Hyperpigmentation isn’t necessarily a condition but a term that describes skin that appears darker. It can:
- occur in small patches
- cover large areas
- affect the entire body
While increased pigmentation usually isn’t harmful, it can be a symptom of another medical condition. Learn about types of hyperpigmentation, causes, and how to treat it.
Types of hyperpigmentation
There are several types of hyperpigmentation, the common ones being melasma, sunspots, and post-inflammatory hyperpigmentation.
- Melasma. Melasma is believed to be caused by hormonal changes and may develop during pregnancy. Areas of hyperpigmentation can appear on any area of the body, but they appear most commonly on the stomach and face.
- Sunspots. Also called liver spots or solar lentigines, sunspots are common. They’re related to excess sun exposure over time. Generally, they appear as spots on areas exposed to the sun, like the hands and face.
- Post-inflammatory hyperpigmentation. This is a result of injury or inflammation to the skin. A common cause of this type is acne.
What are the symptoms and risk factors?
Darkened areas on the skin are the main symptoms of hyperpigmentation. Patches can vary in size and develop anywhere on the body.
The biggest risk factors for general hyperpigmentation are sun exposure and inflammation, as both situations can increase melanin production. The greater your exposure to the sun, the greater your risk of increased skin pigmentation.
Depending on the type of disorder, other risk factors for hyperpigmented patches may include:
- oral contraceptive use or pregnancy, as seen with melasma
- darker skin type, which is more prone to pigmentation changes
- drugs that increase your sensitivity to the sunlight
- trauma to the skin, such as a wound or superficial burn injury
What causes hyperpigmentation?
A common cause of hyperpigmentation is an excess production of melanin. Melanin is a pigment that gives skin its color. It’s produced by skin cells called melanocytes. Several different conditions or factors can alter the production of melanin in your body.
Certain medications can cause hyperpigmentation. Also, some chemotherapy drugs can cause hyperpigmentation as a side effect.
Pregnancy changes hormone levels and can affect melanin production in some women.
A rare endocrine disease called Addison’s disease can produce hyperpigmentation that’s most obvious in areas of sun exposure, such as the face, neck, and hands, and areas exposure to friction, such as elbows and knees.
The hyperpigmentation is a direct result of an increased level of a hormone in your body that results in increased melanin synthesis.
Excessive sun exposure can also cause an increase in melanin.
How is hyperpigmentation diagnosed and treated?
A dermatologist can diagnose the cause of your hyperpigmentation. They will request your medical history and give you a physical exam to determine the cause. In some cases, a skin biopsy can narrow down the cause.
Topical prescription medication can treat some cases of hyperpigmentation. This medication usually contains hydroquinone, which lightens the skin.
Using topical retinoids also assists with lightening dark spots of the skin.
Both of these medications can take a few months to lighten darkened areas.
Commonly requested compounded formula for patients with hyperpigmentation:
Hydroquinone 4% / Tretinoin 0.05% / Triamcinolone 0.1% Gel
Home care sometimes includes over-the-counter medications that may lighten dark spots. These medications don’t contain as much hydroquinone as prescription medications.
Home care also includes using sunscreen. Sunscreen is the single most important factor in improving most causes of hyperpigmentation. Look for:
- a physical blocking sunscreen, preferably with zinc oxide as the main active ingredient
- at least an SPF 30 to 50
- broad spectrum coverage
Use a sunscreen daily. Reapply it every 2 hours if you’re out in the sun — more frequently if you’re sweating or swimming.
There are also skin disorders with which visible light may play a role in perpetuating the hyperpigmentation, such as in melasma.
In that case, look for a mineral sunscreen that also has iron oxide in it, which can block some visible light. Use daily. Wear sun-protective clothing that’s SPF-infused.
Your doctor may also suggest laser treatment or chemical peels to reduce hyperpigmentation, depending on the cause of your hyperpigmentation.