Hyperpigmentation & Melasma

The color of your skin is determined by the presence of pigments manufactured by specialized cells in the skin called melanocytes. Individuals with darker skin tend to produce more eumelanin pigment. Fair complected persons tend to produce more pheomelanin pigment. In general, most people have a combination of both types of pigment. When there is an increased amount of melanin in the skin, this causes darkening of the skin.

One of the most common and troubling types of pigmentation problems is Increased pigmentation on the face. This can be due to a variety of causes: genetics, pregnancy, oral contraceptives, sun exposure, photosensitizing medications, an underlying irritant dermatitis, and inflammation from acne. It commonly occurs on the forehead, cheeks, upper lip, and mid-chin.

A number of treatment options exist for treating excessive pigmentation: chemical peels, laser, intense pulsed light, prescription topical lightening agents, high protection UVB-UVA sunscreens, antioxidants. In general, the most effective approach to lightening unwanted pigmentation is a combination of therapies. Higher sun protection factor (SPF) sunscreens (> 30) decrease stimulation of melanin production by melanocytes in the skin. Bleaching agents inhibit the enzyme that produces pigment. Lasers, Intense Pulsed Light (IPL), and chemical peels help remove cells containing pigment by sloughing away pigment containing layers of skin. Other prescription topical medications can be used to increase shedding of excess pigment containing cells and inhibit transfer of melanin from melanocytes to the cells in the more superficial layer of skin where the pigment is more noticeable.

Pigment that is more superficial is easier to remove than pigment located in the deeper layers of skin. Any therapy used will require time and patience to see results. Laser, intense pulsed light, and peels need to be done as a series of treatments to be beneficial.