You’ve survived the pimply teen years, and made it through the hormonal acne and late nights of your twenties relatively unscathed. So it’s a bit unfair that you now have to deal with hyperpigmentation – arguably the next stage of annoying skin ailments. But don’t lose hope quite yet. There’s a number of treatments – both from your local beauty counter, and friendly dermatologist – that can help clear up your complexion.
Hyperpigmentation refers to areas of skin that are darker than the surrounding complexion, from teeny lentigos (better known as freckles), patches of uneven skintone on the face and larger swathes that can cover a sufferer’s back. (Conversely, hypopigmentation describes paler patches appearing on darker skin.)
This colour comes from an overproduction of melanin, usually triggered by sun exposure or an excess deposit of hemosiderin (the end product of damaged red blood cells). It doesn’t take too much to set off a batch of hemosiderin-triggered hyperpigmentation, as it can be caused by everyday skin complaints such as bruising, acne blemishes, allergic rashes, and dermatitis. Hyperpigmentation can also be a side-effect of more serious afflictions, including Addison’s, Cushing’s and Grave’s diseases, which in those cases makes a few freckles the least of your worries.
Dr S. Manjula Jegasothy, a board-certified dermatologist and the founder and CEO of the US’ Miami Skin Institute, says that hyperpigmentation is more likely to occur in darker skin types due to their genetic make-up. ‘Olive to darker complexions have more inherent melanin in their skin to begin with,’ she explains. ‘[They] are more easily able to produce excess melanin after a skin inflammation,’ resulting in patches appearing anywhere on the body, although the face, neck and backs of hands are more prone due to their frequent exposure to the sun. With the majority classed as being a benign melasma, marks caused by hyperpigmentation are usually not a danger to your health, but can still be an unwelcome addition to your complexion.
Out, out, spot!
As with the majority of skin ailments, prevention is the best cure, says Dr Jegasothy. That means loading up on the SPF, avoiding picking at your skin, and tending to vitamin deficiencies, bruising, allergens and stressors that can trigger changes in your skin. However, spending life swaddled in sunscreen may not be enough to prevent marks appearing. For example, with pregnancy-induced hyperpigmentation, it’s the change in hormones combined with a genetic predisposition that then triggers your skin to produce variations in skin colour.
For 37-year-old Dubai resident Shima, the dark marks that first appeared just above her jawline when she was pregnant with her second child were an unexpected side effect that she initially blamed on long days at the beach. ‘They appeared almost overnight, and I was desperate to get rid of them as they looked like a stain from dirt,’ she recalls. In frustration, Shima used anything that promised a deep clean. ‘I started washing my face with a body scrub made with salt, which only made my skin dry. My mother-in-law then suggested to use Fairy liquid [dish-washing detergent], and in desperation I did, but that made my skin feel rough, and still the marks stayed,’ she says, wincing at the memory. ‘I was like Lady Macbeth, moaning and scrubbing away at my stains every night.’ After almost a year, she finally booked an appointment with a dermatologist who prescribed a course of clinically-tested products with vitamin C for hormonal-induced hyperpigmentation.
‘It turned out that my family has a history with hyperpigmentation – my mum had it when she was first pregnant, and my aunties too. But we all thought it was from being in the sun, which wasn’t the case at all.’
As Shima discovered, hyperpigmentation isn’t something that can be physically scrubbed away, with extra rough handling often stressing skin out even further. Instead, sufferers should take a more gentle approach to coax away marks.
A popular solution is introduce a spot-lightening step to your skincare routine to fade away older marks. Here, the ‘whitening’ action is actually a chemical exfoliation, using potent ingredients to safely fade away unwanted marks, without damaging or discolouring the surrounding skin. These formulas encourage skin cells to turnover and replenish at a faster rate, and eventually evening out the unwanted pigmentation. One of the hero ingredients featured in the more effective brightening creams, vitamin C, aka ascorbic acid, is particularly good at shifting surface skin cells without causing further damage, with research by Oregon State University suggesting that vitamin C is up to 20 times more effective when applied topically. By adding a form of the powerhouse vitamin to your skincare routine, whether as a serum, night cream or fading treatment, you can start easing your way back to a more even complexion.
For fresh cases of hyperpigmentation, Dr Jegasothy recommends to seek help from a dermatologist as soon as you notice any tonal changes in your complexion. She explains that early detection is the best way to implement a strategy and long-term treatment plan for hyperpigmentation, giving you the best chance of returning to completely blemish-free skin.
‘Dermatologists often use prescription topical agents such as Tri-luma cream or different types of fruit-based acid peels such as salicylic acid, lactic acid, mandelic acid and pyruvic acid to help patients with their hyperpigmentation,’ says Dr Jegasothy, pointing out that these options are usually prescription-based only. ‘Many of these solutions are very safe and can be used in darker skin types without a possible threat of causing even more hyperpigmentation.’
While turning to over-the-counter topical solutions first is the safest – and most budget-friendly – way to tackle dark blemishes, there are cases that will require further intervention to see satisfying results, points out Rebecca Treston, manager of Rebecca Treston Aesthetics at Euromed Clinic Centre in Dubai. ‘If someone has a persistent hyperpigmentation that does not fade or go away after using creams, this is when it is time to seek professional help with an expert who can assess your type of pigmentation and explain how it can be treated most effectively,’ she says. ‘If the pigmentation or melasma is deep, then you can opt for lasers, but you should only have laser treatments given by someone who has been rigorously trained in the protocols, as it takes a huge amount of expertise and care.’
The Dubai-based practitioner says that it’s important to keep expectations realistic when it comes to fading hard-to-budge marks, especially if you’ve previously put off seeking treatment – or had a crack at it yourself with the dishwashing liquid. ‘Pigmentation is faded but never cured,’ she says. ‘You need to understand limitations and realistic outcomes of any treatment, which a good practitioner will explain to you.’ In her clinic, Rebecca prefers to treat her busy clientele with targeted lasers, a method that is effective, but that doesn’t cause peeling and the associated down-time.
‘Spectra or Evo Q-switch lasers are my favourite treatments for pigmentation,’ reveals Rebecca. Both of these lasers can help fade marks by producing an acoustic vibration that shatters the darker pigment. But there’s a catch for those who don’t pay attention to what they do after leaving the clinic, with Rebecca warning that disregarding home-care instructions and getting too much sun, too soon, can result in the issue’s swift reappearance and a waste of your dirhams – not how we’d suggest making your mark.
Our pick of at-home skin-care to help clear your complexion.
Nuxe White Eye Contour Cream, Nuxe, Dh195
This newly launched targeted treatment tackles dark spots around the delicate eye area. Dab onto the eye contour and under-eye area to help fade both small marks and dark circles with vitamin C and white floral extracts.
Intensive-C Radiance Peel, Murad, Dhs232
Used as a ten-minute facial masque one to two times per week, this ascorbic and glycolic acid-loaded formula encourages the turnover of skin cells, eventually fading the visible surface pigment.
Even Up Clinical Pigment Perfector, Colorescience, Dh484
Apply this three-in-one skin-brightening complex every morning to treat existing marks, and prevent new ones from forming with a high SPF. The brand boasts a clinical study in which 94 per cent of patients saw an improvement in the appearance of skin pigmentation.
15% Vitamin C, Glo.Therapeutics, Dh362
A concentration of mark-erasing vitamin C, an intense serum like this is best used under the guidance of a dermatologist, and at night to prevent skin photosensitivity.
Advanced Pigment Corrector, Skinceuticals, Dh400
Knock out swathes of pigmentation with this light lotion that’s gentle enough for everyday wear. Exfoliating ellagic and hydroxyphenoxy propionic acids work away discolouration and leave skin brighter.