prescribe creams or lotions that can help lighten the skin. But most of the time, acanthosis nigricans doesn’t need treatment. 

What Else Should I Know?

Skin areas with acanthosis nigricans can look dirty, but they’re not. Scrubbing the skin does not help and can irritate it. Gently clean the skin and don’t use bleaches, skin scrubs, or over-the-counter exfoliating treatments.

Eating a healthy diet and getting regular physical activity can help lower insulin levels and improve skin appearance. It can help to:

  • Eat whole grains and plenty of fruits and vegetables.
  • Drink water or low-fat milk instead of soda, juice, or other sugary drinks.
  • Limit highly processed foods, fatty foods, and sugary treats.
  • Be physically active every day.

4 Ways to Get Rid of Acne and Dark Spots on Your Back

  • Back acne and hyperpigmentation are common skincare concerns in the summer months.
  • Washing your clothes more frequently and using a body wash with salicylic acid can help cut down acne.  
  • Sunscreen and brightening spot treatments can reduce the appearance of hyperpigmentation on your back.

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More sun exposure and humidity can lead to acne and hyperpigmentation. 

While your face may bear the brunt of your summer skincare ailments, the rest of your body may also suffer some of the consequences of warmer weather, particularly your back. 

“Back-ne” and hyperpigmentation on your back are common skin concerns during the summer months, according to dermatologists, but there are ways to beat the heat. 

It’s important to wash your back and your clothes frequently — especially after every workout

Voyagerix/Getty Images

With the amount of sweat and oil your back produces, it’s no surprise the sebaceous glands on your shoulder blades may get clogged this summer.  

Dr. Sunitha Posina, a New York City-based internal medicine physician, previously told Insider back-ne can be a common concern for people during the summer, particularly if people don’t regularly wash their sports bras, binders, or workout shirts. 

You should wash your clothes after a day of sweating, just so you don’t put oil and dirt back on your acne.

In addition to washing your clothes, taking frequent showers after you work out or sweat a lot can cut down on the oil on your back and prevent clogged pores.  

Using sunscreen can help reduce hyperpigmentation 

MesquitaFMS/Getty Images

Hyperpigmentation usually occurs after long periods of direct sunlight. in the summertime, areas of the body that are exposed to the sun more often like your back and face are more likely to develop dark spots. 

Dr. Heidi Waldorf, a cosmetic dermatologist, previously told Insider sunscreen can be a great way to protect your skin from the sun and block the harsh UV rays that cause hyperpigmentation areas. 

If you’re worried about the white caste some mineral sunscreens leave behind on darker skin, you can use a chemical sunscreen instead. 

Use a body wash that contains salicylic acid to reduce your acne

If frequently washing your body and clothes isn’t cutting down your acne, you can also look for a body wash with salicylic acid to help break down the dirt and debris. 

Insider previously reported salicylic acid works by killing the bacteria that cause acne and reducing inflammation on the surface of the skin. 

Spot treatments with vitamin C and other natural brightening agents can reduce the appearance of hyperpigmentation

If you still get a few spots on your back despite putting on sunscreen, you can use spot treatments to reduce hyperpigmentation.  

Posina previously told Insider people should look for spot treatments that contain brightening ingredients like vitamin C, azelaic acid, niacinamide, arbutin, and kojic acid.

Brightening agents can lighten the appearance of hyperpigmentation by stopping the enzyme that produces melanin from overproducing it. 

9 Dark Spot Treatments That Really Work, According to Dermatologists

When it comes to dark spot treatments, there are so many options out there that it can be hard to know where to start. What ingredients should you look for? And most important, which ones will get rid of dark spots for good?

To answer these questions, SELF talked to several dermatologists to find out how they treat dark spots on the face. Because, as a beauty editor, my ultimate quest is to achieve flawless skin. You know, the I-don’t-even-need-any-makeup type of complexion we all desire. But I’m not quite there yet.

The number one thing keeping me from my no-makeup goal? Dark spots. Uneven skin tone keeps me reaching for my makeup bag again and again. With that said, keep reading to learn what causes dark spots in the first place, plus nine dark spot treatments that dermatologists recommend.

What causes dark spots?

“Dark spots or hyperpigmentation are due to the overproduction of melanin in the skin by melanocytes,” plastic surgeon Melissa Doft, M.D., tells SELF. This extra melanin can be triggered by a lot of different things, she says: “Hormones—both estrogen and progesterone—can increase the level of melanin—why pregnant women see dark spots that often lighten following birth; the sun can increase the level of melanin—why we have more dark spots after the summer; and age can increase the size of the melanocytes—why we see dark age spots in older patients.”

Other factors, like skin irritation as a result of acne, waxing, and harsh scrubs, can also cause dark spots. Now that you know where dark spots come from, keep reading to discover how to get rid of dark spots.

1. Vitamin C

Think beyond orange juice: Vitamin C can be used as a topical antioxidant that helps to block free radicals from causing oxidative damage to the skin (which can lead to wrinkles and a dull complexion, among other things). “It also inhibits enzymatic processes that produce melanin in the skin, as such it can help to reduce dark coloration of the skin,” Sumayah Jamal, M.D., of Schweiger Dermatology Group, tells SELF.

