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After a few too many appointments where a dermatologist inquired about my sunscreen habits—or lack thereof (I know, it’s shameful)—I decided to look into the treatment of hyperpigmentation. I always just shrugged the tiny discoloration off as cute, youthful freckles, but after it got a bit worse, I could tell it was more than that.
Hyperpigmentation, or darkening, can be a result of any type of skin trauma—a breakout, a bug bite, or even an area you scratched or picked a few times. That, and exposure to the sun. Skin often releases color in response to injury, and it can take months for the color to fade. Thankfully, there are tools to expedite the fading.
After a quick (and somewhat frightening) Google search, I was a bit scared of the technical and intense-sounding treatments available. I decided to check in with my go-to dermatologist, Rachel Nazarian of Schweiger Dermatology, and Dr. Scott Wells to find out the easiest ways to prevent and treat my discoloration. Were the harsh treatments worth it? Would they ultimately just aggravate my skin? Are there products I can buy at the drugstore that actually work?
Meet the Expert
- Rachel Nazarian, MD, is a board-certified dermatologist and fellow of the American Academy of Dermatology. She specializes in cosmetic treatments, skin cancer, and dermatologic surgery.
- Dr. Scott Wells is a plastic surgeon and skincare expert with a focus on facial rejuvenation. He has more than 20 years of professional experience and is located in Manhattan and Long Island.
Step 1: Sunscreen
“The initial step is to avoid anything that may prolong pigment deposition in the skin and keep hyperpigmentation from resolving on its own. Sunscreen, at least SPF 30, will help encourage fading by blocking UV radiation, which typically keeps and produces more pigment in skin (Elta MD is a great choice),” Nazarian suggests.
Wells agrees: “Obviously, sun exposure is one of the most controllable factors. Patients prone to hyperpigmentation must avoid direct exposure, wear hats and other occlusive clothing, and always wear a sunblock of SPF 30 or higher. My overall favorite types of block are mineral blocks containing micronized zinc and titanium dioxides”
Step 2: Wound Care
“Wound care is also important because areas of healing, such as a scratched bug bite or a picked pimple, are prone to infection and inflammation—making hyperpigmentation of the skin more likely,” says Nazarian. “That also means cleaning the skin with a gentle cleanser and not picking at the leftovers (scabs or old pimple scars) or scrubbing with a harsh cleanser.”
Step 3: Chemical Exfoliation
Nazarian adds, “Gentle chemical exfoliants can also enhance and increase the rate of skin cell renewal—basically inducing the hyperpigmented skin to be replaced by new skin cells. This can also be done through topical creams, washes, and solutions that have ingredients like vitamin C or glycolic acid. I suggest Revision Vitamin C lotion 30%.”
Step 4: Physical Exfoliation
“Microdermabrasion,” explains Nazarian, “is a gentle physical form of exfoliation. It can be utilized to slough surface skin cells causing a faster cell turnover and quicker fading of darkened skin.”
Step 5: Cell Turnover and Brightening
Wells suggests, “Reducing pigment that exists already in the skin is best done using a combination of in-office peels combined with a regimen of retinol and Arbutase, which we custom-blend for our patients. The retinol helps even out pigment cells while the Arbutase contains hydroxy acids for cellular turnover (as well as brightening agents). Patients may stay on this ‘resurfacing cream’ for extended periods safely.”
Step 6: Other Options
“Of course, you can always discuss with your dermatologist other options,” Nazarian offers. “Prescription lightening creams (including those with kojic acid and hydroquinone) are ideal for stubborn dark spots, and deeper chemical peels can be done to lift stains and help with long-term hyperpigmentation. For that, I typically recommend the Vi Peel along with stronger resurfacing lasers (such as Fraxel), which may have longer downtime but lead to more dramatic results."
“Lastly, under certain circumstances, laser energy may be used successfully to treat hyperpigmentation,” Wells adds. “This is slightly more risky, however, since the laser itself can stimulate pigment cells not effectively destroyed by the treatment. Make sure your doctor is very experienced! Treatments for hyperpigmentation cost between $250 and $450 for light peels, up to $1500 per session for spot lasering, and $5000 for comprehensive facial laser resurfacing.”
Cleveland Clinic. Pigmentation: abnormal pigmentation. Updated March 29, 2016.