Our skin cells contain melanocyte cells, a cell that produces melanin, a chemical that gives skin its color. Too much melanin leads to hyper pigmented skin – including freckles, darkening of the skin in patches, and age spots. Hyper pigmentation can occur from over sun exposure, trauma to the skin (i.e. laser treatments, peels, etc.) or as a side effect of certain drugs. While hyperpigmentation is not a serious medical condition, it is one of the most common skin conditions and arguably the most difficult to treat and correct.
We enlisted the expertise of Dr. Goldfaden to help us understand how hyper pigmentation occurs, what we can do to prevent it and the best and most effective treatments, both in-office and at-home.
Q: What exactly is hyper pigmentation? “Hyperpigmentation is defined as any spot on your skin that’s dark enough to effectively stand out against the surrounding area. This phenomenon is usually the result of your skin’s efforts to protect itself from the harmful effects of ultraviolet light. It occurs when overexposure to sunlight causes the melanocytes in the deeper layers of your skin to produce cells that contain a skin-darkening pigment called melanin. These specialized cells known as melanosomes are picked up by your keratinocytes that are constantly migrating upwards toward your skin surface.” Dr. Gary Goldfaden MD
Q: What are the different types of hyperpigmentation one can develop? “Age spots or sun spots (sun damage), melasma, scarring, post-inflammatory hyper pigmentation.” Dr. Gary Goldfaden MD
Q: What is post-inflammatory hyper pigmentation? “Post-inflammatory hyperpigmentation is usually temporary and can be caused by inflammatory acne, a severe burn or injury to the skin. While anyone can suffer from this, it is more common in dark skin types.” Dr. Gary Goldfaden MD
Q: What is the difference between acne scars and hyperpigmentation? “This can be very difficult to differentiate. Acne scars can appear dark and be Post-inflammatory hyperpigmentation, which should go away (as it is temporary). However, if exposed to the sun then this may become long-term hyperpigmentation. General rule of thumb, if the acne mark or lesion is still visible after 6-12 months then it is considered a scar.” Dr. Gary Goldfaden MD
Q: What is the difference between hyperpigmentation, sun spots and freckles? “All fall under the umbrella of Hyperpigmentation. Sun exposure has a lot to do with the darkness and severity. If you have freckles and have sun exposure the melanin will be activated and the freckle will be darker.” Dr. Gary Goldfaden MD
Q: What causes hyper pigmentation? “Hyperpigmentation occurs when overexposure to sunlight causes the melanocytes in the deeper layers of your skin to produce cells that contain a skin-darkening pigment called melanin. These specialized cells known as melanosomes are picked up by your keratinocytes that are constantly migrating upwards toward your skin surface and cause the dark spots/areas. Hormones, birth control pills can also cause this and sunlight can increase the severity.” Dr. Gary Goldfaden MD
Q: Is anyone more prone to hyperpigmentation, such as different races or skin tones? “Darker skin types are more prone. All skin generally has the same amount of melanosomes , the difference in lighter skin and darker skin is the size. Darker skin has larger melanosomes(what contains/distributes the melanin) hence more susceptible to hyperpigmentation.” Dr. Gary Goldfaden MD
Q: Is it preventable? If so, how? “Wearing an SPF at all times when exposed to the sun. Exfoliation can help the appearance as it removes dead, dry, dark skin cells fort he surface of the skin. Using proper actives to protect against sun damage and treat sun damage and dark spots. In office micro-dermabrasion treatments and laser treatments.” Dr. Gary Goldfaden MD
Q: Can it ever be reversed completely? “Yes, but it is very difficult and takes a lot of diligence. Even laser treatments are not 100% successful and the dark spot can come back.” Dr. Gary Goldfaden MD
Q: What’s the best way to treat any existing spots? “SPF at all times, sun protective gear (hat, glasses, clothing), Exfoliation, and an active treatment serum.” Dr. Gary Goldfaden MD
Q: What are the best in-office treatments one can receive? “Fraxel laser and Clear and Brilliant are two of the popular and introductory laser treatments that work to combat uneven skin tone, including discoloration. Micro-Dermabrasion is also very popular choice. In office chemical peels can be very effective as well. Glycolic and lactic acid peels are recommended for at-home maintenance usage.” Dr. Gary Goldfaden MD
Q: What are 3 ingredients people with hyperpigmentation should look for in daily skincare products? “Vitamin C, GlycolicAcid/Lactic, Alpha Arbutin, and Kojic Acid.” Dr. Gary Goldfaden MD