Another added benefit is that vitamin C lightens only targets problem pigmentation areas, not the rest of your skin, Fran E. Cook-Bolden, M.D., dermatologist, cosmetic surgeon, and director of Skin Specialty Dermatology, tells SELF.

Isdinceutics Melaclear Dark Spot Correcting Serum

This powerful brightening serum uses ingredients like vitamin C and phytic acid to help improve uneven skin tone and discoloration.

How to use it: Massage a few drops daily onto cleansed skin, preferably before applying sunscreen in the a. m.

2. Hydroquinone

When it comes to dark spot treatments, hydroquinone has been the gold standard for over 50 years. You can find this ingredient over the counter in concentrations of 2% or less, whereas the prescription has 4% or greater. On a biological level, hydroquinone works by inhibiting an enzyme called tyrosinase, which aids in the production of melanin, Dr. Cook-Bolden says. Naturally, the less tyrosinase produced, the less melanin produced.

In some cases, the effects of hydroquinone can be seen in as little as two weeks. However, most should anticipate 8 to 12 weeks of use to see a visible difference depending on a few factors (such as the extent of the hyperpigmentation, how deeply it penetrates, how long it’s been there, etc.).

Pigmentation disorders | DermNet NZ

Author: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2009. Updated September 2014.


Pigmentation of the skin normally varies according to racial origin (see Fitzpatrick phototypes) and the amount of sun exposure. Pigmentation disorders are often more troublesome in skin of colour.

The melanocytes (pigment cells) are located at the base of the epidermis and produce the protein melanin. Melanin is carried by keratinocytes to the skin surface. The melanocytes of dark-skinned people produce more melanin than those of people with light skin. More melanin is produced when the skin is injured, for example following exposure to ultraviolet radiation. The melanisation process in dark skin is protective against sun damage, but melanisation in white skin (for example after sunburn) is much less protective.

Hormonal effects of oestrogen during pregnancy or due to medication can cause pigmentation of nipples, vulva and abdomen (linea nigra).

Some skin diseases and conditions result in generalised or localised hyperpigmentation (increased skin colour, hypermelanosis), hypopigmentation (reduced skin colour, hypomelanosis), or depigmentation (absent skin colour, leukoderma).

A Wood lamp may be used to assess pigmentation during the examination of the skin, as pigmentary changes are often easier to identify while exposing the affected skin to long-wavelength ultraviolet rays (UVA).

Skin colour

Generalised hyperpigmentation

Generalised hyperpigmentation or hypermelanosis may rarely arise from excessive circulating melanocyte-stimulating hormone (MSH) when it often has a bronze hue. It occurs:

A differential diagnosis is carotenoderma, in which the skin colour takes on a yellow-orange hue due to ingestion of coloured fruit and vegetables.

Localised hyperpigmentation

Localised pigmentation may be due to melanin, haemosiderin, or externally-derived pigment.

If dark patches are observed, the main diagnoses to consider are:

  • Benign pigmented skin lesions, such as melanocytic naevi (moles), seborrhoeic keratoses,  and lentigines
  • Skin cancers, such as melanoma and pigmented basal cell carcinoma
  • Post-inflammatory pigmentation due to prior injury, current or prior inflammatory skin disease such as eczema, especially in dark-skinned individuals, or fixed drug eruption
  • Current or previous superficial skin infection, particularly pityriasis versicolor and erythrasma
  • Chronic pigmentary disorders, particularly melasma and acquired dermal macular hyperpigmentation
  • Photocontact dermatitis to certain plants
  • Thickened skin eg, acanthosis nigricans or ichthyosis
  • Pigmented purpura due to bleeding into the skin, such as capillaritis or senile purpura
  • Intentional or accidental tattoo.

Localised hyperpigmentation

What is the treatment of hyperpigmentation?

If pigmentation due to melanin affects an exposed site, daily application of broad-spectrum SPF 50+ sunscreen is important to minimise darkening caused by UVR. This is not effective for melanin located in the dermis or to reduce pigmentation caused by carotene, drugs, or tattoos.

Cosmetic camouflage can be used.

The following agents can be used to lighten epidermal melanosis alone or, more effectively, in combination:

Resurfacing using chemical peels, laser (especially picosecond laser), intense pulsed light (IPL) or dermabrasion may be effective but unfortunately risks further damage to the epidermis and formation of more pigment. Cautious cryotherapy to small areas of postinflammatory pigmentation can be effective but risks causing permanent hypopigmentation.

Cosmetic camouflage using make-up is sometimes the best advice.

Generalised hypopigmentation

Generalised reduction in melanin pigmentation at birth (congenital) may be racial in origin or due to albinism. Pituitary failure resulting in lack of MSH rarely results in acquired generalised hypomelanosis.

Pallor is much more frequently due to blood loss or anaemia.

Localised hypopigmentation

Localised hypopigmentation may be due to vascular changes or partial loss of melanin. It can be congenital or acquired.

If single or multiple pale patches are observed, diagnoses to consider include:


White depigmented patches (leukoderma) may be due to: 

Localised hypopigmentation and leukoderma

What is the treatment of hypopigmentation?

Hypopigmentation due to inflammatory skin disorders and infections usually resolves by itself over weeks to months once the underlying disorder has been cleared. There is no effective treatment for achromia due to scarring. The response of vitiligo to therapy is highly variable.

