Dermatologist's Guide to Your Best Skin

How to Treat Brown Spots and Hyperpigmentation

Understanding Hyperpigmentation and Dark Spots

Hyperpigmentation refers to areas of the skin that are darker than one’s skin tone making the skin look uneven. These spots can be freckles, age or sun spots, seborrheic keratosis, melasma, skin post-inflammatory hyperpigmentation and even skin cancer.

Risk Factors of Hyperpigmentation

• Genetics: Having family members who made dark spots
• Sun Exposure: UV rays stimulate pigment cells (melanocytes) to make more pigment. This starts as an even tan but as we age becomes more spotted. 
• Hormones: Elevated hormones such as during pregnancy or while taking birth control pills, can trigger pigmentation causing conditions like melasma.
• Inflammation: Skin inflammation from acne, injuries, or even skin procedures increases your risk of making pigmentation in those same areas. 

Preventing Hyperpigmentation

No matter the underlying diagnosis, preventing dark spots and hyperpigmentation can be challenging, but here are some effective strategies:

1. Wear Zinc-Based Sunscreen: Daily application of sunscreen with at least 10% zinc helps protect your skin from UV rays to minimize sun exposure and slow down the formation of brown. 
2. Regular use of ingredients that promote cell turnover: Ingredients like tretinoin, retinol, bakuchiol and glycolic acid will lighten dark spots making the skin more uniform in color. 
3. Don’t over do it: Select products that are gentle on your skin to avoid irritation leading to pigmentation
4. Avoid Picking and Scratching: Picking at acne or scratching itchy skin can cause further injury and lead to dark spots.
5. Protect Your Skin Post-Procedure: After dermatological procedures, follow post-care instructions to minimize hyperpigmentation risk. Inform your provider about your skin’s propensity for dark spots..

Why Summer Is Prime Time for Hyperpigmentation

During summer, the days are longer and the sun’s rays are more intense, which stimulates melanocytes to be more active. This increased pigment production leads to more unwanted dark spots on our faces and bodies.

Treating Hyperpigmentation

Treating dark spots and hyperpigmentation can be challenging, but certain ingredients can help:

• Vitamin C: Helps lighten existing dark spots on skin and protect against new pigmentation. Our Day Preventive Treatment contains 10% vitamin C (THD).
• Hydroquinone: A powerful ingredient for lightening dark spots, available in prescription formulations like Tri-Luma. You cannot use it year round, but it is quite helpful for lightening brown.
• Retinoids: Promote cell turnover to shed pigmented skin cells.
• AHAs and BHAs: Exfoliate the skin to remove dead skin cells and promote new cell growth. Our Night Repair Treatment contains bakuchiol, glycolic acid and gluconolactone to reverse sun damage.
• Chemical Peels: Peels are going to lighten up your brown without the risk of heat which can often make brown worse.
• Laser Treatments: Can be effective but must be used cautiously to avoid causing more pigmentation through inflammation. One of the safer ones to use is a gentle resurfacing laser, like a Clear and Brilliant, that for most people's skin types will not activate the brown.
• Oral Medication: For people with really bad melasma, there's actually an oral medication called tranexamic acid that also will lighten brown. The oral form seems to work much better than the topical form, but the topical form is also available

Ingredients to Avoid

Avoid products and practices that cause skin inflammation. For example, manual exfoliation can irritate the skin, leading to more dark spots. Gentle and steady treatment is crucial—aggressive approaches can exacerbate the problem.

Recommended Products for Hyperpigmentation
Morning Products:

• Vitamin C: 
• Doctor Rogers Day Preventive Treatment
• HyperSkin
• SkinBetter Alto
• Moisturizer: Follow with skin barrier building moisturizer like Doctor Rogers Face Lotion that calms inflammation with niacinamide and centella asiatica 
• Zinc-based sunscreen
• Kinship Self Reflect
• Kinfield
• Vanicream Facial Moisturizer

Evening Products:

• Cell Turnovers Treatment:
• Doctor Rogers Night Repair Treatment with bakuchiol and glycolic acid
• SkinCeuticals Retinol
• MAELOVE Retinal Super Serum
• Prescription bleaching agents with hydroquinone
• Cannot be used continuously, if you use it for 3 months, you need to take 3 months off. 

Comprehensive Skin Care Routine
Morning:

1. Splash face with water.
2. Apply an antioxidant serum (Day Preventive Treatment)
3. Moisturize with a gentle, supportive lotion (Face Lotion or Face Cream)
4. Apply zinc-based sunscreen before makeup (see recommendations)

Evening:

1. Cleanse with a non-irritating, supportive cleanser (Face Wash)
2. Apply a cell turnover treatment (Night Repair Treatment)
3. Moisturize with a richer cream (Face Cream)

If your skin becomes sensitive, pause the use of any treatment steps and focus on calming and healing your skin with supportive cleansers and moisturizers. Gradually reintroduce the steps once your skin has stabilized.

Conclusion

While hyperpigmentation and dark spots can be persistent, a combination of prevention, gentle treatment, and professional care can significantly improve the appearance of your skin. By protecting your skin from the sun, avoiding inflammatory triggers, and using the right skincare products, you can maintain a more even and radiant complexion.

 

These recommendations are not sponsored. They are the result of Dr. Heather D. Rogers, MD evidence-based research and extensive clinical experience. 

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