Hyperpigmentation

Hyperpigmentation refers to darkening of the skin and uneven skin tone. It can be due to multiple causes and can be focal (occuring in one area) or diffuse (occurring across larger areas). Hyperpigmentation is often benign (harmless), but it is important to have the cause evaluated in case it is a symptom of an underlying medical condition.

For people looking to reduce the appearance of their hyperpigmentation, the providers at Skin and Laser Dermatology Center have a variety of treatment methods appropriate for all skin types. Hyperpigmentation can be difficult to improve and often people spend time and money trying treatments that do not work and even exacerbate the condition. The providers at Skin and Laser Dermatology Center will be able to tailor their treatment plan for the results you hope to achieve, so you can most effectively get the results you want. Depending on the recommended treatment, it may take multiple sessions to achieve optimal results. The number of treatment sessions that can be expected will be discussed during the cosmetic consultation.

One representative example of the outcome of 5 sessions of laser treatment for hyperpigmentation.This is not meant to represent all possible patient outcomes for all laser resurfacing results.

Who is most likely to develop hyperpigmentation?

People with naturally tan or brown skin are more likely to develop hyperpigmentation than people with fair skin although it can occur in any skin type.

What is the mechanism of action behind hyperpigmentation?

Your skin gets its color from a pigment called melanin produced by cells called melanocytes. Most cases of hyperpigmentation are due to an increase in the production of melanin. The melanin builds up in the skin, creating darkened areas.

What are some of the most common reasons that focal, localized (occuring in one area) hyperpigmentation occurs?

• Sunlight is what triggers melanin production in the skin. Excessive sun exposure can cause more melanin production, which can in turn lead to hyperpigmentation.
• Inflammation can also cause hyperpigmentation (known as postinflammatory hyperpigmentation), especially in people with naturally tan or brown skin. The original inflammation may be caused by an injury (cuts, burns, etc.) or other medical conditions or procedures (acne, rashes, lupus, laser treatments, chemical peels, etc.). After the inflammation subsides, postinflammatory hyperpigmentation can remain. This usually appears as a flat area of discoloration.
• Localized hyperpigmentation can also occur because of melasma, freckles, cafe-au-lait macules (light brown birthmarks), or other conditions.
• It could also be an indication of other serious medical conditions, which is why hyperpigmentation should be medically evaluated.

What causes diffuse (spread across larger areas) hyperpigmentation?

Hyperpigmentation that occurs diffusively, spread across large and potentially many parts of the body, can result from normal sun-exposure, but can also be a sign of an underlying systemic condition or reaction to medication. Patients with hyperpigmented patches should come in for medical evaluation to be screened for underlying disease and conditions.

How does hyperpigmentation relate to melasma?

Melasma is a condition where larger patches of hyperpigmentation develop, usually on the face. Melasma can affect both men and women but it is more common in women. Melasma can be triggered by a number of factors, but is often due to changes in hormone concentrations and sunlight exposure.

Does hyperpigmentation get worse with age?

As the skin ages, the number of melanin-producing cells (melanocytes) decreases, but the remaining ones increase in size. This is why hyperpigmented age spots are more common in older individuals.