90,000 Hyperpigmentation. Removal of age spots

Uneven skin tone can spoil the impression of the most pretty face. Of course, we are not talking about freckles, which add charm to the image, but about various acquired pigmentation disorders. They definitely do not decorate anyone!

What are the most common skin pigmentation disorders?

Freckles. Small yellowish brown pigment spots, most often localized on the face, back or arms.Brighter under the influence of the sun and brighter in winter. Freckles are genetically determined and are most commonly seen in redheads with fair skin.

Hyperpigmentation from the sun or solar lentigo. Occurs due to active exposure to sunlight. These can be spots on the site of healed sunburns or simply darkened areas of the skin due to mutagenic disturbances in the work of melanocytes after excessive insolation. Those who like to be in the sun from 11 years old have a big risk of getting such pigmentation.00 to 15:00, at the peak of solar activity, as well as fans of solariums. Such people have an increased risk of getting not only age spots, but also malignant skin formations.

Do not use cosmetics with acids, essential oils, sanding and peeling procedures in the summer. and it is also necessary to remember that taking contraceptives, antibiotics, retinoids and other medications increases the sensitivity of the skin to ultraviolet irradiation. Sunscreens of course help if you use SPF 50-100 and are in the shade or with a hat.

Remember that hyperpigmentation is easier to prevent than to cure, as methods for removing age spots remove the melanin pigment itself, and mutated melanocytes, as soon as they see the sun, paint new patterns on the skin with melanin.

Age spots, senile lentigo – dark rounded spots on the skin that appear after 45-50 years. Most often, they are localized in places that were previously exposed to active solar radiation (face, hands, décolleté). The reason is excessive sunbathing at a young age and an increase in the number of melanocytes – the cells that produce the tanning pigment melanin.They are well removed, but new ones may appear.

Chloasma are sharply delineated symmetrical dark spots that most often appear at a young age during or after pregnancy, as well as when taking hormonal drugs. The mechanisms of the appearance of chloasma are not fully understood, most often it is associated with a change in the hormonal background of the body . With the normalization of the hormonal background, themselves disappear.

Melasma – unlike chloasma, melasma is never associated with pathology of the reproductive system, it develops under the influence of sunlight in people suffering from various diseases of the gastrointestinal tract.

Post-acne spots or post-acne spots, stagnant spots – the consequences of acne. They occur at the site of healed pimples and may be brown, bluish, or reddish. Often, acne darkens under the influence of the sun. Very good and quick removal.

Prevention of skin hyperpigmentation

An important step in the prevention of hyperpigmentation is not sunscreen, but dosed sun exposure. Those who like to be in the sun from 11 years old are at high risk of getting hyperpigmentation.00 to 15:00, at the peak of solar activity, as well as fans of solariums. Such people have an increased risk of getting not only age spots, but also malignant skin formations.

Remember: even if you do not see the manifestations of solar exposure immediately, there is no guarantee that they will not appear in a few years, mutations in cells accumulate, and then only appear. Sunscreens with an SPF of at least 30 units for urban use and 50-100 units for sunbathing.Do not forget to apply protective products to exposed skin areas (face, décolleté, hands), even if you do not plan to sunbathe on the beach – half an hour in the open sun at peak times is enough to get age spots.

It is forbidden to use cosmetics with acids, essential oils, to carry out procedures of resurfacing and peeling in the summer, the last peeling should be 3-4 weeks before sun exposure. It must be remembered that taking contraceptives, antibiotics, retinoids, etc. medications increases the sensitivity of the skin to ultraviolet irradiation.

A healthy lifestyle, proper nutrition and prevention of vitamin deficiency is the second step in maintaining healthy skin. Vitamin C and B vitamins (especially riboflavin and folic acid) normalize the metabolism of melanin in the skin and help smooth out its tone.

Skin hyperpigmentation treatment

Cosmetic procedures that have a good effect on various types of hyperpigmentation:

1. Chemical peeling is a procedure for removing the top layer of the skin with acids.Chemical peels are more often used for extensive pigmentation. Under the influence of fruit acids, the overall skin tone is evenly brightened. Retinoic acid (yellow peeling) has the best whitening quality. It is also possible to remove small stains pointwise with the powerful TCA peeling for local action.

2. Hardware grinding. Microdermabrasion – crystals of an abrasive substance under pressure are applied pointwise to the skin and removes even a relatively deep stain.

3. Laser and photorejuvenation – the action of this method is based on the absorption of the cells containing melanin, the laser beam, as a result of which the melanin is gradually destroyed.

4. Cryodestruction of stains using liquid nitrogen. After the procedure, the affected area turns red, but after a few days the top layer of the skin darkens, peels off and the age spot disappears. It is used for single spots with clear contours.

5. Professional cosmetics based on retinol and OBAGI hydroquinone.

6. Folk cosmetology: an example of several face masks that can be used at home when solving this problem:
Tibetan mask. It is very simple to prepare: mix 100 grams of natural honey with the juice of one lemon. Blot with ordinary napkins with the resulting mixture and apply on face for 10-15 minutes. After that, wash with plain water.
Yeast mask. This mask is very comfortable as it is suitable for all skin types. Dissolve the yeast in warm milk (dry skin), or in warm water (normal skin), or in a 3% solution of hydrogen peroxide (oily skin) until the consistency of thick sour cream.The resulting mass must be applied to the area of ​​the skin of the face subject to pigmentation. After the mass has dried, it must be washed off.

