The Dos and Don’ts of Dealing with Hyper Pigmentation by
Dr. Amit & Aarti Bhasin

Dr. Amit & Dr. Aarti BhasinSeptember 8, 2023

Dr. Amit & Aarti Bhasin

Pigmentation issues are a common concern in dermatology, with conditions like melasma standing out due to their impact on skin appearance and self-esteem. Melasma, characterized by patchy brown or grayish-brown facial discoloration, is a distressing condition for many. Let’s delve into the causes of pigmentation and melasma, along with home regimens and dermatologist-led treatments that can help manage these concerns.

Causes of Pigmentation and Melasma

Pigmentation, the color of our skin, is primarily determined by the presence of a pigment called melanin. Melanin production is influenced by various factors, including genetics, sun exposure, hormones, and inflammation.

Melasma, Specifically, is Triggered by a Combination of Factors:

1. Hormonal Fluctuations:

Hormones like estrogen and progesterone play a significant role in melasma development. Pregnant women, those using birth control pills, or undergoing hormone replacement therapy are more prone to melasma due to hormonal fluctuations.

2. Sun Exposure

Ultraviolet (UV) radiation stimulates melanocytes (melanin-producing cells) to produce more melanin. This exacerbates melasma, especially if sun protection measures aren’t followed.

3. Genetics

A family history of melasma can increase one’s susceptibility to the condition.

4. Ethnicity

Individuals with darker skin tones, particularly skin types III to VI, are more prone to melasma.

5. Cosmetics and Medications

Wrong cosmetics, skincare products, self medications can make the skin more sensitive to UV exposure and worsen melasma.

6. After Inflammatory lesions like Pimples/Acne

7. Excessive exfoliation, etc.

Treatment Approaches

Both Home Regimens and Dermatologist-Led Treatments are Integral to Managing Pigmentation and Melasma.

Home Regimen

1. Sun screen: Wearing broad-spectrum sunscreen with a high SPF daily and reapplying it every 3 hours is crucial. Sun protection is crucial for managing melasma. Use broad-spectrum sunscreen with SPF 30 or higher, even on cloudy days. Seek shade, wear wide-brimmed hats, and use protective clothing. Consider using topical antioxidants and avoiding direct sun exposure during peak hours.

2. Topical Agents: The following ingredients are for topical application:

Vitamin C: An antioxidant that helps fade dark spots and promote even skin tone.
Niacinamide: Reduces inflammation, inhibits melanin production, and improves skin texture.
Retinoids (Retinol, Tretinoin): Speed up cell turnover, promote collagen production, and fade dark spots.
Kojic Acid: Inhibits melanin production (which causes pigmentation) and reduces pigmentation

Alpha Hydroxy Acids (AHAs): Exfoliate the skin’s top layer, improving the appearance of dark spots.
Beta Hydroxy Acid (Salicylic Acid): Exfoliates and helps with pigmentation in oily/acne-prone skin.
Licorice Root Extract: Contains compounds that help fade dark spots and soothe skin.
Azelaic Acid: Reduces melanin production and helps with inflammation. Patch testing is advisable before using these products.

3. Cleansing: Using mild, non-abrasive cleansers helps prevent further irritation.

4. Avoid Triggers: Discontinuing the use of products that may exacerbate melasma, such as harsh exfoliants or irritating skincare.

Treatments

1. Prescription Creams

Dermatologists after examining your skin and depth of pigmentation will be prescribing oral vitamins and topical creams. Doctor will also try to rule out your underlying cause and fix it Doctor can prescribe stronger formulations of hydroquinone, corticosteroids, or tretinoin to milder topical creams to target melasma.

2. Chemical Peels

Superficial peels with ingredients like glycolic acid, salicylic acid, Vitamin A, lactic acid, etc can promote skin exfoliation and reduce pigmentation.

3. Laser Therapy

Various laser treatments, such as fractional laser and pixelated Q switch like Clear lift.

4. Light Therapy

Intense pulsed light (IPL), can break down melanin and stimulate skin renewal.

There are multiple other procedures like
Mesobotox , Mesotherapy, Microdermabrasion , Microneedling, etc.

Pigmentation issues, including melasma, have multifactorial causes and require a comprehensive approach. While home regimens aid in prevention and mild cases, dermatologist-led treatments provide advanced solutions for stubborn pigmentation. Collaborating with a dermatologist ensures a tailored treatment plan that addresses individual concerns and yields the best possible results, ultimately boosting one’s confidence and improving skin health. Remember, consistency and patience are key when managing pigmentation and melasma.