HYPERPIGMENTATION (Continued)

There are different types of epidermal hyperpigmentation

Although all hyperpigmentation is a result of excess melanin, different names are used to describe it based on the cause of the excess melanin production and its appearance on the skin.

Melasma is skin coloration that appears as blotchy brown spots often occurring on the cheeks, forehead, or temples. The condition is usually associated with hormonal changes. Pregnancy, for example, can trigger overproduction of melanin, causing the mask of pregnancy on the face and the darkening of skin on the abdomen and other areas. This facial hyperpigmentation sometimes occurs with menopause too. Women who take birth control pills also may develop this type of hyperpigmentation because their bodies undergo the same kind of hormonal changes that occur during pregnancy. Another name for melasma is chloasma.

Age spots or liver spots are small darkened patches on the skin of older adults who have been regularly exposed to the sun over many years. Usually the face and the backs of the hands are most affected by these spots, which may have a somewhat depressed surface. Solar lentigines is a medical name for this naturally occurring condition. It is usually light-complexioned people with a tendency to burn, rather than tan, who develop age spots in later years.

Freckles are small, flat, tan to brown spots that can be anywhere on the body. Often a hereditary characteristic, freckles can darken with sun exposure and fade when there is little exposure to sunlight.

Postinflammatory hyperpigmentation may occur following any process that causes skin inflammation. For example, skin diseases such as acne or shingles may leave darkened spots after the condition clears up. Scars from skin injury or surgery may also become hyperpigmented.

Cosmetic procedures, such as chemical peels and dermabrasion, may also leave the affected area darker than the normal skin color.

To avoid hyperpigmentation, avoid the sun.

Hyperpigmented skin patches may become more pronounced when skin is exposed to the sun. This happens because the skin's pigment, melanin, absorbs the energy of the sun's harmful ultraviolet rays in order to protect the skin from overexposure. Skin tanning occurs as a result of this process, causing hyperpigmented areas to become even darker.

Minimizing your exposure to sunlight can help prevent further darkening of existing hyperpigmented patches, as well as the formation of new ones. This is especially important for women who take birth control pills or hormone supplements and for people who have had hyperpigmentation in the past. To protect your skin, dermatologists recommend the use of a sunscreen product with an SPF (sun protection factor) of at least 15 that protects against both UVA and UVB light. A sunscreen should be used year-round on areas of skin that are regularly exposed to sunlight, such as the face and hands. Many skin moisturizers and cosmetics contain sunscreens, providing an easy way to make sure your skin is protected. Wearing long-sleeved clothing, long pants, and hats can also block the effects of sunlight exposure.

How is hyperpigmentation treated?

To help patients with hyperpigmentation achieve a more even skin tone, physicians may prescribe the use of skin bleaching products. Skin bleaches slow the production of melanin, causing dark spots to gradually fade and return to normal skin color. These skin medications must be applied regularly, usually twice a day, to be effective. The skin lightening process may take several months to achieve the desired results.

The active ingredient in skin lightening products is called hydroquinone. The maximum prescription strength is 4% hydroquinone, which contains twice the amount of active ingredient as over-the-counter skin bleaches. Some hydroquinone may also be combined with glycolic acid for its skin moisturizing benefits.