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Oksana Volkova Medical Cosmetology Center

The main substance that determines the color and uniformity of skin color is the pigment melanin. The color of the skin depends on its concentration – from the lightest to almost black. Melanin, produced by cells of the epidermis – melanocytes – protects the body from the harmful effects of ultraviolet and infrared rays.
Excessive sun exposure is the most common reason for the appearance of age spots, since under the influence of UV radiation, melanocytes are activated and melanin synthesis is stimulated.
In this case, hyperpigmentation will be predominantly located on open areas of the body and face. These phenomena can be observed at any, even in adolescence and young age.

In case of mechanical, chemical or any other damage to the skin, an inflammatory reaction is triggered in the body.Inflammatory mediators stimulate the activity of melanocytes. Therefore, the consequence of various skin injuries, including those arising after cosmetic procedures, is often local post-inflammatory pigmentation.

Changes in hormonal levels are a common cause of hyperpigmentation. For example, fluctuations in the level of sex hormones during pregnancy (chloasma of pregnant women), when taking contraceptives and during menopause.

Modern studies on the occurrence of hyperpigmentation indicate the existence of an aging pigment – lipofuscin, which cannot be corrected using conventional methods.However, mesotherapy with DMAE is an effective way to combat this hyperpigmentation.

Treatment of hyperpigmentation

Hyperpigmentation is a complex problem. Having established the cause of the disease, the specialist, based on his professional knowledge and experience, as well as on the individual characteristics of the patient, selects the appropriate methods and duration of the course of treatment. Modern dermatocosmetology has in its arsenal reliable and proven methods of treatment with a stable clinical effect.

Proven treatments:

Creams with UV protection are reliable prevention of the appearance of age spots after sunburn. Moreover, you need to use them not only on the beach and not only in summer. Even in winter, the sun’s rays are very aggressive! In the Centers of Medical Cosmetology, professional lines of cosmetics are presented. Your beautician will select the necessary care products to protect your skin.

Primary biliary cirrhosis / Diseases / Clinic EXPERT

Symptoms of PBC

At the initial stages of the disease (in the preclinical stage, often with “accidental” detection of changes in the analyzes) with primary biliary cirrhosis a person may not be bothered by anything .

But with the development of the clinical picture, all manifestations of PBC can be divided into three groups:

1. Symptoms due to the actual primary biliary cirrhosis.

2. Complications of liver cirrhosis.

1. Manifestations of concomitant autoimmune syndromes

PBC Associated diseases Complications of liver cirrhosis



syndrome Sjogren Bleeding varices
metabolic bone disease (osteoporosis) syndrome Raynaud Hepatic encephalopathy
Xanthoma Scleroderma Hypersplenism
deficiency of fat-soluble vitamins Rheumatoid arthritis Hepatocellular carcinoma
Jaundice Celiac disease
Hyperpigmentation Inflammatory diseases intestine

Urinary tract infection

The most common symptom of PBC is fatigue (increased fatigue) , which occurs in 70% of patients.It should be noted that significant fatigue can be the cause of sleep disturbance or depression.

Often such patients feel good in the morning, but they notice a “loss of energy” in the afternoon, which requires rest or even sleep. Most people with PBC find that sleep does not make them feel energized.

The disease begins suddenly , most often with itching of the skin on the palms of the hands and soles of the feet , not accompanied by jaundice. Later, it can spread to the whole body.The intensity of itching may increase at night and decrease during the day. Nighttime itching often interferes with sleep and leads to increased fatigue. The cause of the development of itching remains unclear today.

People suffering from primary biliary cirrhosis (especially if jaundice is present) may experience back pain (often in the thoracic or lumbar spine) along the ribs. This pain may be due to the development of one of two metabolic bone diseases – osteoporosis (sometimes referred to as “thinning” of the bones) or osteomalacia (“softening” of the bone).The cause of the development of bone lesions in the case of PBC is long-term chronic cholestasis.

Approximately 25% of patients with PBC have xanthomas at the time of diagnosis. The appearance of xanthomas is preceded by a long (more than 3 months) increase in blood cholesterol levels of more than 11.7 μmol / l.

A variety of xanthomas – xanthelasma – flat or slightly elevated soft, painless, yellow formations, usually located around the eyes. But xanthomas can also be seen in the palmar folds, under the mammary glands, on the neck, chest, or back.They disappear with the resolution (disappearance) of cholestasis and normalization of cholesterol levels, as well as with the development of the final stage of the disease (liver failure) due to impaired cholesterol synthesis in the damaged liver.

Also, in chronic cholestasis PBC (due to impaired bile secretion), malabsorption of fats and fat-soluble vitamins (A, D, E and K) develops, which can lead to diarrhea, weight loss and a lack of these vitamins.

Vitamin A deficiency causes decrease in vision in the dark . Vitamin E deficiency can manifest as skin discomfort or muscle weakness. Vitamin D deficiency contributes to the progression of bone changes (osteomalacia, osteoporosis). Deficiency of vitamin K leads to a decrease in the synthesis of proteins of the coagulation system by the liver and, therefore, to a tendency to bleeding .

