How to Tackle Hyperpigmentation on Darker Skin Tones

Hyperpigmentation on Skin of Color

Hyperpigmentation is a skin condition that causes dark spots and discoloration to form in patches on the skin. It commonly shows up on the face, underarms, inner thighs, and legs.

The most common cause of hyperpigmentation, especially on lighter skin tones, is overexposure to the sun. Hyperpigmentation is present in all skin types, but it can be especially pronounced on black skin. Though darker skin tones naturally have more melanin, which helps to limit sun damage, PIH or post-inflammatory hyperpigmentation (hyperpigmentation caused by wound healing) is especially common on skin of color, with over 65% of African Americans experiencing symptoms. Freckles, rosacea, birthmarks, and sunspots are all different manifestations of hyperpigmentation that can appear anywhere on the body.

There are many things that can cause hyperpigmentation including:

• Pimples
• Skin conditions like eczema, psoriasis, and dermatitis
• Hormonal changes (usually due to pregnancy and melasma)
• Skin trauma like burns, cuts, and scrapes
• Some cosmetic treatments
• Bug bites
• UVA and UVB rays

Once dark spots appear, they are hard to remove without intervention by a dermatologist or over-the-counter topical products and supplements. In fact, it's likely the number one skin concern of black people and especially older people, according to the American Academy of Dermatology.  

Effective Treatment Options for Reducing Hyperpigmentation on Darker Skin Tones

Treating hyperpigmentation is a delicate balance of obtaining results without irritating the skin, and stimulating PIH. Hyperpigmentation is not harmful, but many people seek to reduce spots and uneven skin tone without reducing their skin's natural pigment overall. Certain chemical peels and laser treatments meant to help treat hyperpigmentation can end up causing more harm than good for people of color, because the irritation from these procedures can then cause PIH.

Dr. Andrew Alexis, an expert dermatologist who specializes in treating skin of color, advised that in order to treat hyperpigmentation and specifically PIH, you need to first manage the source of inflammation, such as acne. Otherwise, it is like an endless circle of treating an area with an overproduction of melanin, but creating new hyperpigmentation in its place. Many brightening ingredients (such as hydroquinone) have mildly irritating ingredients which can have an impact on overall skin color, texture, and quality. Instead, the following gentle treatments are advised to holistically and delicately treat and prevent hyperpigmentation.

Effective treatments depend on the depth of the pigmentation, how broadly it has spread, and the primary cause of the pigmentation. Before you begin any of these treatments, consult a dermatologist, particularly one that is skilled in working with skin of color.

• Start with sunscreen: Though melanin production helps to protect from sun damage, sun exposure is still a leading cause of hyperpigmentation. Broad-spectrum SPF 30 or higher is recommended to protect against all forms of UV rays. This not only helps to prevent hyperpigmentation, adding oil-free SPF to your skincare routine will help prevent breakouts that can make PIH even worse. Plus, it has many anti-aging benefits to protect your youthful glow!

• Don't skip the moisturizer: Skin hydration is critical for protecting against sun damage and promoting skin cell turnover. Use a lightweight, non-irritating moisturizer on your face and body every day, or get one with SPF to protect your skin inside and outside.
• Use a tyrosinase inhibitor: Tyrosine is an enzyme needed for melanin and pigment production. Over the counter tyrosinase inhibitors such as kojic acid, lactic acid, azelaic acid, glycolic acid, arbutin, ascorbic acid (vitamin C), retinoids and liquorice root extract have brightening and pigment-inhibiting powers that stop the tyrosine enzyme from producing any extra melanin. It's a great solution for managing hyperpigmentation without bleaching the skin. Use them overnight and always follow up with sunscreen the day after to avoid further hyperpigmentation.

• For stubborn hyperpigmentation, consider an Rx: Hydroquinone is a powerful prescription skin lightener that may make an effective spot-corrector for hyperpigmentation. However, when used improperly, it can cause further PIH. If you've tried tyrosinase inhibitors and the hyperpigmentation won't budge, consult a dermatologist for guidance on using this powerful ingredient and discussing other treatment options.
• In-office chemical peels and laser therapy only: Treating hyperpigmentation from home can be tricky. If over the counter facial acids aren't helping, don't try to do an irritating chemical peel or use a laser device; this may make the hyperpigmentation even worse. If you do want to seek further treatment, discuss your options with a dermatologist. Certain laser treatments have come a long way and are now used to treat hyperpigmentation on darker skin.
• Take a collagen supplement: Unlike the other topical products listed above, oral collagen supplements may be able to improve skin quality and reduce hyperpigmentation from the inside out. Collagen is a natural protein used in wound healing, which may help to regulate PIH. It can also be used after a chemical or laser treatment to prolong its effects and support healthy recovery. Additionally, collagen has been shown to help retain the skin's moisture. Unfortunately, collagen proteins are too large to penetrate the skin barrier, so collagen creams are useless. Instead, try adding a flavorless, additive-free collagen supplement to your morning coffee, to help protect your skin against the common signs of aging.

• Keep inflammation at bay: Inflammation is a contributor to many different illnesses and conditions. It also directly relates to skin conditions like psoriasis, eczema, and of course, PIH. While inflammation may not be avoided 100%, it can be regulated with anti-inflammatory medicines. Boswellia Serrata, an Ayurvedic inflammation supplement, has been shown to inhibit pro-inflammatory mediators in the body. Unlike other anti-inflammatories which can be hard on the stomach, Boswellia is considered safe for daily use. Because of this it may help to decrease inflammation in the skin, which can lead to further hyperpigmentation.

Article References:

1. https://skinofcolorsociety.org/dermatology-education/post-inflammatory-hyperpigmentation-pih/
2. https://www.aad.org/public/everyday-care/skin-care-secrets/routine/fade-dark-spots
3. https://www.everydayhealth.com/beauty-pictures/tricks-to-treat-hyperpigmentation.aspx
4. https://www.aad.org/news/skin-of-color