Hyperpigmentation

Hyperpigmentation is a common, harmless condition without additional symptoms, however, it can cause psychological and emotional distress which negatively impact on a person’s quality of life.

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Hyperpigmentation refers to a common dermatological condition characterised by patches of skin that become darker in colour than the surrounding area due to excess production of melanin, the pigment responsible for skin coloration. This condition can result from various factors such as sun exposure, hormonal changes, inflammation, or skin injuries.

SYMPTOMS AND SIGNS:

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Skin Discoloration: Hyperpigmentation presents as areas of the skin that appear darker than the surrounding skin.

Patchy Appearance: The affected areas may vary in size and shape, ranging from small spots to larger patches.

Common Sites: Hyperpigmentation commonly occurs on areas exposed to the sun, such as the face, hands, arms, and shoulders.

Potential Symptoms: Depending on the underlying cause, hyperpigmentation may be accompanied by other symptoms such as itching, inflammation, or pain.

MELANIN IS UNEVENLY DISTRIBUTED DUE TO DIFFERENT TRIGGER FACTORS

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Melanin, the pigment responsible for skin coloration, can be unevenly distributed due to various trigger factors, leading to hyperpigmentation.

Hormonal Changes: Hormonal fluctuations, particularly during pregnancy (melasma) or hormonal contraceptive use, can trigger melanocyte activity and melanin production⁴.

Inflammation: Skin inflammation resulting from conditions such as acne, eczema, or psoriasis can stimulate melanocytes and lead to post-inflammatory hyperpigmentation¹.

Skin Injuries: Trauma to the skin, including cuts, burns, or surgical scars, can trigger melanin production as part of the skin’s healing response, resulting in darkened areas known as hyperpigmented scars².

Genetic Factors: Genetic predisposition can influence an individual’s susceptibility to hyperpigmentation. Certain genetic variations may affect melanin synthesis, distribution, or metabolism, contributing to uneven skin tone and pigmentation⁵.

Sun Exposure: Ultraviolet (UV) radiation from the sun is a primary trigger factor for melanin production. Chronic sun exposure stimulates melanocytes to produce excess melanin, leading to the development of sunspots, freckles, and uneven skin tone³.

COMMON TREATMENTS:

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Topical Treatments:

Thiamidol:

effectively reduces melanin production by blocking the enzyme tyrosinase, which converts the amino acid tyrosine into melanin. Less melanin is transported from the basal layer of the skin to the top of the skin and with that, dark spots gradually fade and are prevented from reappearing.

Hydroquinone:

Often considered the gold standard treatment for hyperpigmentation, hydroquinone works by inhibiting melanin production. It is available in various strengths and formulations.

Topical Retinoids:

Retinoids such as tretinoin can help improve hyperpigmentation by promoting cell turnover and fading dark spots.

Vitamin C:

Topical formulations containing vitamin C have been shown to have a brightening effect on the skin and can help reduce hyperpigmentation.

Azelaic Acid:

This ingredient has both lightening and anti-inflammatory properties, making it effective for treating hyperpigmentation associated with acne and melasma.

 

Chemical Peels:

Glycolic Acid Peel:

Chemical peels using glycolic acid can help improve skin texture and tone by exfoliating the outer layer of the skin and reducing the appearance of hyperpigmentation.

Trichloroacetic Acid (TCA) Peel:

TCA peels are deeper peels that can effectively target moderate to severe hyperpigmentation by promoting skin regeneration.

 

Laser Therapy:

Intense Pulsed Light (IPL) Therapy:

IPL therapy targets melanin in the skin, breaking down excess pigment and reducing hyperpigmentation.

Fractional Laser Resurfacing:

This treatment works by delivering laser energy to the skin in a fractionated pattern, stimulating collagen production and reducing hyperpigmentation.

 

Oral Medications:

Oral Tranexamic Acid:

This medication can help reduce hyperpigmentation by inhibiting melanin synthesis and decreasing pigment production.

Oral Isotretinoin:

Isotretinoin, commonly used to treat acne, has been shown to improve hyperpigmentation associated with acne scars.

Please note that some of these treatments are only available under supervision or with a recommendation from your dermatologist

Taking care of your skin through proper skincare, sun protection, and regular visits to a dermatologist is crucial for maintaining skin health and preventing various dermatological conditions, including hyperpigmentation

IMPORTANCE OF SKINCARE:

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Importance of Visiting a Dermatologist:

Early Detection and Treatment of Skin Conditions: Regular visits to a dermatologist allow for the early detection and treatment of various skin conditions, including skin cancer, eczema, acne, and psoriasis. Early intervention can help prevent complications and improve treatment outcomes.

