Video link: https://youtu.be/BMT6CH9sTBs
Can you describe what hyperpigmentation is?
This refers to having additional pigment in some areas of the skin making it look less uniform in color. It can be due to various things including sunspots, melasma, or simply after inflammation such as from acne or an injury.
What are the causes of hyperpigmentation?
Typically it is a combination of genetic predisposition, sun exposure, hormones, and inflammation of the skin.
How can you avoid hyperpigmentation?
Ideally, you would prevent it from ever happening! All you have to do is wear sunscreen every day, never take hormones like birth control pills and ensure your skin never becomes inflamed, never has acne, irritation, or injury. So simple! But we all know that all those things are not possible.
So what you can do is:
- Wear your zinc-based sunscreen.
- Be selective about your skin care products.
- Don't pick at your skin when you have acne and don’t scratch when your skin itches. Both of those things can cause further injury.
- If you are having a procedure at a dermatology office, make sure you are prepared to protect your skin afterward to limit the risk of hyperpigmentation. If your skin is prone to hyperpigmentation, tell your provider before the treatment so they can take the necessary steps to limit your risk.
I read that summer is a prime season for hyperpigmentation, why is that?
The sun stimulates our melanocytes (pigment cells) to make more pigment. The pigment’s job is to protect our cells from UV damage coming from the sun.
How can you treat hyperpigmentation? What ingredients should you look for in skincare products?
An ounce of prevention is worth a pound of cure. Hyperpigmentation is hard to treat and impossible to cure. But you can make it better by taking away the causes (sun, hormones, and inflammation) and treating the brown that is there with topicals like Vitamin C, hydroquinone, retinoids, AHAs, BHAs, and laser treatments that promote cell turnover. However, you must be very gentle with the laser treatments because too much heat or energy can cause inflammation, leading to more pigmentation.
What ingredients should you avoid?
I always tell my patients to avoid anything that causes inflammation in their skin. For example, manual exfoliation can easily irritate your skin, so don't do it. Even topicals can be a problem if they are used too often or too aggressively. Slow and steady always wins the race here. To treat pigmentation, you have to remove the stimulus (sun, hormones, or inflammation) and gently lift any unwanted pigment. If you try to get rid of it too quickly you will cause inflammation and more pigmentation.
If you are looking for a serum for hyperpigmentation, what should you look for?
Every morning you want to use a serum with Vitamin C in it to protect your skin from free radicals created by the sun and pollution while also lighting the brown pigments you have already made.
In the evening, you can use more potent serums to promote cell turnover and inhibit the formation of new pigment. Tri-Luma/Klingman's formula is the most powerful– a prescription combination of tretinoin, hydroquinone, and weak steroid. However, you cannot use this all the time, so I often have my patients use it two weeks on and then two weeks off. During the off weeks, I suggest using plain tretinoin or AHA to continue to promote cell turnover without the risk of long-term hydroquinone or steroid use on their skin.
What are your favorite serums for hyperpigmentation?
My recommended morning options are HyperSkin, SkinBetter Alto, ISDIN Melaclear, and MAELOVE's The Glow Maker. In the evening, I suggest prescription Tri-Luma and tretinoin, SkinCeuticals retinol, MAELOVE Retinal Super Serum, and Super Smooth.
Here are my recommended steps for overall healthy, beautiful skin that will minimize irritation:
In the morning, splash your face with water, then apply an antioxidant serum followed by a moisturizer (choose one that is non-irritating and skin supportive like the Doctor Rogers RESTORE Face Lotion), and finish with a zinc-based sunscreen before applying any makeup.
In the evening, wash your face with a non-irritating, skin supportive cleanser like my RESTORE Face Wash, follow with a treatment step (examples may include tretinoin, Tri-Luma, or retinol), and finish with a heavier moisturizer like my Face Cream.
If your skin becomes even mildly sensitive, you should immediately stop the antioxidants until your skin feels healthy again, typically taking 2 –4 weeks. Once your skin has settled, then you add these steps back step one per week. If your face wash and face cream are well-formulated to support your skin, then they are all you need to get things back on track. I made RESTORE to provide people with products that help heal and keep their skin healthy because so many of the products in the beauty industry do the exact opposite, which often leads to pigmentation and aging of the skin!
Meet the author: Board-certified and practicing dermatologist, Dr. Heather D. Rogers, MD, is the founder of Doctor Rogers Skin Care and Modern Dermatology in Seattle, Washington. She studied at Stanford, University of Washington School of Medicine and Columbia University Medical Center. She lectures nationally, is well published, and an active member of the American Academy of Dermatology. Highly respected among the skin care community, Dr. Rogers has been annually named “Top 1% of Most Honored Doctors in the US” by Castle Connolly.
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