Jaundice , as a rule, the first “noticeable” sign of the disease is yellowing of the whites of the eyes and skin.It reflects an increase in the level of bilirubin in the blood. A slight tint of yellowness can only be detected in sunlight and not in artificial light.

Chronic disturbance of the outflow of bile increases the synthesis of a dark pigment – melanin, which is contained in the skin. Darkening of the skin is called hyperpigmentation . It may look like a sunburn of the skin, but it shows up even on closed areas of the body. In addition, with itching and at the site of “chronic” scratches, pigmentation is more pronounced, which gives the skin a variegated appearance

Treatment of hyperpigmentation Lumeca (IPL) Inmode

This non-invasive procedure is carried out on the newest multifunctional device InMode with the use of a special photo attachment Lumecca, which acts on the skin with IPL radiation – pulsed light of a modified spectral range.

Thanks to 1-2 procedures on Lumecca, you can quickly and safely, in comfortable conditions and effectively get rid of any manifestations of hyperpigmentation. In addition, after the procedure, not only pigment spots will completely disappear, the skin will also become lighter, smoother and more toned, a healthy glow will appear and small vascular networks will disappear.

Lumecca acts on the melanin contained in pigmented spots with IPL radiation, i.e. the heat of a pulsating light beam. Melanin absorbs the heat of light and is destroyed, and within two weeks, its decay products are naturally excreted from the body.It is after this that the complete disappearance of unwanted pigmentation occurs. In addition to removing hyperpigmentation, flashes of light also contribute to overall skin health and rejuvenation. The skin begins to intensively synthesize collagen, due to which a lifting effect is achieved, smoothing of fine wrinkles, narrowing of pores, and after the procedure, small vascular networks disappear.

Lumecca is good because it allows you to treat hyperpigmentation at any time of the year and in patients with any skin type, on any part of the face and body.At the same time, the handpiece is equipped with a built-in cooling system, which prevents tissue overheating, making the procedure completely safe and painless. It does not require anesthesia and does not cause pain or discomfort in the patient, only a sensation of impulses of heat. And thanks to the sufficiently large working surface of the nozzle and high-frequency light pulses, even large problem areas are processed quickly.

In preparation for the procedure, it is enough to stop any thermal procedures two days before the session, and remove contact lenses before the procedure.

Before proceeding with the treatment of the problem area with the apparatus, the cosmetologist cleans the skin with tonic or lotion, and then applies a special gel to it, which ensures full contact of the nozzle with the skin. It is necessary to preset the necessary parameters of IPL radiation and skin cooling on the device. After the procedure, it is enough to adhere to the simple recommendations of the cosmetologist.

Lumecca hyperpigmentation treatment contraindicated in patients:

  • during pregnancy and lactation;
  • for severe diseases of internal organs;
  • for exacerbation of dermatological diseases;
  • with cancer;
  • with mental disorders.

How to get rid of age spots on the face

What are age spots?

A cosmetic defect in the form of flat areas, darker than the main area of ​​the skin, appears due to increased synthesis of melanin in specific areas. Pigmented spots can form at birth or develop throughout life. Elements are responsible for the skin tone, each of which has its own function:

  • melanin – protects against the negative effects of ultraviolet radiation, has antioxidant properties, participates in the elimination of the effects of stress, reduces the activity of free radicals;
  • carotene – ensures cell regeneration, slows down the aging process;
  • hemoglobins – blue and oxyhemoglobin are intended for blood coloring, are responsible for a healthy glow and natural skin tone.

Increased pigmentation is the result of excess melanin. Most often, pigmentation is observed in the form of freckles, which are associated with a genetic factor or exposure to ultraviolet radiation.

Freckles are more common on the face, décolleté, back and forearms. Less commonly, they cover the arms. They can be very small in size or coalesce in conglomeration, forming large areas of hyperpigmentation. Red-haired people with fair skin are prone to freckles.The spots become paler in winter and brighter in summer. They are not dangerous to health, it is just a cosmetic flaw from the point of view of some people, and a “highlight” – in the opinion of others.

There are also other types of pigmentation, some of them are dangerous in terms of degeneration into malignant neoplasms:

  1. Nevi and birthmarks – uneven distribution of melanin in skin cells. The shade ranges from light pink to dark brown. They are not particularly dangerous until they begin to change their structure.It is best to remove birthmarks on the face, visible areas and areas subject to friction.
  2. Melasma, chloasma without sharply defined boundaries on the face, neck, shoulders. Associated with problems of the hormonal system. Eliminated with the help of cosmetic procedures.
  3. Lentigo – age pigmentation, age spots. Most often they cover the upper part of the body. They are poorly masked with cosmetics, but it is possible to reduce their intensity with the help of salon procedures.
  4. Hypopigmentation includes vitiligo and albinism, which are discolored areas of the skin.

Pigmentation is dermal, forming in the deep layers of the epidermis. And epidermal, which affects the upper layers of the skin.

Causes of age spots on the face

A cosmetic defect occurs in women, men and even newborns. There are several reasons for pigmentation:

  • frequent and intense exposure to ultraviolet radiation on the skin – disrupts the structure of cells, inhibits regeneration, destroys collagen fibers;
  • trauma – scratches, abrasions, cuts, hematomas can activate the production of melanin in a certain area;
  • hormonal imbalance – during puberty, during pregnancy, menstruation, during menopause;
  • pathologies of internal organs – more often the adrenal glands, liver, biliary and thyroid glands;
  • skin diseases, especially acne;
  • taking certain medications with photosensitization effects;
  • circulatory disorders in the extremities;
  • diseases of the reproductive system;
  • infections, viruses, bacteria, fungal pathologies;
  • heredity.

