Whether it’s discolouration on your chin from a breakout that’s come and gone, or sun spots making an appearance on your chest after years of not-so-diligent sunscreen application, or the freckle-like spots of melasma (a.k.a. the “mask of pregnancy”), we’ve all experienced some form of hyperpigmentation. It’s a universal skin concern that affects people of all skin types and tones with a wide variety of underlying causes–but the good news is, it can be treated and prevented. We sat down with Dr. Douglas C. Wu, an Edmonton dermatologist who now practices in California, and Dr. Sonya Abdulla, a dermatologist at Dermatology on Bloor in Toronto, to share everything you need to know about hyperpigmentation.
What is hyperpigmentation?
Hyperpigmentation is a broad term used to describe any discolouration of the skin, explains Wu, whether it’s an acne scar, sun spots or melasma. While summer and spring are prime hyperpigmentation seasons thanks to stronger UVB rays (the ones that cause sunburn), UVA rays are present year-round and damage the deeper levels of the skin, which can also trigger discolouration. In winter, dry air and lower humidity levels can lead to irritation, which can also cause dark spots. In short, hyperpigmentation is a concern no matter the season.
What causes hyperpigmentation?
There are multiple factors that can trigger hyperpigmentation. The most common cause is chronic sun exposure, which can lead to benign marks that pop up in areas of the skin that get a lot of sun such as the cheeks, chest, hands and forearms, says Abdulla. Along with damaging UV rays, Wu goes on to explain that hyperpigmentation can also occur from skin injuries, inflammation, irritation, a genetic predisposition, hormonal factors and certain medications that can play a role in general skin health, all of which stimulate the pigment-making cells in the skin.
What is melasma?
Melasma is a type of hyperpigmentation that’s characterized by blotchy, irregular brown patches on the skin, explains Abdulla. It most often occurs on the cheeks, forehead, nose and upper lip, but it can also affect the chest and forearms. Unlike other forms of hyperpigmentation, it can be caused by hormonal changes. Think of it this way: All melasma is hyperpigmentation, but not all hyperpigmentation is melasma.
What causes melasma?
Melasma can be triggered by sun exposure or by hormonal changes in the body. The skin condition is more common in women due to its link to changes in hormone levels, often appearing during pregnancy, after starting oral contraceptive pills or during menopause. “Melasma is referred to as the ‘mask of pregnancy’ for that reason,” says Abdulla, noting that the skin condition is driven by fluctuations in estrogen levels. The link between estrogen and melasma is not fully understood, though it is believed that the hormone influences the pigment-making cells in the body and that an increase in estrogen can make cells more sensitive to sunlight. While estrogen may trigger melasma in some, she notes that sun and heat typically play a bigger role in activating the condition.
According to Wu, aside from pregnancy and oral contraceptive pills, hormonal therapy (which is used during menopause and to treat some types of cancer) is another culprit. Lifestyle factors, like stress, can also contribute to the worsening of melasma. This means that, like many other skin conditions such as eczema, melasma is unpredictable and can flare up.
Melasma requires a more specialized approach to prevention, treatment and maintenance. It’s recommended to use pigment-busting ingredients regularly (more on those later) to keep it under control between flare-ups, but a visit to a derm is a good idea. Aside from at-home skincare routines, hydroquinone and oral tranexamic acid can be prescribed if necessary.
Are some people more likely to develop hyperpigmentation and melasma than others?
While hyperpigmentation and melasma can affect anyone, people with darker skin tones are more likely to develop the conditions. Genetics can also play a role in how prone an individual is to certain types of hyperpigmentation.
How do you treat hyperpigmentation and melasma?
Both Wu and Abdulla swear by the same two-step routine when dealing with skin discolouration. “Daily, year-round sun protection and topical pigment-controlling active ingredients are the mainstays of treatment for hyperpigmentation and melasma,” says Wu. Abdulla recommends layering a vitamin C skincare product underneath your sunscreen in the morning. Vitamin C, typically used for brightening, isn’t a one-trick pony—it also minimizes free radical damage (caused by unstable molecules that attack healthy cells), which helps prevent visible signs of aging such as wrinkles, support collagen production and improve the look of hyperpigmentation. Over time, regular vitamin C application will deliver an improvement in fine lines, skin luminosity, as well as a more uniform and radiant complexion.
While sun protection and targeted skincare are tried and true methods for minimizing hyperpigmentation, each case is different and thus has to be treated with a targeted approach. Both experts say the right diagnosis is key when treating hyperpigmentation. An effective treatment plan relies on your doctor determining whether your dark spots stem from trauma to the skin (such as an injury or acne scarring), sun damage or melasma. Depending on your skin, some in-office treatments for dark spots, like microneedling, peels and lasers can actually make melasma worse. So, if you’re interested in a more targeted and personalized treatment for hyperpigmentation, make an appointment with a dermatologist.
What are the best skincare ingredients to treat hyperpigmentation and melasma?
Vitamin C is a dermatologist-backed, clinically-tested powerhouse ingredient for the prevention and treatment of dark spots, but it’s far from the only option for treating hyperpigmentation. Ingredients like retinol, niacinamide, arbutin, kojic acid, tranexamic acid and AHAs such as glycolic and lactic acids are also recommended. However, they should be worked into your routine slowly and one at a time. (Some potent actives don’t play well together, so it’s important to educate yourself or ask an expert for advice before mixing them.) “Sun protection and vitamin C are meant to be used on a daily basis, but [other ingredients] need to be approached with caution before committing to daily use,” warns Abdulla. Jumping headfirst into using potent skincare ingredients like retinol and AHAs can trigger inflammation in some skin types, which could worsen hyperpigmentation.
How do you prevent hyperpigmentation and melasma?
Prevention is better—and much easier—than cure when it comes to all forms of hyperpigmentation, so it’s worth repeating again: Diligent sun protection is the most important preventative step you can take. To highlight the importance of prevention, Abdulla notes that once the tendency for hyperpigmentation has been triggered in your skin, it will likely persist and lead to more dark spots. Wearing SPF 30 or higher regardless of the weather forecast (yes, even on rainy days!) is your best line of defense, plus it will also help minimize fine lines and wrinkles over time and protect you against skin cancer. Protective clothing, sunglasses and sun hats are also useful prevention tools, adds Wu.
Want to take care of dark spots at home? Try one these picks loaded with pigment-busting ingredients.
Garnier Vitamin C Super Glow Serum
Neutrogena Rapid Tone Repair 20% Vitamin C Serum
Skin Republic Vitamin C 6% + Alpha Arbutin Serum
Vivier QuintiSerum with 15% Vitamin C
The Body Shop Vitamin C Overnight Mask
SkinCeuticals Discoloration Defense
Reversa Radiance Cream SPF 30
Dr. Dennis Gross Vitamin C Lactic Dewy Deep Cream
First Base Skincare Double Dose Organic Vitamin C Serum
Murad Correct & Protect Serum SPF 45