Hyperpigmentation: Causes, Symptoms & Treatment Measures

Hyperpigmentation is a type of skin pigmentation that can occur anywhere on the body in the form of dark patches. Skin pigmentation of this type may not always be harmful on its own, but may be an indication of another serious condition. This is why it is important to get your pigmentation consulted. In this way, if your skin pigmentation is a part of another underlying condition, it can be diagnosed and treated.

It is important to learn about hyperpigmentation, its causes, its symptoms, and its appropriate treatment options.

What are the types of hyperpigmentation?

Hyperpigmentation is a patch of dark-colored skin on your body. But why did it develop? Hyperpigmentation can be classified broadly into two types - localized and diffuse. Let us list down the most common ones for you and what they mean.

Localized Hyperpigmentation

This type of pigmentation is generally a primary skin condition with no internal involvement.

Sunspots: Let’s start with the most obvious one. We all know how the sun’s UV rays affect our skin. This is one of the foremost reasons sunscreens are recommended. Sunspots are also known as solar lentigines or liver spots and appear on the exposed parts of the body most commonly the hands, neck and face as a result of prolonged and unprotected exposure to the sun. These develop with age as cumulative exposure increases.

Post-inflammatory hyperpigmentation: This form of hyperpigmentation happens as a result of all kinds of skin inflammation like acne, or any injury. The same areas affected will darken during the healing process and result in hyperpigmentation. This occurs more frequently in those with darker skin tones.

Melasma: This is also a common form of skin pigmentation wherein several factors like UV radiation, hormonal changes and certain drugs may play a role. Melasma can also develop during pregnancy, owing to altered hormonal activity. This form of pigmentation may also be inherited through genetic predisposition. These most commonly appear on the face, but can also occur on the neck and arms.

Diffuse Hyperpigmentation

This type of pigmentation is usually due to underlying conditions and is not a primary skin disease.

Metabolic Conditions: Metabolic causes of hyperpigmentation include vitamin deficiencies, such as vitamin B12 and folic acid and conditions like hemochromatosis. These cause pigmentation on the genitals, mucosal surfaces and exposed skin as well.

Hormonal Pigmentations: Underlying hormonal conditions like thyroid disease and Addison’s disease may also present with diffuse pigmentation over the pressure points, skinfold and palms. 

Drugs: Hyperpigmentation can also be due to drug intake. Certain medications like NSAIDs, phenytoin, antimalarial agents and tetracycline antibiotics can cause hyperpigmentation on the skin and the mucosa. . The same can happen due to the topical application of certain drugs too. The offending agent must first be discontinued before further treatment of the patches.

Malignancy: Although not as common, many cases of malignancy, especially related to melanoma, have been known to cause diffuse hyperpigmentation. This is more common in patients with metastatic disease. The skin of color patients presents an even tougher challenge in that they are often diagnosed late in the disease process and/or go undiagnosed for a longer period of time than perhaps an individual with a lighter skin type. Therefore, appropriate screening and management in patients with skin color is extremely important.

If you think your dark patches of skin may be due to any one or more of the above-mentioned causes, do seek medical advice. You may need to be evaluated and managed appropriately. 

Let’s now move onto the symptoms of hyperpigmentation.

How do you identify skin pigmentation, particularly, hyperpigmentation? Do all the discolorations qualify as hyperpigmentation? Clearly not. Certain signs are unique to the skin condition and help you recognize it and subsequently get it treated.

 

• Patches of varying shades of brown or black

• The discoloration is seen after inflammation or injury on the skin 

• Discolored patches turning darker after sun exposure

• Raised dark patches growing in size

Mostly, these are the indicators of hyperpigmentation that you need to watch out for. Any such thing, and you should consider consulting your dermatologist for further diagnosis and treatment. It’s always safer not to indulge in self-treatment. 

Apart from these, you have to be on the lookout for certain risk factors as well. Be cautious if any of these factors are at play in your case.

• Genetics: Approximately 40% of the melasma patients had relatives who had the disorder. 

• Psychotropic drugs: Be cautious if you are taking any anti-anxiety or antidepressant medication. These can increase the chances of hyperpigmentation.

• Over-exposure to the sun: If you are a sportsperson or anyone who spends a lot of time outdoors, you are at a greater risk of getting hyperpigmentation.

• Darker skin tones: People with darker skin tones are at a greater risk of pigmentation than those with lighter skin tones.

• Pregnancy: If you are pregnant, your hormonal changes can put you at risk of hyperpigmentation.

• Skin conditions: People who suffer from skin conditions such as eczema and psoriasis develop skin pigmentation due to the inflammation.

It is always best to connect with your dermatologist. If the doctor suggests basic topicals you may be required to undergo a thorough investigation before initiating therapy.

When you consult the dermatologist for hyperpigmentation, be sure to carry your medical history, including your drug usage and genetic conditions. This helps the doctor understand the root of the problem and also prescribe medication that does not interact adversely with your system.

