Hyperpigmentation Is Notoriously Hard to Battle—but a Derm Says It’s Possible
"There are 3 major causes of hyperpigmentation," says Heather Woolery-Lloyd, MD, a Miami-based dermatologist. "One is dark spots from pimples in adult women—it's from female adult acne. The other is melasma, which shows up as brown patches on the cheeks usually. And the other is general uneven skin tone, which happens as the skin changes with age."
Thankfully, there are various methods out there that can help, and no surprise here: Sunscreen is at the top of the list. "The sun really drives those processes in the skin, and when you cut off its exposure, it allows your skin to heal," says Dr. Woolery-Lloyd. "Treating pigment without sunscreen is like pushing a rock uphill—you can try all day but without SPF nothing will be effective." So slather on the SPF and keep on scrolling for the intel on how to tackle all the different types of hyperpigmentation.
Post-inflammatory hyperpigmentation (PIH)
Had acne? Yeah, then you're probably familiar with post-inflammatory hyperpigmentation, which is just a scientific term for those pesky dark spots that show up once a zit goes away. "These dark spots occur after a pimple has healed, but can also happen after any trauma to the skin—like a scratch or an insect bite," says Dr. Woolery-Lloyd. "Any irritation such as this causes the melanocytes—the cells that make pigment in the skin—to turn on and create more pigment. This results in a dark spot where the irritation was."
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Treatment: The best thing you can do is prevent the cause of this PIH in the first place. "In the case of acne, getting the acne under control can prevent new dark spots from forming," says Dr. Woolery-Lloyd. Also key (besides sunscreen)? Retinol. "Retinol increases your cell turnover rates and aids in exfoliation to even your skin tone," she says. "Combine this with natural skin brighteners like licorice and niacinamide for long-term maintenance." Try SkinMedica Age Defense Retinol Complex 0.5 ($78).
Photoaging
Photoaging (AKA sun spots) typically show up later in life after prolonged sun exposure. Need another reminder to slather on the SPF? This is it. "Uneven skin tone on the face usually starts in the late thirties or early forties after years of everyday sun exposure," says Dr. Woolery-Lloyd. This form of pigmentation usually appears larger than freckles, and more as clusters of darker spots on the complexion.
Treatment: Dr. Woolery-Lloyd recommends chemical peels as a tried-and-true way of helping to eliminate photoaging. "In lighter skin tones, intense pulsed light (IPL) is an excellent option for treatment," she says of the no downtime, lunch-break laser. "The benefit of this device is that it also helps with the redness that can occur with photoaging." However, IPL isn't effective at treating darker skin tones, and can cause adverse reactions, which is a big part of the reason why Dr. Dennis Gross aimed to bottle up the laser's effects in the brand-new Clinical Grade IPL Dark Spot Correcting Serum ($92). The serum uses a combination of L-ascorbic acid, AHA, and kojic acid to lift away pigmentation safely for every skin tone. Then there's Susanne Kauffman's Skin Brightening and Radiance Complex ($270), which works for all types of hyperpigmentation, but is particularly good for sun spots due to a brightening pea extract complex.
Melasma
Pigmentation created by melasma, which the American Academy of Dermatology characterizes as it as "gray-brown patches" on the cheeks, upper lip, and center of the forehead are frequently caused by hormones. That's why the condition is incredibly common during pregnancy. "Melasma is a chronic condition that's common in pregnancy and when taking birth control pills," says Dr. Woolery-Lloyd. "For most people, it resolves after pregnancy or after stopping the pill, but for some it persists. It can also show up in some women out of the blue with no hormonal explanation. Regardless of the cause, sun exposure plays a big role in melasma and always makes it significantly worse."
Treatment: Look for natural skin brighteners like licorice, vitamin C, kojic acid, and green tea, which can be found in products like this Babyface Vitamin C Lightening Mask ($23). "These ingredients can be used for longterm maintenance," says Dr. Woollery-Lloyd. As far as professional treatments go, she notes that both chemical peels and microneedling in conjunction with brightening agents can be really helpful.
Freckles
I never realized this, but the smattering of tiny brown spots—AKA freckles—are a breed of hyperpigmentation. "Freckles are hereditary brown spots that are most prominent on the bridge of the nose and cheeks," says Dr. Woolery-Lloyd. "They can occur at any age, but often start in childhood and become more prominent after years of sun exposure." The thing about these spots is that they're challenging to get rid of. "People with freckles are predisposed to them," she says. The best thing you can do, according to Dr. Woolery-Lloyd, is minimize excessive sun exposure.
Treatment: Daily sunscreen (of course). "Daily sunscreen is essential in treating all types of hyperpigmentation, and minimizing sun exposure can help freckles fade and to prevent new ones," says Dr. Woolery-Lloyd. Try slathering on Coola Full Spectrum 360° Sun Silk Drops SPF 30 ($46) which go on smoothly like a serum and don't disrupt makeup application.
To help keep the acne away (and avoid PIH altogether), here's what you need to know about medicine for acne. And these are the dermatologist and facialist-approved anti-acne products to try.
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