Personalised Skincare Recommendations: Dermatologists can provide personalised skincare recommendations tailored to your specific skin type, concerns, and needs, helping you establish an effective skincare routine and choose appropriate products for your skin.

Monitoring Skin Changes: Dermatologists can monitor changes in your skin over time, such as the development of new moles or lesions, and provide guidance on when further evaluation or treatment may be necessary.

Professional Treatments: Dermatologists offer a wide range of professional treatments for various skin concerns, including laser therapy, chemical peels, and injectable treatments, which can complement your skincare routine and help achieve optimal results.

Maintaining Skin Barrier Function: A proper skincare routine helps to maintain the integrity of the skin barrier, which serves as a protective barrier against environmental factors, pathogens, and irritants. This barrier function is essential for preventing moisture loss and maintaining skin health.

Preventing Premature Aging: A consistent skincare regimen that includes moisturising, cleansing, and the use of appropriate skincare products can help prevent premature aging by promoting skin hydration, improving elasticity, and reducing the appearance of fine lines and wrinkles.

Addressing Specific Skin Concerns: Skincare products containing active ingredients such as retinoids, antioxidants, and alpha hydroxy acids can target specific skin concerns such as hyperpigmentation, acne, and uneven skin tone, helping to improve overall skin health and appearance.

Boosting Confidence: Healthy, well-maintained skin can boost self-esteem and confidence, as it contributes to a more youthful and radiant appearance.

 

Importance of Suncare:

Preventing Sun Damage: Sun exposure is a major contributor to skin damage, including sunburn, premature aging, and an increased risk of skin cancer. Using sunscreen with a high SPF and broad-spectrum protection can help prevent sunburn and minimize the harmful effects of UV radiation on the skin.

Reducing Hyperpigmentation: Sunscreen usage is essential for preventing and reducing hyperpigmentation, as UV exposure can exacerbate existing pigmentation issues and lead to the formation of dark spots and patches on the skin.

Maintaining Skin Health: Protecting the skin from UV radiation helps to maintain its health and integrity, reducing the risk of sunburn, inflammation, and long-term damage such as photoaging and skin cancer.




Signs and Symptoms / Common treatments:

Grimes, P. E. (2007). A microsponge formulation of hydroquinone 4% and retinol 0.15% in the treatment of melasma and postinflammatory hyperpigmentation. Cutis, 79(6 Suppl), 27–44.

Sarkar, R., & Arora, P. (2013). Melasma update. Indian dermatology online journal, 4(4), 298–308.

Alexis, A., & Callender, V. (2010). Racial and Ethnic Differences in Skin Aging: Implications for Treatment with Fractionated Carbon Dioxide Laser. Journal of Drugs in Dermatology, 9(10), 1161–1164.

Hexsel, D., & Hexsel, C. (2014). Efficacy of new vehicle formulations of 4% hydroquinone and 0.05% tretinoin in treating solar lentigines. Journal of Drugs in Dermatology, 13(4), 390–392.

Bagatin, E., et al. (2018). New Insights on the Management of Skin Hyperpigmentation. American Journal of Clinical Dermatology, 19(1), 1–9.

Importance of skincare:

Lim, H. W., et al. (2019). Sunscreen and Prevention of Skin Aging: A Randomized Trial. Annals of Internal Medicine, 163(12), 879–889.

Kaur, R., & Zito, P. M. (2020). Cosmetics: Skin Care and Sun Protection. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539701/

Tsai, T. F., et al. (2018). Strategies for managing hyperpigmentation: a review. Journal of Dermatological Treatment, 29(4), 370–377.

Murrell, D. F., et al. (2020). Dermatological Findings Associated with COVID-19: A Comprehensive Review. Clinical Reviews in Allergy & Immunology, 59(2), 184–192.

³ Kohli, I., & Sachdeva, S. (2016). Melasma: A comprehensive update: Part I. Journal of Cutaneous and Aesthetic Surgery, 9(1), 1–7.

⁴ Passeron, T. (2017). Melasma pathogenesis and influencing factors—An overview of the latest research. Journal of the European Academy of Dermatology and Venereology, 31(S4), 8–15.

¹ Davis, E. C., & Callender, V. D. (2010). Postinflammatory hyperpigmentation: A review of the epidemiology, clinical features, and treatment options in skin of color. Journal of Clinical and Aesthetic Dermatology, 3(7), 20–31.

² Vashi, N. A., et al. (2016). Pigmentation in African American skin decreases with skin aging. Dermatologic Surgery, 42(7), 846–852.

⁵ Bin, B. H., & Kim, D. J. (2017). Genetic and epigenetic regulation of PDZK1 expression: Impact on melanogenesis. Molecular and Cellular Toxicology, 13(3), 299–304.

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