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Hyperpigmentation treatment dermatologist: Acids, Peels, Lasers, and More

Acids, Peels, Lasers, and More

You may be able to treat hyperpigmentation with over-the-counter (OTC) skin acids and retinoids. A dermatologist can also perform procedures that may help reduce its appearance.

Hyperpigmentation is a medical term used to describe darker patches of skin from excess melanin production. This can be caused by everything from acne scars and sun damage to hormone fluctuations.

If you’re dealing with hyperpigmentation, know that you aren’t alone. Hyperpigmentation is a common skin condition, and there are a number of different treatment options available.

Keep reading to learn more about your options, including what to expect from procedures like microdermabrasion, and more.

Face acids, or skin acids, work by exfoliating, or shedding, the top layer of your skin.

Whenever you exfoliate your skin, new skin cells emerge to take the place of the old ones. The process helps even out your skin tone and makes it smoother overall.

Many face acids are available OTC at beauty stores and drugstores. Popular options include:

  • alpha hydroxy acids, such as glycolic, lactic, citric, malic, or tartaric acid
  • azelaic acid
  • kojic acid
  • salicylic acid
  • vitamin C (in the form of l-ascorbic acid)

Who should try this?

Face acids work well for mild hyperpigmentation on fairer skin tones.

What products can you try?

Look for an acid content of 10% or less. Higher concentrations can increase your risk of side effects and are best left to professional peels performed in-office.

Derived from vitamin A, retinoids are among some of the oldest OTC skin care ingredients used. Their small molecular structure allows them to penetrate deep into the skin and treat the layers below your epidermis.

Retinoids can come in either a prescription or OTC formula. However, OTC versions tend to be weaker. If you don’t see any results after a couple of months, talk with your dermatologist about the prescription retinoid tretinoin (Retin-A).

If you don’t already have a dermatologist, the Healthline FindCare tool can help you find a physician in your area.

Who should try this?

OTC retinoids may be safe for all skin tones, but you should double-check with your dermatologist if you have darker skin and plan on using these products long term.

It’s also important to note that retinoids are more often used to treat wrinkles than hyperpigmentation. This means that retinoids may not be the best first-line treatment.

What products can you try?

If you have multiple skin concerns, you may be interested in trying:

  • Differin Gel: Previously available by prescription only, this retinoid helps address both acne and hyperpigmentation.

A chemical peel uses acids at stronger concentrations to treat the desired area of skin. They reduce the appearance of hyperpigmentation by removing the top layer of your skin (epidermis). Deeper versions may also penetrate the middle layer of your skin (dermis) to produce more dramatic results.

Although many chemical peels are available OTC, you might consider getting a professional-grade peel at your dermatologist’s office. These are more powerful, and they yield quicker results.

Due to their strength, in-office peels may also increase your risk for side effects. Talk with your dermatologist about your individual risks.

Possible risks with both at-home and in-office chemical peels include:

  • redness
  • irritation
  • blistering
  • infection
  • scarring
  • allergic reaction

If you’re out in the sun on a regular basis, chemical peels may not be the best treatment option for you. Chemical peels cause your skin to be more sensitive to the sun’s rays.

If you don’t adequately apply sunscreen and use other UV protection, the sun may worsen your hyperpigmentation. You’ll need to take extra precautions for at least one week after your last chemical peel.

Who should try this?

Chemical peels may work if you have:

  • age spots
  • sun damage
  • melasma
  • blotchy skin

They also work best for fairer skin tones, and they may provide faster results than face acid products.

What products can you try?

If you’re looking for a professional-grade peel to use at home, consider a glycolic acid peel from Exuviance. This product may be used up to twice a week. It can also help reduce the appearance of wrinkles.

If you have a darker skin tone or want a stronger peel, talk with your dermatologist. They can discuss the professional peels that they have available and help you decide on the right peel for you.

A laser peel (resurfacing) treatment uses targeted beams of light to reduce hyperpigmentation.

There are two types of lasers: ablative and non-ablative.

Ablative lasers are the most intense, and they involve removing layers of your skin. Non-ablative procedures, on the other hand, target the dermis to promote collagen growth and tightening effects.

Ablative lasers are stronger, but they may cause more side effects. Both destroy elements in your skin to ensure that new skin cells grow back tighter and more toned.

Who should try this?

There isn’t a one-size-fits-all approach to skin resurfacing.

Ablative lasers may work better for people with fair skin. For some people, non-ablative versions may cause the skin to darken instead of lighten.

Your dermatologist will work with you to assess your discoloration and overall skin tone to select the best option for your skin.

