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Cosmetic Dermatology

Hyperpigmentation Causes and Treatments

Posted on: October 25th, 2019 by Our Team

What is hyperpigmentation?

Melanin is the substance that gives our skin color. Hyperpigmentation is a condition characterized by the production of excessive melanin which causes dark spots on the skin. Dark spots include age spots, liver spots, freckles, sun spots, and melasma. Hyperpigmentation can affect any skin type but is most common on the face, ears, back of the hands, arms, neck, chest, shoulders and back.

What causes hyperpigmentation?

Excess melanin production develops in response to the sun, acne, melasma, aging, certain medical conditions, heredity, some prescription medications and hormone imbalances. Dermatitis, rashes, trauma, surgery, and burns can also cause hyperpigmentation.

Age spots (Solar Lentigines)

Age spots are flat pigmented spots on sun exposed skin.  The sun is the primary cause of age spots. Sun damage may have occurred in the past but doesn’t show as age spots for years. They are called age spots and are found on 90% of light skinned people over the age of 60. People with fair skin are most at risk for age spots. Age spots typically appear on the face, hands, forearms, chest, back and shins.

Common treatments include:

  • chemical peels
  • a photofacial or IPL (intense pulsed light)
  • broad band light (BBL)
  • Fractional Co2 laser skin resurfacing
  • Retin A
  • Hydroquinone (a bleaching agent) 

Combination treatment has been found to be the best approach, in addition to the daily use of a sunscreen.

Post-inflammatory hyperpigmentation (PIH)

PIH is hyperpigmentation is caused by inflammatory skin conditions like acne; skin infections from bacteria, viruses, and fungus; skin eruptions due to certain medications; eczema and psoriasis or another skin inflammation. PIH is the discoloration left after acne or other inflammation heals. PIH can be pink, red, purple, brown or black flat discolored areas. Acne breakouts often result in PIH. Acne scars may also be discolored. Over exposure to the sun, and drugs that cause hypersensitivity to the sun, such as some antibiotics, can cause PIH.

PIH discolorations take a long time to fade with some studies reporting that it can take 24 months or longer to fade superficial spots, and longer to treat deeper discolorations that may not fade on their own. People with medium to dark complexions are more prone to PIH.

The first step is to get your acne or blemishes under control. Then your PIH can be treated. However topical retinoids can treat acne and PIH.

Common treatments may include:

  • Alpha hydroxy acids like glycolic acid speed exfoliation and can improve PIH.
  • Hydroquinone
  • Retin A
  • Azelaic acid
  • chemical peels
  • microdermabrasion
  • laser therapy


Melasma is a common problem that affects women caused by hormone changes. In pregnancy it is called the “mask of pregnancy”. Melasma can also be caused by birth control pills and hormone replacement therapy.

It appears as brownish- gray patches on the face, bridge of the nose, forehead, chin and upper lip. Sun exposure can trigger the return of melasma after it has faded. Melasma is difficult to treat and may require maintenance therapy after it clears. Common treatments include Hydroquinone, Retin A, corticosteroids, and Azelaic acid.

When you are distressed by dark spots, sun spots, melasma and acne discolorations professional treatments can help. Moy, Fincher, Chipps Facial Plastics & Dermatology provides board-certified dermatology and our team is expert at treating hyperpigmentation. Contact MFC to schedule a consultation, receive an accurate diagnosis, and the correct treatments to brighten your skin and clear your dark spots.

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