Sunspots, age spots, dark spots … call them what you will, those unsightly blotches on our skin are sure to dent the confidence of even the most self-evolved among us. And even though they may not necessarily mean anything more serious than too many sun-soaked hours by the pool, we should be aware of potential warning signs.
Dr Nomphelo Gantsho, a Cape Town-based dermatologist and executive committee member of the South African Society for Dermatological Surgery (SASDS), talks us through the main causes of (and treatment options for) hyperpigmentation.
What is hyperpigmentation?
Often known as uneven skin pigmentation, hyperpigmentation is a common skin complaint. It occurs when our pigment cells (i.e. melanocytes) overproduce melanin in certain spots on the skin.
What causes uneven skin tone?
There are several causes of hyperpigmentation, the main one being sun exposure. The sun triggers the production of melanin but factors like hormonal fluctuations, inflammation of the skin and certain diseases could also play a role.
Common causes of hyperpigmentation include:
1. Post-inflammatory hyperpigmentation (PIH)
Due to trauma or inflammation on the skin, discolouration can remain behind when skin heals. One of the most common causes of PIH is acne. Skin inflammation can also be caused by irritation from certain skincare products.
2. Solar lentigines or sunspots
These emerge from chronic sun exposure, and usually present as small, round spots in a brownish colour visible on sun-exposed areas.
3. Melasma: often referred to as ‘mask of pregnancy’
Triggered by hormonal factors, including pregnancy and the oral contraceptive pill, melasma appears mainly on the face as brown or greyish irregular patches. Hormones stimulate overproduction of melanin when skin is exposed to the sun.
4. Certain medications
Hyperpigmentation is also a side effect of certain hormone treatments, such as chemotherapy drugs, antibiotics, antimalarials and anti-seizure drugs.
5. Diseases or disorders
Addison’s disease can affect the skin and cause hyperpigmentation. Addison's is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. These include cortisol and / or aldosterone.
What can be done about hyperpigmentation?
Anyone who has hyperpigmentation should make a real effort to understand the root cause of the problem in order to select the best treatment. If the damage to the skin is severe, treatment for hyperpigmentation can be challenging and can take a long time. If, after trying topical treatments, you don't notice any improvement, it is advisable to seek specialist help to identify the cause and treat the hyperpigmentation accordingly.
However, it’s encouraging to know that, for most mild cases of hyperpigmentation, there are treatments that can decrease the hyperpigmentation over time. Some of the available treatments include:
• Creams to even out skin tone
• Retinoids
• Chemical peels
• Microneedling
• Laser
Be careful of supposed miracle quick fixes, as these may actually do more harm than good. Make sure any products you use are from a credible brand with proven safety and efficacy, and that they are formulated specifically to your skin's unique needs. Remember that, as with most things, early intervention is key to treating all types of pigmentation.
Look out for the following active ingredients in your products:
• Melanyde: Slows down the production of melanin (pigment)
• Retinaldehyde: Help remove excess melanin in the skin
• Pre-tocopheryl: Prevent melanocytes from being damaged (antioxidant)
Look after your skin properly
Add a good-quality sunscreen to your daily skincare routine – and never skip it! Sun exposure is the number one cause of hyperpigmentation as it’s sunlight that triggers the production of melanin in the first place. Melanin acts as your skin’s natural sunscreen by protecting you from harmful UV rays but excessive sun exposure can disrupt this process, leading to hyperpigmentation.
Once dark spots have developed, sun exposure can also exacerbate dark spots by making freckles, age spots, melasma and post-inflammatory hyperpigmentation spots even darker.
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