Hyperpigmentation: Causes, how to get rid of it – La Roche-Posay

What is hyperpigmentation?

Hyperpigmentation, or uneven skin pigmentation is a common condition. It shows up as dark spots or patches on areas of the skin that are most often exposed to the sun, like the face and hands. In this article, we talk about the different types of hyperpigmentation and what causes them. We also take a look at how you can help prevent hyperpigmentation and how to reduce dark spots.
Before we get into the details of hyperpigmentation, let’s talk about pigmentation, or skin color. The color of normal skin is influenced by several factors including vascularity (volume of blood vessels); the distribution of melanin and carotene (natural pigments); and the thickness of the skin. We’re about to talk some serious skin science.
Melanin is the main component of skin color, blended with other skin “chromophores,” or light-absorbing elements. It is produced by cells called melanocytes, which are found on the basal epidermal layer of the skin, at the dermo-epidermic level. This melanogenesis, or melanin production, takes place in melanosomes. With time, the keratinocytes (cells that produce keratin) and melanosomes migrate to the surface of the skin and are shed. The melanin synthesis within melanosomes and their transfer to neighboring keratinocytes determines skin pigmentation or color. The type, number, size and distribution of melanin are controlled by genetics and influenced by environmental factors, especially ultraviolet light.

Still with us? Now that we’ve tackled the basics of skin pigmentation, we’re ready to explore hyperpigmentation.

Hyperpigmentation is the development of an area of skin which is darker than surrounding skin. This is caused by the excess volume and uneven distribution of melanin, which, as mentioned above, is the natural pigment that gives the skin its color. A build-up of melanin can result in the development of colored marks on the skin's surface. In this way, hyperpigmentation is a form of "scarring" resulting from melanocyte hyperactivity. It is symptomatic of inflammation, which may be caused by the effects of UV rays, or by interaction between UV rays and a chemical substance in the skin (like hormones in the case of melasma, or a medication for drug-induced pigmentation, etc.), or direct inflammation (in the case of post-inflammatory acne scars, for examples). Hyperpigmentation affects many people and can develop due to various causes, making it widespread and universal. It remains, however, deeply individual.
L'Oréal has been studying the subject of pigmentation for over 20 years in its laboratories. As early as 1996, the first work consisted in developing a model of pigmented reconstructed skin in vitro to gain knowledge on the mechanisms of pigmentation induction. Our laboratories were the first to develop this type of model and to show that it was possible in vitro not only to obtain skins of different colors depending on the origin of the melanocyte donor, but also that these models could react to stimuli such as UV light by generating hyperpigmentation. 
Over the past 20 years, numerous studies have been carried out in vitro and then in vivo on humans to assess the efficacy of different active ingredients: over 121 clinical studies have been carried out in 20 years in 13 countries/5 continents, involving more than 12,000 participants. Finally, in a recent study using AI, our researchers characterized skin ageing in over 600,000 women of European and Asian origin, showing differences between these 2 populations in the appearance of hyperpigmentation with age. L'Oréal laboratories therefore have a long and solid expertise in skin pigmentation in all its diversity.

Signs of an uneven complexion- Nascent dark spots
Dark spots originate from and in melanocytes, the pigment-producing cells in the basal layer of the epidermis. These cells react to stimuli (like exposure to UV rays) by producing too much melanin. These excess melanin deposits gradually begin to rise up within the epidermis changing uniformity of the skin, but remain invisible until they reach the skin’s surface.

Loss of skin uniformity - Established dark spots
Deposits of excess melanin reach the upper epidermal layers. The dark spots become established on the surface of the skin and are thus visible.

Long-term alteration of the skin's uniformity - Recurrent dark spots
It is possible to reduce dark spots at the epidermal surface. However, the melanocytes responsible for their appearance remain overactive. As a result, these spots will reappear and once again impact the quality of the complexion.

What causes hyperpigmentation?

There are numerous causes for the appearance of dark spots on the skin, and several factors can be considered responsible for their appearance. Generally speaking, pigmentary changes may have genetic causes, or they may be acquired. Specifically, they may also be medication-related, or otherwise related to an aesthetic procedure, like a chemical peel for example. Other pigmentary disorders may be transmitted through infection. When it comes to hyperpigmentation, we’ll discuss the three main causes: sun exposure, inflammation, ageing and hormones.

Sun spots or sun lentigos form due to direct, prolonged exposure to UV (ultraviolet) rays. Exposure to UV rays and to pollution may cause inflammation of the skin, both in the form of sunburn, and in the overproduction of free radicals in skin cells. In turn, this triggers a chronic inflammation process, speeding up the production of melanin, which over time, may cause the appearance of sun spots.