IPL therapy is a type of non-ablative (fractional) laser treatment. Also known as a photofacial, IPL therapy stimulates collagen growth within the dermis. It usually requires multiple sessions.

IPL is used for overall pigmentation issues, but flat spots especially respond to this treatment. It may also help reduce the appearance of wrinkles, spider veins, and enlarged pores.

Who should try this?

According to the American Society for Dermatologic Surgery (ASDS), IPL works best for people with fair skin.

Microdermabrasion is an in-office procedure used to treat hyperpigmentation that affects the epidermis only (superficial scarring).

During the procedure, your dermatologist will use a drill-like handheld tool with a wire brush or another abrasive attachment. The tool is then swiped across your skin to rapidly — but gently — remove the epidermis.

You may need multiple sessions to achieve your ideal result.

Who should try this?

Microdermabrasion works best on superficial scars. Your dermatologist can help you determine whether this treatment is right for you.

It also works well for people with fairer skin.

Dermabrasion also involves the removal of your epidermis, but its effects continue down to a part of your dermis.

While dermabrasion is sometimes used to smooth out wrinkles, the procedure has been historically used to address texture concerns. These include:

  • acne scars
  • age spots
  • chickenpox scars
  • injury scars
  • sun damage

As with microdermabrasion, your dermatologist will use a drill-like handheld tool with a wire brush or other abrasive attachment. They’ll move the tool across your skin to rapidly — but gently — remove your entire epidermis and the top part of your dermis.

Who should try this?

Dermabrasion may be a good option if you’re looking to decrease pigmentation at a faster rate than microdermabrasion.

It works best for fairer skin. However, further hyperpigmentation as a result of the procedure can occur with all skin types. The new patches of hyperpigmentation may lighten after about eight weeks.

Lightening creams are over-the-counter (OTC) treatments that work with select ingredients to help decrease pigmentation. Many of these creams are available in stronger prescription forms.

They’re usually applied once or twice a day to help lighten the skin over time. Topical treatments for lightening also come in gel form.

Common ingredients found in OTC lightening products include:

  • licorice extract
  • vitamin B-3 (niacinamide)

Who should try this?

Lightening creams or gels work best for flat spots, such as melasma or age spots. They’re effective for patches of discoloration on most skin types.

Online retailers make it easy to access beauty and skin care products that you wouldn’t otherwise be able to access. You should only purchase products from retailers and manufacturers that you trust.

What products can you try?

OTC products are accessible (and sometimes more affordable) options for hyperpigmentation, but these can take longer than professional treatments.

Look for creams with ingredients like niacinamide.

The Food and Drug Administration (FDA) recommends using caution when purchasing OTC skin lighteners, as they may contain traces of mercury.

Skin tone can play a role in the intensity and length of hyperpigmentation treatments. As noted by Dr. Cynthia Cobb, DNP, APRN, WHNP-BC, MEP-C, people with fair, medium, and dark skin tones can use some of the same therapies, but people with darker skin need more time for the treatment to work.

Fair skin responds well to most hyperpigmentation procedures.

The following might be off limits if you tan easily or have darker skin:

  • high-beam lasers
  • IPL therapy

Medium skin tones may find the following options helpful:

  • chemical peels
  • microdermabrasion

Darker skin might benefit from:

  • glycolic acid
  • kojic acid
  • OTC lightening creams
  • microdermabrasion
  • lower-strength chemical peels
  • laser treatments, but only when used at lower intensities over a larger number of sessions

Topical treatments generally take longer to produce visible results. Patience is key with any treatment option.

Your dermatologist can help you identify the cause of your hyperpigmentation and work with you to develop an appropriate treatment plan.

No matter what treatment you ultimately choose, it’s important to protect your skin from further sun damage and hyperpigmentation.

Wearing sunscreen every day is a must. You should apply sunscreen every morning — even when it’s cloudy! — and reapply as needed throughout the day. Be sure to use sunscreen with SPF 30 or higher.

Acids, Peels, Lasers, and More

You may be able to treat hyperpigmentation with over-the-counter (OTC) skin acids and retinoids. A dermatologist can also perform procedures that may help reduce its appearance.

Hyperpigmentation is a medical term used to describe darker patches of skin from excess melanin production. This can be caused by everything from acne scars and sun damage to hormone fluctuations.

If you’re dealing with hyperpigmentation, know that you aren’t alone. Hyperpigmentation is a common skin condition, and there are a number of different treatment options available.

Keep reading to learn more about your options, including what to expect from procedures like microdermabrasion, and more.

