Hyperpigmentation is a major skincare concern in South Africa, affecting women of all ages, races and skin types
To better understand how hyperpigmentation forms, and how to prevent and treat it, we asked Lamelle expert Karen Bester some commonly asked questions.
What are some of the most common causes of hyperpigmentation?
There are many causes of hyperpigmentation. Anything from sun exposure to some medical illnesses and medications can cause the skin to over-produce pigment (melanin).
The most common types of hyper pigmented skin that we treat in the medical aesthetic and skincare industry, would be caused by three things:
- Hormones – the fluctuation in hormones can lead to hyperpigmentation. This is called melasma (or chloasma when it happens in pregnancy).
- Sun – repeated sun exposure will cause dark marks that we call sun spots. They are also called age spots or liver spots. This is generally due to frequent sun-induced injuries over a long period of time so we generally see this in more mature persons.
- Inflammation – in especially darker skins, when there is an injury of the skin the melanocytes, the cells that make pigment, will respond to the inflammation by making more pigment. We call this Post Inflammatory Hyperpigmentation (PIH). Some people refer to it as acne scarring. There might be actual scar but the dark area is actually excess melanin. This is much easier to correct then a collagen-fibre scar.
Why is hyperpigmentation so common during pregnancy?
This is due to the fluctuation in hormones.
We don’t understand exactly what hormone causes hormonal hyperpigmentation. What we do know is that it has a specific picture – areas of pigmentation are on both sides of the face and in specific areas on the face.
It is also more common where there are fluctuations in hormones. In pregnancy, going on the oral contraceptive pill, changing your contraceptive, fertility treatment etc. These situations can all trigger this form of hyperpigmentation. It is more common in pregnancy though.
In some – and I think probably most cases – the darkened pigment does disappear after the baby is born. In some cases it does not and it sometimes worsens with subsequent pregnancies.
There is also a strong genetic predisposition to this condition. So if your mother had it you have a higher probability of having it as well.
Are some skin tones or types more prone to developing hyperpigmentation than others?
The darker your skin type is the more prone you will be to getting hormonal or inflammatory caused hyperpigmentation. Sunspots are more specific to more mature skin that is lighter in colour.
Sun exposure is a determining factor. In our sunny environment we are all more prone to get hyperpigmentation, regardless of our skin colour and genetic make-up. This is due to the fact that all forms of hyperpigmentation are exacerbated by sun exposure.
Is there anything you can do to minimise your risk of developing hyperpigmentation?
The challenge with hyperpigmentation is that the tendency is generally based on your genetic material. So, you have a genetic predisposition to get it.
Avoiding the sun is always a good idea.
Generally we manage hyperpigmentation when it happens.
Is it possible to get rid of hyperpigmentation completely?
In my opinion – It is very possible yes.
The challenges are:
- It takes time – many months of commitment to a strict program will be required. If you have hyperpigmentation caused by hormones (melasma) you will probably need to stay on some form of pigment inhibition until you go into menopause.
- It takes commitment to a program – this would include, peels and in-salon treatments, twice daily application of product that inhibit the production of hyperpigmentation.
- It takes adjustment of your lifestyle – you will have to be careful of the sun and religious about applying sunscreen daily and re-applying it often if you are spending time outdoors. It is also important to avoid activities that include heat like sauna’s and heated yoga as examples.
- You will need to budget – some treatments may be costly.
- It is individual – we do see great results if you are able to commit time, routine and money. The challenge is that each person’s skin is different and sometimes (in about 10% of cases of melasma) even with this commitment a little bit of hyperpigmentation might remain.
- Maintenance is important – with each type of hyperpigmentation there is a cause that will need ongoing management;
- With hormonal hyperpigmentation you will always need to inhibit the melanocyte as it is genetically over stimulated.
- With inflammatory hyperpigmentation it is important to have treatments that heal the injuries as quickly as possible e.g. acne treatments.
- With hyperpigmentation caused by the sun it is important to use sunscreen daily and add antioxidants to your skincare and supplementation routine.
What products and or treatments would you recommend?
We do advise the use of a combination of peels with topical products.
Product and treatment choice should be dependent on the cause and severity of the hyperpigmentation. This will be determined by your skin care therapist or doctor during your skin care consultation. These consultations can be done safely, online at Lamelle.
A few products to try: