Hyperpigmentation: Types, symptoms, causes, prevention, and treatment 

 Key takeaway

• The overproduction of melanin, the dark brown or black pigment that gives skin its color, leads to hyperpigmentation.
• Hyperpigmentation can appear as brown patches all over exposed parts and may fade with time, depending on the underlying cause.
• Hyperpigmentation is classified as solar lentigines, melasma, post-inflammatory hyperpigmentation, and ephelides, having different underlying causes. 

Some internal and external factors such as injury, acne, eczema, UV exposure, hormonal changes, inflammations, and certain medications can all affect the skin, leaving scars, patches of discoloration, and blemishes that are difficult to remove, as well as darkening some areas of the body (particularly the face)—this is hyperpigmentation in a nutshell.

 What is hyperpigmentation?

The word 'hyper' means 'excessive,' and "pigmentation" means "coloration". So, hyperpigmentation is a phrase used to describe when the skin becomes darker than its typical tone. It occurs when the skin produces excess melanin—the pigment that gives the skin its color. The darker tones may appear in patches and cause discomfort to the affected individual.

It is all too easy to blame hyperpigmentation on sun exposure or using skin-harming cosmetics, but hyperpigmentation and how it occurs is much more complex, as you will find out in this article.

 Types and symptoms

As mentioned previously, several internal and external influences might contribute to hyperpigmentation, and these factors will determine the type of hyperpigmentation a person has.

Hyperpigmentation is divided into four categories:

• Solar lentigines (sunspots) 
• Melasma
• Post-inflammatory hyperpigmentation 
• Ephelides 

 Solar lentigines

The primary cause of solar lentigines is UV radiation exposure, which results in patches of macular lesions ranging in size from a few millimeters to more than a centimeter in diameter. Other names for solar lentigines are sunspots, actinic lentigines, liver spots, or age spots.

Sunspots form on visible body parts like the face, neck, hands, and forearms and are prevalent in more than 90% of white adults over 50 years. The initial manifestation of solar lentigines is macules or patches in the affected areas.

 Melasma

Pregnant people or those who use birth control pills may notice blotchy patches and freckle-like markings on their faces; these patches are melasma, otherwise known as 'the mask pregnancy.'

Melasma, while frequent during pregnancy, is not confined to pregnancy; it can also form in areas where sunlight strikes your skin and causes it to manufacture more melanin.

Stress, tanning beds, thyroid disease, and several drugs, such as antiseizure medications, birth control pills, and sun-sensitive medications, may cause this skin problem.

If you are a female between the ages of 20 and 40 with a medium or dark skin tone or blood relatives with melasma, you are at risk of developing it. Also, melasma typically clears if you treat the underlying causes. If not, it may remain for years.

 Post-inflammatory hyperpigmentation (PIH)

Acne, atopic dermatitis, and impetigo are some conditions that may cause post-inflammatory hyperpigmentation. When you have inflammation, it causes the production of excess melanin in the dermis or epidermis, resulting in post-inflammatory hyperpigmentation.

PIH can occur in any gender; it is chronic and more prevalent in people with a darker skin tone.

In addition to atopic dermatitis, impetigo, and acne, other conditions that can lead to PIH include:

• Psoriasis
• Chemical exfoliants
• Reactions to insect bites
• Radiation therapy for burns
• Infections from fungi 

PIH is asymptomatic, but patches or macules with a tan, brown, or dark-brown color that may last for months or years develop in areas of prior inflammation or injury.

 Ephelides

You may be familiar with the term "freckles," a common nickname for ephelides. But you may not know that hyperpigmentation can cause it.

Ephelides are little pigmented spots that range from red to light brown. Sunlight exposure causes these spots, and they typically appear in people with fair skin or red hair. 

Ephelides are mostly seen on the face, arms, neck, and chest because you expose these areas to sunlight. 

They are similar to Lentigines in that they are both triggered by sunlight; however, ephelides can be genetic and have a smaller diameter.

Ephelides occur from ages 2 to 3 after sun exposure and may disappear as an individual grows.

 Causes of hyperpigmentation

Different conditions that harm the skin and stimulate the body to produce excess melanin are one of the major causes of hyperpigmentation. 

Melanin is the bodily pigment that gives the skin its color, and hyperpigmentation occurs when there is stimulation to generate excess pigment. Some of the conditions that can contribute to the excessive synthesis of this pigment are as follows:

• Burns
• Cuts
• Inflammation
• Acne Vulgaris
• Sunlight
• Genetics, as in the case of ephelides
• Hormone changes
• Tanning beds
• Thyroid disease
• Some medications, like retinoids and birth control pills

 Does hyperpigmentation occur in Blacks or people of color?

Hyperpigmentation can affect people of all ages, races, and genders, but it is more common in people with darker skin tones.

Due to the existence of melanin in dark skin—which causes their skin to have a darker color— and the common negligence to use sun protection because of their skin color, they are more prone to developing hyperpigmentation. If you have dark skin, you can check for skincare products for hyperpigmentation in dark skin.

 Tips for preventing hyperpigmentation

Although hyperpigmentation is very common, you can prevent it by following the tips below:

• Always wear a hat and carry a shade while going under the sun.
• Avoid going under the sun at peak times.
• Apply broad-spectrum sunscreen before going out and reapply every 2 hours.
• Keep your hands off cuts or bites on your skin to avoid leaving marks.
• Wear clothes that protect your body from sunlight.

 Treatment for hyperpigmentation

Hyperpigmentation requires consistency and patience to clear, and it may take months or years to vanish completely.

Dermatologists have provided some not-so-quick hyperpigmentation treatment options, ranging from brightening beauty products that you may include in your daily routine to medical procedures that require professional aid, and they involve:

 1. Topical treatments

Having a skincare routine is often helpful in treating skincare issues like hyperpigmentation. Your skincare products should include the following:

• Retinoids creams
• Azelaic acid creams 
• Hydroquinone cream
• Zinc sulfates
• Arbutin
• Kojic acid

 2. Chemical peels

Chemical peels may include:

• Salicylic acid peels 
• Glycolic acid peels

 3. Laser therapy

This involves using focused light from specialized light beams to improve appearance. Laser therapy can be used to improve skin discolorations and reduce scars.

 Can hyperpigmentation go away on its own?

Some hyperpigmentation, such as ephelides, may fade away over time. While others, depending on the depth of the injury on the skin, may require further aid or therapies to fade away faster. 

 When to seek medical attention

Seek the help of a dermatologist when you notice some dark patches that do not clear away over time on some areas of your skin. 

 Wrap-up

Although hyperpigmentation can be a pain in the flesh that causes discomfort, with consistency, patience, the right treatment procedures like topical treatments, chemical peels, or lasers, and persistence, it may eventually go away. 

Also, if you are experiencing difficulties identifying the best therapy for your skin, speak with a licensed dermatologist for effective care.