Common from the age of forty onwards, so-called age spots are caused by oxidative stress and changes in the metabolism of the skin cells like melanocytes, in the basal epidermal layer. Melanocytes represent less than 1% of our epidermal cells and are more numerous on the face than on other parts of the body. Their number diminishes with age: We lose 10% of these cells every 10 years (Whiteman et al., 1999)

Contraceptive pills and certain medications which affect the body's hormonal balance can also cause dark spots to form, especially after prolonged sun exposure. Hormone activity and hormonal changes can lead to the appearance of what’s known as “pregnancy mask,” which affects certain pregnant women, before and/or after the birth.

Hyperpigmentation may also be symptomatic of different health conditions or medical treatments. For example, certain autoimmune or gastrointestinal diseases as well as medications like chemotherapy drugs or antibiotics may cause the appearance of dark spots.

Types of hyperpigmentation

With their various causes, dark spots can show up on the skin a number of different ways. We’ll explore three of the most common forms of hyperpigmentation.

ACTINIC LENTIGO

Another condition that results in dark spots is Actinic Lentigo or Solar lentigo, which results from exposure to UV rays. Solar lentigos are very common, especially in people over the age of 40, and they are also known as “old age spots” or “senile freckles.” Solar lentigo dark spots are flat and may be round, oval or irregularly shaped. Their color and size may vary. Often appearing in groups, these dark spots are generally seen on the parts of the skin most often exposed to the sun: like the face or the back of hands. Commonly more numerous in fair-skinned individuals, they do occur on skin of varying complexions.

POST INFLAMMATORY HYPERPIGMENTATION

The third main category of dark spots results from Post Inflammatory Hyperpigmentation, or PIH. These spots appear in men and women of all ages, but more frequently in young adults, and the spots can last for many years. PIH appears after what is known after “cutaneous injury,” or damage to the skin. This may result from acne, infections, insect stings, burns, shaving bumps or other injuries. Procedures like laser, peeling, dermabrasion, and surgery can also damage the skin leading to the appearance of these dark spots. Certain drugs and inflammatory disorders may also be a cause. Dark spots related to PIH are particularly common in darker complexions and PIH has been reported to be the second most important dermatological diagnosis in the African-American population (Alexis, Sergay, & Taylor, 2007).

MELASMA

Melasma or chloasma is a form of light or dark-brown hyperpigmentation that is common in women, especially during and after pregnancy. It normally appears as large dark patches on the face although other parts of the body, especially those that are exposed to the sun, can also be affected. Melasma-affected skin has a high quantity of melanin throughout the epidermal and dermal layers. Up to 1/3 of women are at risk from melasma. And among people with darker complexions, women are 9x more at risk.

Like other kinds of dark spots, melasma may have several causes. Excess or accumulated sun exposure is one potential cause. Melasma’s dark spots may also be caused by genetic factors. Pregnancy, too, may be a factor, which is why melasma is sometimes referred to as pregnancy mask. Treatment with estrogen or oral contraceptives, which impact one’s hormones, represent another potential cause. Thyroid dysfunction may also be related to melasma, though the link between the two is not entirely clear. Photosensitizing drugs, which make one’s skin more sensitive to light, can also affect melanin production and the appearance of these kinds of spots.

How to get rid of hyperpigmentation?

Hyperpigmentation, whether resulting from melasma, solar lentigo, or PIH are very common skin conditions and they can have a huge impact on a person’s quality of life and their self-confidence. Every individual will have a completely different, personal experience. Patients with pigmentary disorders often deal with a high frequency of psychological disturbances, including anxiety and depression. Depression has been observed in 13% of people living with melasma patients; these individuals also report feelings of frustration stemming from their melasma-related dark spots. Many seek guidance or treatment when it comes to their dark spots.

The first and most important step of the treatment approach is to determine the cause of the hyperpigmentation. This requires a detailed history as well as any clinical findings. It is often helpful to consult with a dermatologist. They can help determine if the concern is more cosmetic, or medical, and how to select the best treatment. Depending on the causes, depigmentation of the lesions can be achieved by interfering at different biological stages or processes.

After years of dedicated research La Roche-Posay has developed a new re-unifying skincare routine that can help remove dark spots. Formulated by dermatological experts La Roche-Posay’s MELAB3 Serum, contains the new active ingredient when it comes to correcting hyperpigmentation and eliminating dark spots: Melasyl. Thanks to this multi-patented ingredient developed through 18 years of research, MELAB3 Serum is stronger solution for dark spots, bringing visible results in just one week. While other skincare products on the market which block melanin production, this serum intercepts the excess melanin before it marks the skin. MELAB3’s groundbreaking intensive care formula includes 10% Niacinamide (a form of Vitamin B3), another key ingredient, which helps build keratin to help maintain skin health. MELAB3 Serum leaves the skin even and radiant.