Face acids, or skin acids, work by exfoliating, or shedding, the top layer of your skin.

Whenever you exfoliate your skin, new skin cells emerge to take the place of the old ones. The process helps even out your skin tone and makes it smoother overall.

Many face acids are available OTC at beauty stores and drugstores. Popular options include:

  • alpha hydroxy acids, such as glycolic, lactic, citric, malic, or tartaric acid
  • azelaic acid
  • kojic acid
  • salicylic acid
  • vitamin C (in the form of l-ascorbic acid)

Who should try this?

Face acids work well for mild hyperpigmentation on fairer skin tones.

What products can you try?

Look for an acid content of 10% or less. Higher concentrations can increase your risk of side effects and are best left to professional peels performed in-office.

Derived from vitamin A, retinoids are among some of the oldest OTC skin care ingredients used. Their small molecular structure allows them to penetrate deep into the skin and treat the layers below your epidermis.

Retinoids can come in either a prescription or OTC formula. However, OTC versions tend to be weaker. If you don’t see any results after a couple of months, talk with your dermatologist about the prescription retinoid tretinoin (Retin-A).

If you don’t already have a dermatologist, the Healthline FindCare tool can help you find a physician in your area.

Who should try this?

OTC retinoids may be safe for all skin tones, but you should double-check with your dermatologist if you have darker skin and plan on using these products long term.

It’s also important to note that retinoids are more often used to treat wrinkles than hyperpigmentation. This means that retinoids may not be the best first-line treatment.

What products can you try?

If you have multiple skin concerns, you may be interested in trying:

  • Differin Gel: Previously available by prescription only, this retinoid helps address both acne and hyperpigmentation.

A chemical peel uses acids at stronger concentrations to treat the desired area of skin. They reduce the appearance of hyperpigmentation by removing the top layer of your skin (epidermis). Deeper versions may also penetrate the middle layer of your skin (dermis) to produce more dramatic results.

Although many chemical peels are available OTC, you might consider getting a professional-grade peel at your dermatologist’s office. These are more powerful, and they yield quicker results.

Due to their strength, in-office peels may also increase your risk for side effects. Talk with your dermatologist about your individual risks.

Possible risks with both at-home and in-office chemical peels include:

  • redness
  • irritation
  • blistering
  • infection
  • scarring
  • allergic reaction

If you’re out in the sun on a regular basis, chemical peels may not be the best treatment option for you. Chemical peels cause your skin to be more sensitive to the sun’s rays.

If you don’t adequately apply sunscreen and use other UV protection, the sun may worsen your hyperpigmentation. You’ll need to take extra precautions for at least one week after your last chemical peel.

Who should try this?

Chemical peels may work if you have:

  • age spots
  • sun damage
  • melasma
  • blotchy skin

They also work best for fairer skin tones, and they may provide faster results than face acid products.

What products can you try?

If you’re looking for a professional-grade peel to use at home, consider a glycolic acid peel from Exuviance. This product may be used up to twice a week. It can also help reduce the appearance of wrinkles.

If you have a darker skin tone or want a stronger peel, talk with your dermatologist. They can discuss the professional peels that they have available and help you decide on the right peel for you.

A laser peel (resurfacing) treatment uses targeted beams of light to reduce hyperpigmentation.

There are two types of lasers: ablative and non-ablative.

Ablative lasers are the most intense, and they involve removing layers of your skin. Non-ablative procedures, on the other hand, target the dermis to promote collagen growth and tightening effects.

Ablative lasers are stronger, but they may cause more side effects. Both destroy elements in your skin to ensure that new skin cells grow back tighter and more toned.

Who should try this?

There isn’t a one-size-fits-all approach to skin resurfacing.

Ablative lasers may work better for people with fair skin. For some people, non-ablative versions may cause the skin to darken instead of lighten.

Your dermatologist will work with you to assess your discoloration and overall skin tone to select the best option for your skin.

IPL therapy is a type of non-ablative (fractional) laser treatment. Also known as a photofacial, IPL therapy stimulates collagen growth within the dermis. It usually requires multiple sessions.

IPL is used for overall pigmentation issues, but flat spots especially respond to this treatment. It may also help reduce the appearance of wrinkles, spider veins, and enlarged pores.

Who should try this?

According to the American Society for Dermatologic Surgery (ASDS), IPL works best for people with fair skin.

Microdermabrasion is an in-office procedure used to treat hyperpigmentation that affects the epidermis only (superficial scarring).

During the procedure, your dermatologist will use a drill-like handheld tool with a wire brush or another abrasive attachment. The tool is then swiped across your skin to rapidly — but gently — remove the epidermis.