In newborns, age spots may appear due to the difficulties of the mother’s delivery. Most of them pass on their own in the first year of life, but all education requires supervision.

How to remove age spots on the face with a beautician

Aesthetic medicine provides a variety of techniques for removing a defect. But before determining the method of affecting the age spot, the cosmetologist must conduct an examination.Consultations of specialized doctors may be required: endocrinologist, gynecologist, dermatologist, venereologist. Techniques for removing age spots in specialized institutions:

  • chemical exfoliation (peeling) with preparations based on fruit acids – activates metabolic processes, cleanses the skin, evenly discolors spots, restores velvety;
  • photorejuvenation – reduction of pigmentation brightness, cell regeneration, brightening effect;
  • microdermabrasion – soft resurfacing of the surface layer of the skin, evens and brightens the tone, improves microcirculation;
  • cryotherapy – exposure to cold through liquid nitrogen, is more applicable to eliminate nevi and severe pigmentation;
  • mesotherapy – injection method of clarification with preparations containing peptides;
  • laser therapy – a painless procedure for removing pigmentation, suitable for treating large areas and intensive stains.

Any cosmetology technique requires preparation and implementation of the rules of care after manipulations. In some cases, one procedure is sufficient, in others, 3 to 5 sessions are required.

How to remove pigmentation on the face at home using cosmetics

If the spots do not differ in intensity and do not occupy large areas, you can make them lighter yourself. Pharmacy products and beauty products are suitable for this:

  1. Hydroquinone, lavender oil, hydrogen peroxide, resorcinol have an exfoliating and keratolytic effect.
  2. Weak fruit acids, which can be used at home, bleach well stains. This is citric, ascorbic, and lactic acid of low concentration. These products are also suitable for preparation for salon chemical peels.
  3. Anti-Pigment marked brightening cosmetic formulations. Creams, lotions and serums containing azelaine, kojic acid, vitamin C.

Any product can be used only after a test for possible allergies.If the body perceives the composition calmly, without a negative reaction, you can proceed to the procedures according to the instructions for the drug.

Is it possible to remove age spots on the face with folk remedies?

If the pigmentation is very pronounced, only a professional cosmetologist will help get rid of it. Small, dim spots, freckles brighten well with the help of components that are always at hand:

  • lemon;
  • parsley extract;
  • cottage cheese, whey and yogurt;
  • cucumber;
  • potatoes;
  • buckwheat and oat flour;
  • apple cider vinegar;
  • aloe vera;
  • cosmetic clay;
  • milk;
  • strong infusion of green tea;
  • extract of licorice, orchid and so on.

The components can be mixed, pharmacy products, vitamins can be added. After the whitening procedure, it is imperative to take care of moisturizing and softening the skin.

How to prevent the appearance of age spots?

If the cause of the pigmentation is not a hereditary factor, the cosmetic defect can be avoided. Preventive measures:

  • Do not start diseases of internal organs – it is mandatory to undergo scheduled examinations by doctors twice a year;
  • do not get carried away with tanning – both in the sun and in a tanning bed;
  • take care of skin protection – go outside in winter, after applying a cream with SPF 30, in summer the indicator should be 50;
  • choose the right skin care products to maintain a beautiful and even skin tone;
  • observe the drinking regime – do not let the skin dry out;
  • to monitor hygiene, to prevent the development of acne, the formation of comedones;
  • to control hormones.

It is also important to take care of prevention well before the wilting period. The sooner sufficient attention is paid to care and protection, the later the skin will undergo age-related changes. Pigmented spots are a phenomenon that can and should be dealt with. Do not give up if home procedures have not brought results, you can always seek help from a beautician.

Summer, sun and … hyperpigmentation

Author: Irina Nikolaevna Ivanova – Leading Physician of the Cosmetology and Rehabilitation Department of the DoctorPlastic Clinic.

Hyperpigmentation is a congenital or acquired pathology that is caused by a violation of melanogenesis in the skin. This is a fairly common disease. It is manifested by an excessively intense coloration of certain areas of the skin in comparison with the surrounding skin. It can also be diffuse (discoloration of the entire skin). Inherent in all races. Hyperpigmentation is harmless to health, but can be markers of somatic pathology. Also, being an aesthetic defect, they can cause psychological discomfort.

Melanogenesis is carried out in melanocyte cells located in the basal layer of the skin. Each melanocyte has up to 36 processes connected to keratinocytes, in which melanin accumulates.

It acts as an optical filter that absorbs ultraviolet and infrared radiation, protecting the body from overheating and excessive UV trauma.

The substrate for the synthesis of melanin is tyrosine, which is part of almost all animal and plant proteins, catecholamines (norepinephrine, adrenaline) and dioxyphenylalanine.Under the influence of tyrosinase, they are oxidized and converted through a series of subsequent biochemical reactions into dark-colored melanin.

