Hyperpigmentation is a common, usually harmless condition where patches of skin become darker in color than the surrounding skin. These patches most commonly appear on the cheeks, forehead, bridge of the nose, above the upper lip and on the chin. Although it is less common, some people get patches on their forearms and neck. Hyperpigmentation is also known as sun spots, age spots, dark spots, brown marks and ‘mask of pregnancy’. It can be particularly stubborn to treat and is extremely common in women. Hyperpigmentation can affect the skin color of people of any race. It can be more noticeable on people who have darker skin.
There are several causes of hyperpigmentation. Sun exposure is the most common cause and can lead to solar lentiginosis (liver spots), age spots, dark areas of the skin or freckles. This can be prevented by avoiding the sun or using sunscreen, SPF 30 or greater. Sunscreen should be worn every day including cloudy days and sunscreen needs to be applied every 90-120 minutes of normal sun exposure and every 60-90 minutes with increased sweating or swimming. Inflammation and other skin injuries, including those related to acne are also known to cause hyperpigmentation.
Melasma, a skin condition seen on the face, is characterized by brown patches found in a characteristic pattern on the face which is usually on the forehead, cheeks and upper lip. Hormones are the leading cause of melasma. Females who use oral contraceptive pills or who are pregnant are more prone to developing melasma. When melasma appears in pregnant women, it is called chloasma. Melasma does not cause any symptoms but many people dislike the way melasma makes their skin look.
Topical treatments such as hydroquinone are available for patients who are experiencing hyper pigmentation. Hydroquinone is used to lighten the dark patches of skin and works by blocking the process in the skin that leads to discoloration. Hydroquinone is available over the counter at a lower dosage and can be available by prescription at a 4% dosage and available as a cream, lotion, gel or liquid. This can be used in a cyclical fashion of three months of use with one month break. This helps prevent rebound hyperpigmentation. Protection from the sun is a must when you using hydroquinone.
There are multiple laser options for hyperpigmentation. The first is IPL (Intense Pulsed Laser). IPL is best-known for its ability to treat vascular conditions like broken capillaries (spider veins) and brown spots or “age spots” caused by sun damage. Dr. Jamie Moenster uses the YS hand piece which targets brown pigmentation. This is also called photo-facial in which an IPL or laser device is used to target the reds and browns that occur with sun exposure or hyperpigmentation. IPL also stimulates the production of collagen, which plumps up the skin and give you a fresher look and refines or tightens large pores. IPL uses short blasts of a plychromatic high-intensity light to penetrate just below the skin’s surface. This damages the melanin that makes up brown spots. The skin repairs the damage leaving you with a more even skin tone. It generally takes a series of treatments to see the best results, perhaps three to six treatments. These treatments are usually a month apart. The laser will actually cause a darkening of the spot and then over the next 7-10 days, the darkness will eventually exfoliate off and left behind with be clear or non-pigmented and lighter pigmented skin. This can take several treatments. Occasionally one treatment will be enough to lighten or reduce the spots darkness enough to create a nice cosmetic effect. This can be used on the face, back of the hands, chest and décolletage area as well as the arms and legs for treatment.
Many people have a good outcome under a dermatologist’s care. Hyperpigmentation and melasma can be very stubborn and may take a few months of treatment to see improvement. It is extremely important to following your dermatologist’s advice. After your hyperpigmentation and melasma clears, your dermatologist may recommend a maintenance regimen. This can help prevent melasma from returning. Dr. Weyer and Dr. Moenster are happy to customize a skin regimen and treatment plan for individuals who are experiencing hyperpigmentation and melasma. For more information please contact Dermatology & Plastic Surgery of Arizona at either our Tucson location 520-207-3100 or our Sierra Vista office at 520-458-1787.