What is hyperpigmentation?

Hyperpigmentation is a darkening off the skin as a result of injury, sun damage and hormonal conditions that cause excess melanin production which forms dark patches of skin. Melanin is the brown pigment that gives skin its color. It is a common condition that affects all skin types.

There are 3 main types of hyperpigmentation:

1. Melasma
2. Post inflammatory hyperpigmentation is the result of an injury to the skin leading to increased pigment production and causing dark spots. Underlying causes include acne, eczema, psoriasis and burns.
3. Sun damage is the leading cause of dark spots and can worsen melasma.

What is Melasma?

Melasma is a common skin problem that primarily affects women. Pregnant women often get melasma. Birth control pills and hormone replacement medicine can also trigger melasma. It is so common in pregnancy that it may be referred to as the “mask of pregnancy”.

Melasma is also triggered by Ultraviolet (UV) sunlight that stimulates the melanin production. Melasma typically worsens in the summer due to sun exposure.

Melasma appears as gray-brown patches on the face, cheeks, bridge of nose, forehead, chin, and above the upper lip. It can also appear on other parts of the body that receive significant sun exposure, such as the forearms and neck. There are no other symptoms.

Melasma occurs in all skin types and is more commonly noted in people with deeper skin tones.

A dermatologist can diagnose melasma by examining your skin. Dr. Kandula may also use a device called a Wood’s light to evaluate how deeply melasma has penetrated the skin. She may recommend a biopsy to rule out other skin conditions.

Treatment involves the use of sunscreen on a regular basis. Melasma can fade by itself, especially when the triggering event is removed. When a woman with melasma delivers her baby or stops taking birth control pills, her melasma may fade. Yet some people have melasma for a lifetime.

Treatment options include:

1. Tretinoin and corticosteroids enhance skin lightening. You may receive a prescription for these medicines in addition to hydroquinone. Other topical medicines that may be prescribed are azelaic acid or kojic acid to help lighten melasma.
2. Laser therapy can be effective for improving Melasma. Laser therapy can be used when other therapies have proven ineffective and for patients who desire a more accelerated treatment approach.
3. Chemical peels are often used as a stand-alone treatment or along with topical creams.
4. Selective skincare products are an important component of Melasma treatment. Daily use of specifically targeted products works together with other therapies to accelerate melasma clearing.

Melasma can be stubborn. It may take a few months of treatment to see an improvement.

And after your Melasma clears up, you may need maintenance therapy to prevent it from returning.

It is among the most common skin conditions and can be difficult to treat. The psychological impact on a person’s self-esteem can be significant.

What is post-inflammatory hyperpigmentation (PIH)?

It is red or dark spots or patches that have poorly defined borders but no texture change. The most common causes of PIH are acne, atopic dermatitis, and impetigo. But trauma, allergic reactions and phototoxicity can cause PIH. Additionally, some systemic diseases and some drugs can cause PIH.

Whenever the skin responds to any of these triggers there is a release of inflammatory chemicals in the skin that stimulate the overproduction of melanin at the site of the inflammation.

Treatment is initially focused on eliminating the cause of the inflammation, and the use of sunscreen. There are a host of topical agents that can effectively reduce the hyperpigmentation.

Chemical peels and laser therapy can treat recalcitrant hyperpigmentation

What are dark spots?

Dark spots are skin discolorations that develop when the skin produces excess melanin in response to damage from the sun, aging, acne, melasma, rosacea, prescription medications and hormone imbalances. They affect all areas of skin that is exposed to the sun including the face, hands and chest.

Why should you see a dermatologist about dark spots and hyperpigmentation?

Only a Board-Certified Dermatologist can determine whether your PIH is harmless or more serious. After careful examination of your skin Dr. Kandula will determine the best course of treatment to reduce or eliminate the triggers that cause PIH, and the correct treatment to eliminate PIH.

Contact Dr. Kandula today to schedule a consultation to receive an accurate diagnosis and learn about all your treatment options.