You may need multiple sessions to achieve your ideal result.

Who should try this?

Microdermabrasion works best on superficial scars. Your dermatologist can help you determine whether this treatment is right for you.

It also works well for people with fairer skin.

Dermabrasion also involves the removal of your epidermis, but its effects continue down to a part of your dermis.

While dermabrasion is sometimes used to smooth out wrinkles, the procedure has been historically used to address texture concerns. These include:

  • acne scars
  • age spots
  • chickenpox scars
  • injury scars
  • sun damage

As with microdermabrasion, your dermatologist will use a drill-like handheld tool with a wire brush or other abrasive attachment. They’ll move the tool across your skin to rapidly — but gently — remove your entire epidermis and the top part of your dermis.

Who should try this?

Dermabrasion may be a good option if you’re looking to decrease pigmentation at a faster rate than microdermabrasion.

It works best for fairer skin. However, further hyperpigmentation as a result of the procedure can occur with all skin types. The new patches of hyperpigmentation may lighten after about eight weeks.

Lightening creams are over-the-counter (OTC) treatments that work with select ingredients to help decrease pigmentation. Many of these creams are available in stronger prescription forms.

They’re usually applied once or twice a day to help lighten the skin over time. Topical treatments for lightening also come in gel form.

Common ingredients found in OTC lightening products include:

  • licorice extract
  • vitamin B-3 (niacinamide)

Who should try this?

Lightening creams or gels work best for flat spots, such as melasma or age spots. They’re effective for patches of discoloration on most skin types.

Online retailers make it easy to access beauty and skin care products that you wouldn’t otherwise be able to access. You should only purchase products from retailers and manufacturers that you trust.

What products can you try?

OTC products are accessible (and sometimes more affordable) options for hyperpigmentation, but these can take longer than professional treatments.

Look for creams with ingredients like niacinamide.

The Food and Drug Administration (FDA) recommends using caution when purchasing OTC skin lighteners, as they may contain traces of mercury.

Skin tone can play a role in the intensity and length of hyperpigmentation treatments. As noted by Dr. Cynthia Cobb, DNP, APRN, WHNP-BC, MEP-C, people with fair, medium, and dark skin tones can use some of the same therapies, but people with darker skin need more time for the treatment to work.

Fair skin responds well to most hyperpigmentation procedures.

The following might be off limits if you tan easily or have darker skin:

  • high-beam lasers
  • IPL therapy

Medium skin tones may find the following options helpful:

  • chemical peels
  • microdermabrasion

Darker skin might benefit from:

  • glycolic acid
  • kojic acid
  • OTC lightening creams
  • microdermabrasion
  • lower-strength chemical peels
  • laser treatments, but only when used at lower intensities over a larger number of sessions

Topical treatments generally take longer to produce visible results. Patience is key with any treatment option.

Your dermatologist can help you identify the cause of your hyperpigmentation and work with you to develop an appropriate treatment plan.

No matter what treatment you ultimately choose, it’s important to protect your skin from further sun damage and hyperpigmentation.

Wearing sunscreen every day is a must. You should apply sunscreen every morning — even when it’s cloudy! — and reapply as needed throughout the day. Be sure to use sunscreen with SPF 30 or higher.

What is hyperpigmentation from the point of view of a dermatologist?

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Hyperpigmentation of the skin of the face and body – what is it, causes, types, treatment

06. 04.2023, 15:54 90 003

Hyperpigmentation – focal or diffuse deposition of melanin in skin. As a result, there is a darkening of the color of individual sections of the dermis. The appearance of age spots is due to pathological and physiological factors. To establish the causes, a comprehensive diagnosis is required, it is necessary to visit a dermatologist, an endocrinologist. To get rid of hyperpigmentation, the underlying disease is treated, cosmetic procedures are performed.

What is skin hyperpigmentation, causes of age spots

The main causes of hyperpigmentation are skin exposure to ultraviolet light, changes in hormonal balance, and inflammatory processes. In women, the problem often manifests itself during pregnancy.

Diseases in which age spots may appear:

  • pathologies of the liver, gallbladder;
  • beriberi;
  • thyroid dysfunction, other endocrine disorders;
  • diseases of the ovaries.

Hyperpigmentation may be caused by certain drugs that increase the dermis’ susceptibility to sunlight. These are:

  • tetracycline antibiotics;
  • antifungal drugs;
  • non-steroidal anti-inflammatory drugs;
  • diuretics;
  • retinoids;
  • drugs to lower blood sugar, cholesterol.