How can I prevent hyperpigmentation?

When it comes to preventing dark spots, the first piece of general advice is to limit sun exposure. There are different types of UV rays – UVB rays are stronger in the summer and reach the surface of the skin, while UVA rays are longer, reaching the dermis and creating oxidative stress in the cells. Most protective creams have a certain SPF (Sun Protection Factor) that protects against UVB rays. Some sunscreens have UVA protection as well, and indicate PPD (Persistent Pigment Darkening), which is a specific method of measuring UVA protection.

Avoiding the sun between the brightest, hottest hours of the day, and reducing time outdoors during those hours is helpful (though remember that UV can reach us even through windows). Applying a broad-spectrum sunscreen with at least 30 SPF is recommended, and it should be applied before going outdoors, and reapplied every two hours (or more often if you’re sweating or going swimming). La Roche-Posay’s ANTHELIOS UVMUNE 400 INVISIBLE FLUID SPF50+ SUN CREAM FOR SENSITIVE SKIN provides very high broad spectrum protection (PPD 46, SPF 50+) in a comfortable fluid formula that is ultra-resistant to water, sweat and sand. Covering up with clothing or a hat can help protect your skin as well.

La Roche-Posay’s MELAB3 SPF 30 Skin Corrector helps protect the skin from harmful UV rays, while also intercepting excess melanin before it forms dark spots. This corrective, protective formula harness both Melasyl and 5% Niacinamide to correct even persistent dark spots, and to prevent new spots from appearing. Used as part of a daily skincare routine with the MELAB3 Serum, La Roche-Posay’s MELA B3 SPF 30 ANTI-DARK SPOTS CORRECTIVE PROTECTIVE CARE  doubles your dose of Melasyl. Its velvety, non-sticky texture make it perfect for daily use on the face, hands and neck, and it absorbs easily into all types of skin. La Roche-Posay’s MELAB3 Clarifying Micro-Peeling Gel can be used to cleanse, removing impurities without irritation. Clinically proven on all skin tones, it purifies skin from your very first use, making it look more radiant.

Treating the root cause of dark spots can also help prevent their appearance. When it comes to PIH-related spots, for example, correcting the underlying cause, like acne, eczema, or psoriasis, can help prevent them. It’s also essential to look for the right skincare products with the right ingredients to help prevent the appearance of dark spots. The main ingredient that should be avoided for the treatment of hyperpigmentation is mercury. While this ingredient is used in some skincare products outside of the United States, it is dangerous and can have serious repercussions on health. Ingredients to look for are: retinol or alpha hydroxy acid, kojic acid, Vitamin C, azelaic acid, and glycolic acid.

Hyperpigmentation myths to debunk

There’s a lot of information out there when it comes to hyperpigmentation. We’ve consulted with our experts to answer the most common questions and to address the most common misconceptions surrounding hyperpigmentation.

Does retinol help with hyperpigmentation?
Yes. Retinol helps with the appearance of hyperpigmentation by helping to boost cell turnover, stimulate collagen production and prevent excess melanin production.

How long does hyperpigmentation last? Is it permanent?
Depending on the cause of a specific case of hyperpigmentation, fading may take some time. For a spot that is a few shades darker than your natural complexion, it may take 6 – 12 months for it to fade. For a darker spot arising from deeper within the skin, the coloration may take years to fade. Finding and applying the right care can accelerate the fading process, and results may be apparent within a month. Rich in Melasyl and Niacinamide, MELAB3 Serum is a fast, strong solution for dark spots, bringing visible results in one week.

Does hyperpigmentation get darker before it fades?
Some spots can look darker before they fade. This happens because they slowly reach the surface as you apply your treatment or exfoliate.

Does sunscreen help with hyperpigmentation?
Yes. Limiting sun exposure and applying a broad-spectrum sunscreen with at least 30 SPF associated with UVA protection is an important factor in preventing hyperpigmentation.

Conclusion

Hyperpigmentation affects so many people around the world. Each and every person living with a form of hyperpigmentation has an individual, unique experience. While dark spots are harmless, they can impact mental health or self-esteem. For those who wish lighten their dark spots, or prevent their appearance, it’s important to protect against UV rays and to set up an appropriate skincare routine.

Explore La Roche Posay’s groundbreaking Melasyl-based skincare products now.