- Hyperpigmentation is the formation of dark patches on the skin.
- The form of treatment for hyperpigmentation depends on the nature of the scar.
- One may require persistent efforts to tackle hyperpigmentation.
- Tips to keep hyperpigmentation at bay – Cosmeceuticals, Exfoliation, Moisturizing, Hi-Tech treatments.
Hyperpigmentation is a medical term that describes the formation of dark patches on the skin. Dark spots occur as a result of excess production of the brown pigment in our skin called melanin. Melanin is responsible for giving our skin, eyes, and hair their natural color. The American Academy of Dermatology states that hyperpigmentation can result on account of various factors that trigger increased melanin production like inflammation or trauma to the skin (acne, bug bites, waxing, cuts, scratching, etc.), sun exposure, melasma, certain medical conditions like Addison's disease (an adrenal gland disorder that augments melanin production), drugs and antibiotics.
The time taken for the dark spots to fade away varies from one person to another. How one should deal with these dark spots depends on the type of mark or scarring left behind. According to Dr. Eliot Battle, a globally renowned dermatologist and CEO and co-founder of Cultura Dermatology and Laser Center, hyperpigmentation issues can be predominantly divided into two main categories, depending on the scar:
- Is the wound or scar less than four months old? If yes, then it is superficial.
- Is the wound/scar more than four months old? If yes, then it is a deep one that has reached the second layer, namely the dermis.
Dr. Battle states that dealing with hyperpigmentation requires persistent efforts over several months to see results. The form of treatment needed for hyperpigmentation depends on whether the scar is superficial or deep. Deeper scars may require more potent prescription ointments and clinical therapies. Also, one must keep up with regular treatments to prevent a recurrence. In fact, the best approach, according to Dr. Battle, would be that of a 'hands-off approach' - meaning: do not over treat the dark spots, instead apply fewer products and at fewer intervals. Excessive use of skincare products can increase the trauma to the skin and, therefore, aggravate the dark spots as well.
How to Keep Hyperpigmentation at Bay?
#1. Prevention is the First Step - Consider Moisturizing Agents
The smart option would be to use over-the-counter (OTC) products that not only enhance its appearance but also moisturizes the skin and prevents sun damage, and thereby hyperpigmentation. Products that contain glycerin and hyaluronic acid help to moisturize the skin. One may also consider a product with retinol that enhances cell turnover.
According to Doris Day, MD, Professor of Dermatology at NYU Medical School in New York, a good moisturizer will help to restore the lipid barrier of the skin, further protecting it from the damaging rays of the sun.
#2. Consider Cosmeceuticals
Cosmeceuticals basically are cosmetic-pharmaceutical hybrids that not only enhance beauty but also provide health benefits.
Though they are considered as cosmetics, they also contain various ingredients that enhance the biological function of the skin. Cosmeceuticals are commonly used in treating hyperpigmentation. The commonly used cosmeceuticals for treating hyperpigmentation include Vitamin C, Hydroquinone, Kojic Acid, Azelaic Acid.
Hydroquinone remains the most popular cosmeceutical for treating hyperpigmentation as it inhibits melanin synthesis.
It is commonly used in concentrations varying between 2% to 4%. However, it should be used with caution based on a dermatologist's advice as it augments sensitivity to the sun and applying too much on the skin can cause irritation.
Vitamin C is a common ingredient in many cosmeceuticals and topical creams. Vitamin C works by inhibiting the enzyme tyrosinase. Tyrosinase catalyzes the production of melanin. By inhibiting tyrosinase, vitamin C helps to minimize melanin production. Also, Vitamin C helps to lighten the hyperpigmentation but does not affect the normal skin.
Cosmeceuticals with licorice root and kojic acid are other good options. Glabridin, which is the main component of licorice root extract, offers both melanogenesis inhibition and anti-inflammatory properties.  Kojic acid (KA) is a natural metabolite that is produced by a fungus. It is derived from fermented rice or mushrooms.
KA can effectively inhibit the activity of tyrosinase, plus it also acts as an ultraviolet (UV) safeguarding agent and helps to suppress hyperpigmentation. Kojic acid normally appears in concentrations between 1% and 4% in most cosmetics. 
Azelaic acid is a lesser-known natural ingredient which is obtained from wheat, oat, or rye. Azelaic acid helps to clear various acne scars.
#3. Try Exfoliation
When you talk about exfoliation, there are two ways viz. mechanical and chemical. Mechanical exfoliation uses various manual scrubs. However, when it comes to hyperpigmentation, one has to be careful as too much scrubbing can cause abrasion and increase the dark spots.
Chemical exfoliants perform the task by dissolving the dead skin cells. There are various chemical exfoliants that are basically Beta Hydroxy Acid (BHA) and Alpha Hydroxy Acid (AHA) cleansers, like glycolic acids, lactic acids, benzoyl peroxide, salicylic acid, etc. One has to choose the type that works best for one’s skin.
#4. Consider Prescription Medications
If OTC treatments aren't helping, then it’s time to consider prescription medications. Dermatologists may suggest prescription-strength hydroquinone or retinol that penetrate deeply into the skin and interfere with pigment production.
#5. Check with an Expert for the Latest Technological Options
When pigmentation occurs in the secondary layer of the skin, you might want to consider more robust options. Some aggressive hi-tech treatment options include laser treatments, chemical peels, microdermabrasion, microneedling, etc. However, those with melasma must be cautious as certain techniques like lasers, and chemical peels can worsen your hyperpigmentation.
What Type of Treatments Work Best for Various Skin Tones?
Skin tone is an essential factor that decides the duration and intensity of any hyperpigmentation treatment. According to Cynthia Cindy Cobb, a nurse practitioner specializing in women's health, dermatology, and aesthetics, individuals with fair medium and dark skin tone can use similar therapies. In contrast, those with dark skin tone may require more time for the treatment to work. While fair skin can respond to most hyperpigmentation procedures, those who tend to tan easily may not do good with high-intensity lasers and Intense Pulse Light (IPL) therapy. Medium skin tones can do well with chemical peels and microdermabrasion. Those with dark tones may find OTC skin lightening creams, cosmeceuticals with kojic or glycolic acid, low-strength chemical peels, and multiple low-intensity laser sessions useful.
Topical treatments may take time to work, and hence one must be patient enough to see the results. Stronger professional peels and in-office procedures can be tried out but may have side effects. So they should be taken only after consulting a skincare professional. There is no one-size-fits-all approach as regards to skin resurfacing. So talk to your dermatologist as he/she can identify the cause for hyperpigmentation and work out an appropriate treatment plan for you.
At the end of the day, no matter what treatment option you choose, do not forget to dab that sunscreen to safeguard your skin from sun damage and hyperpigmentation.