To prevent the appearance of age spots while taking drugs with a photosensitizing effect, you should limit exposure to the sun, use sunscreen sprays, creams.

Symptoms of skin hyperpigmentation

Under the influence of provoking factors, melanin synthesis is disturbed, pigment spots are formed, which differ in size and color.

Types of hyperpigmentation:

  1. Freckles (ephelids) are small yellow, brown spots that appear on the face and open areas of the body. The reason is a genetic predisposition, with age they can disappear on their own.
  2. Melasma – age spots with uneven boundaries, often merge. Causes – a change in hormonal balance, excessive exposure to ultraviolet radiation. After elimination of the provoking factor disappear. Chloasma is a type of melasma that occurs in pregnant women.
  3. Becker’s nevus – more often detected in men. A characteristic feature is that hair grows in an area with increased pigmentation, which does not happen with other types of spots. Provoking factors – stress, ultraviolet radiation.
  4. Secondary inflammatory hyperpigmentation – spots are formed in places of wounds, ulcers, cuts, abscesses.
  5. Berlok’s dermatitis – spots on the skin of brown color of various shapes and sizes. The reason is the effect of ultraviolet radiation on the skin after using perfume. Sometimes there is moderate itching, they disappear on their own, special therapy is not required.
  6. Riehl’s melanosis is an occupational disease that occurs due to increased sensitivity to UV radiation with constant contact with oil, tar, tar.
  7. Age-related hyperpigmentation – spots have a heterogeneous color, irregular shape. Formed on the face and various parts of the body. They arise due to a slowdown in metabolic processes, chronic diseases, and unsafe tanning in youth.
  8. Juvenile lentigo – age spots spontaneously appear in adolescents with a change in hormonal levels. Sometimes light stripes form on the mucous membranes – lentigia.

Drug-induced hyperpigmentation is not associated with UV exposure. Often occurs after chemotherapy.

The pathogenesis of skin hyperpigmentation

When the skin is exposed to intense sunlight, special cells (melanocytes) begin to actively synthesize melanin. This is a protective reaction to prevent the destruction of the structures of the dermis.

Melanin is a strong antioxidant that neutralizes the effects of solar radiation. It is unevenly distributed in the layers of the epidermis, heating up in those places where the dermis is most vulnerable.

Classification and stages of development of skin hyperpigmentation

In case of moderate impairment of melanin production, melanosis is diagnosed – a single pigment spot. With increased pigment formation, a significant change in skin color – hypermelanosis with numerous areas of hyperpigmentation.

There is no general classification, but age spots are conditionally divided into:

  • physiological;
  • pathological;
  • are genetic, the appearance of which does not depend on other factors.

Complications of skin hyperpigmentation

Most often, hyperpigmentation is not dangerous to health, but in some cases it can be a manifestation of melanoma. This is a malignant tumor that develops from melanocytes – pigment cells that synthesize melanin.

Dangerous symptoms of cancer:

  • the contour of the spot is blurred or has many notches;
  • education rapidly increases in size;
  • darkens sharply or acquires a red tint, the color is uneven;
  • worries about itching, burning, pain in the spot area, redness around.

If these signs appear, do not self-diagnose, you should consult a dermatologist.

Diagnosis of skin hyperpigmentation

Diagnosis begins with the collection and analysis of history, examination. Using a dermatoscope, a dermatologist examines the skin. To determine the depth of the pigment, a Wood’s lamp is used. The severity of melasma is determined by the MASI index – the area of ​​​​pigmented spots, intensity and uniformity of color are taken into account.

To find out the causes of age spots, you may need to consult a gastroenterologist, endocrinologist, gynecologist.

Treatment of skin hyperpigmentation

The correct therapy to remove hyperpigmentation is selected by the doctor after diagnosis. Often, you can get rid of age spots after proper treatment of the underlying disease, which caused the accumulation of melanin.

The following procedures are carried out in the beauty parlor to eliminate the manifestations of hyperpigmentation:

  • chemical peeling – exfoliation, mechanical removal of pigment with alpha hydroxy acids;
  • mesotherapy – intradermal injection of cocktails with hyaluronic acid, vitamins, amino acids help to even out the skin relief, lighten age spots;
  • biorevitalization – intradermal injections with hyaluronic acid, alternating with peeling;
  • Phototherapy therapy – pulsed polarized light helps to remove or lighten spots by acting directly on melanin; the procedure is considered the gold standard for hyperpigmentation therapy;
  • erbium laser therapy;
  • microneedle RF lifting by stimulating skin renewal; safely corrects the pigment on the skin of the eyelids.