The process of melanin synthesis is regulated by the neuro-humoral mechanism. MSH is melanin-stimulating hormones, melatonin is an antagonist. Other hormones, such as sex hormones, corticosteroids, thyroid-stimulating hormones, etc., also affect the process of melanogenesis. Unfortunately, the process of regulation of melanogenesis is still not well understood.


The role of a trigger in the formation of hyperpigmentation belongs to ultraviolet radiation, but the reasons may be different.

It can be associated with dysfunction of the endocrine glands (adrenal and gonads), pregnancy or menopause, liver and biliary tract disease. Hyperpigmentation is also observed in violation of the vitamin and mineral balance in the body (especially vitamin C), prolonged intoxication with various chronic infections or occupational hazards (tuberculosis, malaria, contact with oil products), metabolic disorders (pellagra, porphyria), as a result of taking certain medicinal funds (antibiotics of the tetracyclines group, salicylic acid preparations, St. John’s wort extract, argyria from silver nitrate).It can also be secondary – post-inflammatory or post-traumatic.


Favorite places for localization of age spots are the face, arms and chest. Skin hyperpigmentation can be congenital (freckles, nevi) and acquired (chloasma, melasma).

Freckles – scattering of small spots from light to brown on the skin of the face, hands, back, chest. Under the influence of insolation, their color becomes brighter.

Nevi can be of various shapes and sizes, increase over the course of life or remain unchanged.

Diffuse melasma occurs when adrenal gland function is impaired, more often when its cortical layer is damaged, pituitary tumors. In this case, the skin is diffusely colored in a brown, bronze color. The most pronounced hyperpigmentation in open areas of the skin: face, neck, hands, as well as in the area of ​​the areola of the nipples, scrotum, perineum, white line of the abdomen.

Acquired melasma (melanosis, melasma, chloasma) often occurs against a background of hormonal stress or imbalance – during pregnancy (often transient), when taking oral contraceptives, in menopause, etc.e. These can be blurred spots on the forehead, cheeks, white line of the abdomen, or clearly delineated (more often on the cheeks), sometimes symmetrical.

With the external or internal use of various medicines (antipyrine, amidopyrine, quinine, sulfonamides), pigmentary toxidermia may develop. The onset of toxic melasma is often associated with skin sensitization by hydrocarbons (resins, lubricating oils, oil).

Hepatic chloasma in chronic liver diseases is localized mainly on the lateral surface of the cheeks with the transition to the neck.Spots with a pronounced mesh of telangiectasias do not have sharp outlines.

Pigmented perioral dermatosis of Broca is manifested by symmetrical pigmentation around the mouth, chin and nasolabial folds. It is observed almost exclusively in women. The spots are yellowish-brown (coffee with milk) and blurred borders. Disorders of ovarian function and gastrointestinal tract can be the cause of spots.

Lentigo – age spots in persons over 40 years old, appear naturally due to the uneven distribution of pigment in the upper layers of the skin.Solar lentigo can occur at an earlier age as a result of excessive sun exposure.

Secondary hyperpigmentation occurs at the sites of resolution of inflammatory elements or after trauma to the skin.

TREATMENT includes several stages

  • elimination of internal causes of pigment formation disorders (treatment of the underlying disease, elimination of contact with photosensitizers, administration of vitamins)
  • external action on the skin by mechanical or chemical exfoliation, bleaching agents (chemical peelings, fractional laser resurfacing, ELOS therapy, phototherapy, mesotherapy, ozone therapy, plasma therapy)
  • additional preventive skin protection during periods of high solar activity (use of physical and chemical factors of protection, absence of excessive insolation, refusal from solarium and “beach” tanning).

In conclusion, it should be noted that the problem of hyperpigmentation is one of the most difficult aesthetic problems today. Treatment is effective only in a number of cases, but most often the disease recurs during a period of increased solar activity.

If you have problems with hyperpigmentation, you should consult a cosmetologist. It is to the doctor. As mentioned above, some types of skin discoloration can be markers of severe somatic pathologies.Then the doctor will prescribe an examination and refer you to the appropriate specialists in order to eliminate the cause (gynecologist, gastroenterologist, endocrinologist).

  • external action on the skin by mechanical or chemical exfoliation, bleaching agents (chemical peelings, fractional laser resurfacing, ELOS – therapy, phototherapy, mesotherapy, ozone therapy, plasma therapy)

Peeling involves exfoliation of the upper layers of the epidermis using mechanical (de-abrasion) or chemical agents.Chemical peels are usually carried out by applying certain acids to the skin. To combat hyperpigmentation, trichloroacetic acid, phytic acid, kojic acid, almond, salicylic, retinoic, etc. can be used. or a combination of both. Peels can be superficial, after such a procedure, peeling is minimal; superficial-median – peeling will be strong, the procedure requires rehabilitation, but the effect is achieved with fewer procedures. Many manufacturers produce ready-made cocktails called “whitening”, “brightening”, etc.e. Protocols of care procedures have also been developed, including surface chemical peels, masks, whitening serums and creams. Usually they contain a complex of antioxidants, high concentrations of vitamin C, A, and the corresponding acids. It should be understood that the softer the effect of one procedure, the more they will be required to achieve the effect.

