Your ultimate guide to skin hyperpigmentation – Introduction, causes and treatment


What is Hyperpigmentation?

Hyperpigmentation, also known as dyschromia, is the presence of abnormal dark spots on the skin which is a result of excessive melanin production. It can present in the form of freckles, age spots, sun spots, liver spots or pregnancy mask.

When melanin is produced in excess it gets deposited in the skin leading to the development of darker patches of skin. Common parts of skin which are frequently involved are hands, arms, and face.

What are the causes of Skin Hyperpigmentation?

The causes of skin hyperpigmentation are as follows:

  • Hormonal imbalance, or changes
  • Exposure to sun
  • Acne
  • Complications of improper skin care treatments
  • Hereditary causes

Based upon the causative factors hyperpigmentation can be classified as follows:

  • Post-inflammatory hyperpigmentation (PIH): As the name suggests the hyperpigmentation in these cases occurs as a result of inflammation. Hyperpigmentation caused by psoriasis, acne, burns, and complications from skin care treatments are classified as PIH.
  • Melasma: Melasma is the hyperpigmentation resulted from hormonal changes, especially during pregnancy. Other melasma causes are thyroid dysfunction, hormonal therapy, or side-effect of oral contraceptive pills (OCP). This type of hyperpigmentation is the most difficult to treat.
  • Lentigines: This type of hyperpigmentation is also called as age spots or liver spots. These are as common as up to 90% of the population above 60 years of age. Lentigines are caused by exposure from the UV rays.

What should I do if I have skin hyperpigmentation?

See a Dermatologist

It’s important to visit a dermatologist so that he/she can take a proper look at the problem, diagnose the real cause behind the hyperpigmentation, classify its type and prescribe appropriate management regime.

The dermatologist would ask you several questions based upon your medical and lifestyle history. A skin examination with magnifying glass should be expected. Your dermatologist may ask some or all of the following things:

  • Frequency of using tanning bed
  • Frequency of using sunscreen
  • Level of sun exposure
  • Current or past medical history
  • History of current pregnancy, use of oral contraceptive pills or hormone replacement therapy, if any of them is applicable
  • History of medications taken recently
  • History of professional skin treatments or cosmetic surgery
  • History of wearing UV protection or sunscreen in past

Get the prescription for topical medication

Many topical medications are available that contains retinoids or alpha-hydroxy acids (AHAs) which can exfoliate and rejuvenate your skin. These are useful in all kinds of hypeigmentations. Available topical medications are as follows:

  • Hydroquinone: It’s the most common topical medication used for hyperpigmentation. In fact, it’s the sole skin lightening cure which is approved by FDA.
  • Kojic Acid: It has a similar action to hydroquinone. It is extracted from a few fungi like Aspergillus oryzae (common name in Japanese is koji).
  • Mandelic Acid: It is derived from almonds and can be used for all kinds of hyperpigmentation.
  • Azelaic acid: Azelaic acid was developed for treating acne, though it is equally effective in treating hyperpigmentation too.

Go for a professional non-ablative procedure

Sometimes topical medications might not give required results, in which case your dermatologist may recommend a non-ablative procedure. Various available options are:

  • Intense Pulsed Light (IPL) therapy: IPL therapy targets only selective hyperpigmented spots. The procedure is done under strict supervision of a qualified physician.
  • Skin peels like salicylic acid peels
  • Laser skin resurfacing.



Get a microdermabrasion treatment from a salon

This procedure is quite popular among the people having hyperpigmentation. Make sure you find an expert in the procedure since if not done appropriately it can cause irritation and make the pigmentation worse. Also, it cannot be done too frequently as the skin requires sufficient time to heal between the two sittings.

Make use of over-the-counter medications

If you do not want to get a prescription for whatever reason, there are a few over-the-counter medications available too.

  • Skin lightening creams: These creams act by reducing the melanin production rate and eliminating the pigment from your skin. Effective skin lightening creams would contain one or more of the following components—hydroquinone, kojic acid, cucumber, soy milk, calcium, arbutin or azelaic acid. (Skin lightening creams on amazon)
  • Topical medication containing alpha-hydroxy acids or Retin – A

Home remedies

There are several home remedies for hyperpigmentation which are effective and easy to use. Some examples are:

  • Rose hip oil
  • Lemon juice
  • Cucumber juice, slices or puree
  • Aloe Vera

Minimize the UV rays exposure

Most common cause of hyperpigmentation is the exposure to UV rays. Although, limiting the UV rays exposure wouldn’t rid you of the hyperpigmentation already present, it would help you prevent further hyperpigmentation.

  • You must make sure to wear a sunscreen at all times when going in the sun. When expecting a direct exposure and strong sun, complement sunscreen with wearing hats and long sleeves. (Sunscreens on amazon)
  • Avoid the tanning beds
  • Reduce your outdoor time and avoid sunbathe

Reconsider the medications

Although, in most cases you might not be able to avoid taking a particular medication simply to prevent hyperpigmentation. Medications like oral contraceptive pills, and other drugs containing hormones cause hyperpigmentation. If you cannot stop the medication, you may consult your doctor for switching to a different option.

Take precautions before opting for a professional skin treatment

Hyperpigmentation can also occur as a complication of various professional skin treatments and cosmetic surgeries. It mainly because of the skin irritation and trauma that leads to hyperpigmentation. Make sure you’ve researched well before going for the procedure. Don’t forget to ask for the precautions you need to take before going for the treatment. Also, be sure that you’ve chosen a highly experienced professional or doctor for the procedure.

Be wary of professional skin treatments

Hyperpigmentation can result from trauma to the skin, which can be caused by plastic surgery and other professional skin treatments. Be sure to do thorough research before opting to get plastic surgery. Make sure your doctor or practitioner is highly experienced.