There are certain ways in which a doctor can diagnose your condition. The most basic is a physical examination that can be taken both via a walk-in appointment or over a video call. We recommend the latter during the current pandemic scenario.

If a physical examination proves sufficient, the doctor may conduct a skin biopsy to find out exactly what is wrong

Once the doctor figures out the cause and type of hyperpigmentation, it is time for treatment.

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Over the counter medicines:

In the case of mild hyperpigmentation, doctors may prescribe over-the-counter (OTC) medication. These medicines can also be acquired without prescriptions as they are primarily created to lighten the dark spots. 

While hydroquinone is a common ingredient in OTC ointments  for hyperpigmentation, one has to remember the side effects as well. If used for a prolonged period, it can actually cause a skin-darkening condition known as ochronosis. The best way to use the drug? Ask a dermatologist. They will guide you on the correct dosage so that you don’t end up getting another condition in the quest to treat the other one.

Topical retinoids:

Another way to treat hyperpigmentation is topical retinoids. These are vitamin A derivatives. Both topical retinoids and hydroquinone are effective but work gradually over a period of time to show some concrete effects on hyperpigmentation. It depends on the severity of skin pigmentation and also the dosage prescribed to you by the doctor. These agents cannot be used by pregnant and lactating women and also cause a range of adverse effects if not used correctly.

Azelaic acid, Kojic acid:

Azelaic acid is a gentle depigmenting agent that is used if hyperpigmentation is caused due to inflammation and severe acne. It is also one of the safest agents. Kojic acid is also a recommended treatment. It is generated from a fungus and is known to produce tyrosine which is an amino acid required for the synthesis of melanin.

Vitamin B,C:

Some of the other treatments include vitamin C or ascorbic acid and Niacinamide which is a derivative of vitamin B3 and also regulates collagen production in the skin, making it supple and elastic.

Chemical procedures:

Sometimes, doctors may also recommend chemical procedures in the form of  chemical peels. These physical treatments peel away or remove the hyperpigmented skin, allowing the healthier skin beneath to take its place.

Laser Therapy: 

These are in-clinic procedures that are more effective when combined with topical therapy. They require multiple sittings and give visible results quicker.

You can also practice prevention, as far as hyperpigmentation is concerned.

Home remedies for hyperpigmentation

There is nothing better than nature when it comes to skin care and prevention of any skin conditions. These natural home remedies as well that can help you prevent or treat hyperpigmentation or any form of skin pigmentation.

Here are some of the herbs and natural ingredients that you can use for mild hyperpigmentation. However, understand that these are not backed by scientific proofs and claims and are only in wider use because of common experiences of the users. You can give these a chance if your hyperpigmentation is not severe. But, know that these may not work if you are suffering from medical conditions.

• Aloe vera gel can help lighten the dark spots

• Liquorice root extract’s active component glabridin works to lighten the pigmented skin

• Green tea also helps in lightening the spots

Apart from these, simple prevention tips can help you out as well.

Hyperpigmentation can be easily prevented. There are certain things that you can do to avoid getting those dark patches.

Apply sunscreen while stepping out. This is one of the most basic things you can do. Sun exposure is one of the main causes of hyperpigmentation. Applying sunscreen with an SPF of 30 to 50 will protect you from all those harmful effects. Try a broad spectrum sunscreen that shields you against both UVA and UVB rays. Reapply every 2-3 hours during daytime, half an hour before stepping out. Consider getting a sweat-proof sunblock if you sweat a lot or are into sports. 

If you can, avoid stepping out into the sun between 9am and 4pm. Wear full-sleeved cotton, light-colored clothes and broad brimmed hats while stepping out, if you have to.

Have a good skincare routine in place. Your skin undergoes a lot of beating on a daily basis, whether due to external factors like pollution or internal ones like stress. Either way, it affects your skin. Hyperpigmentation can be prevented if you identify your skin type and use the products that are meant for your skin type. Also, choose toxicity-free products that are free from alcohol, sulfates, and parabens. Most importantly, use skin products that are gentle on your skin with every use and application.

These are excellent prevention tips in most of the cases, but if you fall in any of the risk categories, you have to be extra careful. In those cases, you may get hyperpigmentation despite following all the tips and tricks.

 

Hyperpigmentation: The bottom line

Hyperpigmentation in itself is not a serious condition. But, as we have emphasized multiple times, it may be an indication of another underlying issue. Hence, it is important to prevent it when it occurs. 

In the pandemic times, with the doctors running pillar to post to bring some semblance of normalcy back to our lives, it is becoming increasingly difficult to get diagnosed for something as simple as hyperpigmentation. How do you walk in and say the same? Fortunately, there are better options.

With SkyMD, you can now consult your doctor on a video call. Get examined over a chat or video call, and get consultation over an audio or video, whatever suits you. You do not need to have a prior appointment as well. All you need to do is download our app, fill up the details, and get going. You are not alone. With SkyMD, get your online dermatologist now.

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