ELOS-therapy – a combination of two energies – photo (light) and RF (electricity). This procedure does not damage the skin and requires virtually no rehabilitation.After it, there may be slight hyperemia, and the areas of hyperpigmentation will temporarily (for 2-3 days) become darker. Then this area is gradually brightened. Since ELOS therapy is successfully used in the treatment of rosacea, it will be most effective for those who, in addition to the pigment, also have a vascular component (telangiectasia). Such procedures for a course of treatment may require 3-8, with an interval of 1 month.

Fractional laser resurfacing is a traumatic procedure, it involves many point laser burns, requires 6-7 days of rehabilitation.It is used to treat chrono- and photoaging, scars, stretch marks. With hyperpigmentation, it is used mainly for combined pathology (for example, flabbiness and hyperpigmentation of the skin) precisely due to its trauma.

Mesotherapy – the introduction of drugs into the dermis using multiple microinjections. To lighten the pigmented areas, ascorbic acid, tyrosinase blockers are introduced there. There are also ready-made cocktails from various manufacturers, where combinations and doses of drugs are designed specifically for the treatment of hyperpigmentation.

Plasma therapy – therapy with your own plasma. From a vein, 8 to 40 ml of blood is taken from a patient into special test tubes and centrifuged. And its own plasma in the technique of mesotherapy is injected into problem areas.

Ozone therapy is also an injection technique, an ozone-oxygen mixture (gas) is injected into the areas of hyperpigmentation.

Treatment of hyperpigmentation is always a course, or the best result is given by a combination of various techniques. However, it must be remembered that each procedure has contraindications.Therefore, only a qualified doctor can develop an individual treatment program.

90,000 Post-acne and hyperpigmentation


Scars appear when collagen is damaged in the deep layers of the skin, and when it is damaged, it is no longer possible to completely restore it. As with almost all things, scars are easier to prevent than to get rid of. So try not to squeeze pimples violently or torment your skin.It is possible to squeeze out pimples, but only when they are not inflamed and are easily squeezed out without effort.

Home remedies can help, but they are unlikely to give any serious results. Here we need funds that affect skin renewal – acids, retinoids (examples will be below). Only a cosmetologist will seriously help with the help of either laser cleaning or a series of deep peels. Peels, even deep ones, can remove a small scar and visibly smooth a deep one. But if you have the latter option, then almost the only way to make it invisible is fillers.

Pigmentation and post-acne

As for post acne, which is expressed in color, not relief, I have good news here. They can be dealt with with home remedies. But it’s difficult. Exactly the same thing works for sun spots. Such pigmentation differs from post-acne in the type of pigment, but the same means are needed.

Before you start treating post acne and pigmentation, you need to make sure that you follow three basic rules, without which all efforts will be in vain:

1.You are not using products that irritate your skin. These include rough scrubs, soap and alcohol as the base of the product. If there are not many of them, this is ok, if it is based on it, it is not necessary. Such things slow down the skin’s ability to repair itself and provoke post-traumatic pigmentation

2. You use Sanskrin every day, even in cloudy weather. Pigmentation and post-acne can appear for various reasons, but the sun always aggravates what is, so you need to protect yourself from it.

3. You don’t torture your face. Do not squeeze or pick inflamed pimples, do not pick what is already healing. Do not use wax on your face. Because all this can also provoke pigmentation.

So what to do. First, for the stain to go away, the skin needs to be renewed. Secondly, it is necessary that there is no pigment in the renewed skin. And there are two types of remedies that will help you.

Refresh & Exfoliate

To renew the skin, you need, in fact, to use funds that stimulate its renewal and exfoliate.

Exfoliation is clear – acids and enzymes. Especially glycolic and azelaic (a little below it will become clear why). If your skin does not accept acids and enzymes, try rolling peels.

But today there are not so many ingredients that can provoke skin renewal. One of them is retinoids. I wrote about them in detail here. The second is vitamin C . I would start with vitamin C and switch to retinoids only if there were no results from it.

Brighten Pigment

Almost all anti-pigmentation products work the same: they
suppress the enzyme tyrosinase, which is involved in the production and transfer
melanin.There are not very many such ingredients, so it is easy to list (in decreasing order of proven effectiveness):

Hydroquinone. has a problem with it, because it is banned in some countries due to toxicity and resistance is developed to it.

Vitamin C. Concentrated serums and creams with vitamin C in the form of ascorbic acid. Pharmacy and professional brands have such things: iSClinical, Rejudicare, Timeless, Ultraceuticals, The Ordinary, SkinSeuticals, Obagi, O.S.T., Clinique, Sesderma, Phyto-C. Nowadays vitamin C has come into fashion in general and many different remedies are made with it.

Azelaic acid. It is good because it can be used during pregnancy and it also exfoliates. That is, it is such a universal remedy, and it is often recommended for pigmentation. – The Ordinary, Skinoren, Azelik, Sesderma Azelac

Arbutin. The Ordinary, Holy Land, Biologique Recherche PIGM

Kojic acid., unfortunately, I won’t tell you the means, but if you know, write in the comments.

Glycolic acid. glycolic acid can be found today
generally everywhere. To me personally, she seems a little aggressive, but it depends
from the skin. Glycolic acid products are often available from drugstore brands,
for example, at Noreva.

Niacinamide. The Ordinary, Paula’s Choice, Glossier Super Pure.

In order for the pigmentation to lighten, you need to combine renewing and lightening components.If you don’t want to use a lot of products, try using only azelaic acid first.