Hyperpigmentation is one of those annoying skincare concerns that seems to pop out from nowhere—it's as though you just wake up one morning and right there across your forehead, cheeks or chin is a smattering of brown-tinged patches that continue to taunt you every time you get even remotely close to a mirror.
But if you think you can just sit back, let your skin do its thing and soon your complexion will return to a blanket of uniform skin tone once more, get ready for a rude awakening: Hyperpigmentation treatment is going to take a little bit of effort. While some types of hyperpigmentation, like the sort that comes after you've popped a rather big spot, will slowly fade, this can still take months. And there are other types (like the kind produced by UV exposure) that will take a little coaxing for it ever to fade.
This topic is one that is definitely best discussed with an expert, and so we turned to Anita Sturnham, GP, dermatologist and founder of Nuriss Skincare & Wellness Clinics, for her advice on the best practice hyperpigmentation treatment. Keep scrolling for her very useful guide on the matter.
What is hyperpigmentation?
"Hyperpigmentation is a common skin condition that can affect all skin types and all ages," explains Sturnham. If you have it, you'll start to notice patches on the skin that don't seem to match your normal skin colour. It'll often show up as brown patches, not too dissimilar to large freckles. There are two classifications, Sturnham adds, "Localised or diffuse, meaning it appears in small patches on the skin or as a larger area of altered pigmentation."
What causes hyperpigmentation?
"Most causes of diffuse hyperpigmentation are caused by systemic conditions, such as autoimmune disease or metabolic disorders, such as B12 or folate deficiency," reveals Sturnham.
On the other hand, localised hyperpigmentation tends to represent a direct injury or inflammation to the skin and is the more common type seen in dermatology clinics. "Anything that causes inflammation in the skin can potentially send a signal to our melanocytes, the cells that produce brown melanin pigment as part of an immune response," she explains. "This inflammation can be caused by UV damage, acne spots and outbreaks, harsh chemicals on the skin and even hormonal fluctuations, such as those in pregnancy or when taking the contraceptive pill."
Are some people more susceptible to hyperpigmentation than others?
Unfortunately, the answer is yes.
"Melanocyte instability is the main reason we develop hyperpigmentation. These pigment-producing cells that live at the dermo-epidermal junction and basal layers of our skin can become hyperactive if triggered and start overproducing melanin, leading to hyperpigmentation and sun spots," Sturnham breaks it down for us. "The more baseline melanin you have in your skin (i.e., the darker your skin tone), the more risk you have of developing hyperpigmentation in the first place."
Can you avoid getting hyperpigmentation?
As with most skincare concerns, Sturnham concludes that prevention is better than cure. Her guide to defending your skin against hyperpigmentation is as follows:
"Firstly, wear a day cream with a minimum of SPF 30 daily (yes, even on those grey and drizzly days), increasing to Factor 50 in hotter climates, to help to prevent UV damage induced pigmentation—the main causative factor for hyperpigmentation."
Secondly, Sturnham suggests you avoid retinol during the day, as UV rays destabilise skincare ingredients and increase your risk of photosensitivity.
Her final step is to use skincare that includes pigment-stabilising ingredients, so they'll be less likely to overproduce melanin and leave you with pigment spots, whether the trigger is UV damage, hormones or outbreaks. "L-Ascorbic acid [also known as vitamin C] (20%) and Alpha Arbutin, derived from the bearberry plant, are excellent natural ingredients—look for these in your serums to use morning and night. These ingredients will also help to break down unwanted pigmentation, without bleaching the skin," Sturnham recommends.
Can you get rid of hyperpigmentation completely?
Yes, well, kind of. "Hyperpigmentation is multifactorial: There may be genetic, metabolic, hormonal and environmental factors, all acting as triggers," warns Sturnham, reminding us that there is no single therapy available that will completely cure hyperpigmentation. But with a more holistic, multitherapy approach, you can get great results. "Using a combination of at-home and in-clinic based procedures, we can generally achieve adequate reduction and even complete resolution in many patients," she promises.
That does come with a disclaimer, however: It's not going to be easy for all of us. "The most challenging treatments are those patients with post-inflammatory pigmentation and a darker skin type. There may be some residual pigmentation, but it is reduced to a level where self-confidence is restored," which does give us all some hope.
Okay, so how?
Our good old friend retinol can help here—when used only at night, of course. "A daily dose of vitamin A (retinol) 0.5% to 1% works well for most patients as it's a fabulous multi-tasker and in a good quality cosmeceutical formulation, it works to reduce cell damage, boost repair, regulate oil production, boost collagen formation and reduce pigmentation," Sturnham explains. "It has a melanocyte-stabilising and melanin-breakdown effect." Look for night cream or serum formulas that contain this magical ingredient (UV rays will destablise it) and ones that come in opaque packaging.
"It goes without saying that protection from melanocyte triggering UV damage is integral to the success of your treatment programme." SPF, we meet again. "Look for a combination of mineral and chemical blocking agents such as titanium dioxide and ethyl salicylate to provide adequate broad-spectrum protection."
Finally, look for skincare formulas that contain natural skin brighteners. Sturnham loves anything with sunflower (rich in B vitamins), niacin and pantothenic acid [commonly labelled at vitamin B5], which naturally brighten and improve skin tone.
What about in-clinic treatments?
For more advanced treatments and procedures, it's definitely worthwhile consulting a dermatologist at a clinic you trust so that they can prescribe the right course of treatment for your individual hyperpigmentation. But what Sturnham tends to see as the best course of action for many of her patients is the use of lasers.
"I find a combination of Clearlift Q-switch laser and AFT laser works well to break down pigmentation at the dermoepidermal junction and the older, more superficially lying pigmentation," she reveals. "In the case of melasma or PIH, topical treatment options may also include prescription-strength retinoids, azelaic acid and chemical peels."
But she also warns that this isn't going to be an overnight fix: "Reassurance and time are also essential elements of a successful treatment programme."
Anything else to note?
A final word of warning from Sturnham: "Don't use bleaching agents on your skin to try to lighten pigment. This can potentially worsen pigmentation and lead to scarring."