Hyperpigmentation is a common clinical condition for which many people seek remedies because they view it as being cosmetically displeasing. It can affect people of all skin colors and races, and tends to increase as we age. For example, almost all African-American infants become darker shortly after birth. Hyperpigmentation is not a medically harmful condition. However, it always is advisable to have new brown spots checked by a physician to make sure they are not skin cancers.
HOW SKIN COLOR IS FORMED?
Normal skin color is formed by melanin, a natural pigment that also determines hair and eye color. The pigment in our skin is formed by the process of converting the amino acid tyrosine into melanin with the help of the enzyme tyrosinase.
WHAT IS HYPERPIGMENTATION?
Hyperpigmentation occurs when too much melanin is produced and forms deposits in the skin. When too much melanin is produced, deposits are formed and hyperpigmentation appears in the skin. Age spots or liver spots are small, mottled or darkened patches of skin which appear in older adults — especially on the face, the backs of hands, and arms in individuals who have been exposed to the sun. The medical name for this condition is solar lentigines. Hyperpigmentation also results from inflammation orother skin insults. For example, skin diseases such as acne or shingles may leave darkened spots. Scars from skin injury or surgery also may become hyperpigmented.
HOW DOES HYPERPIGMENTATION SHOW UP?
Age or “liver” spots are a common form of hyperpigmentation. They occur due to sun damage, and are referred to by doctors as solar lentigines. These small, darkened patches are usually found on the hands and face or other areas frequently exposed to the sun.
Melasma or chloasma spots are similar in appearance to age spots but are larger areas of darkened skin that appear most often as a result of hormonal changes. Pregnancy, for example, can trigger overproduction of melanin that causes the “mask of pregnancy” on the face and darkened skin on the abdomen and other areas. Women who take birth control pills may also develop hyperpigmentation because their bodies undergo similar kind of hormonal changes that occur during pregnancy.
Changes in skin color can result from outside causes. For example, skin diseases such as acne may leave dark spots after the condition clears. Other causes of dark spots are injuries to the skin, including some surgeries. Freckles are small brown spots that can appear anywhere on the body, but are most common on the face and arms. Freckles are an inherited characteristic.
Freckles — small, flat tan-to-black spots that can be anywhere on the body — also become more permanent during the first or second decade of life. Often hereditary, freckles also can darken with sun exposure and fade with less sun exposure. This happens because melanin absorbs the energy of the sun’s harmful ultraviolet rays in order to protect he skin from overexposure. The usual result of this process is skin tanning, which tends to darken areas that are already hyperpigmented. Wearing a sunscreen is a must. The sunscreen must be “broad spectrum” (i.e. it blocks both ultraviolet A and B). A single day of excess sun can undo months of treatment,
WHAT ARE MY OPTIONS FOR TREATMENT?
Effective skin care products are formulated to interfere in the process excess melanin formation and discoloration.
Hydroquinone is a common ingredient in skin lightening products. It is available over the counter in concentrations up to 2 percent, and can be prescribed in concentrations up to 8 percent. However,
hydroquinone can be very irritating at high concentration, and should be used under the care of a physiciancan.
Arbutin is a natural plant extract that helps prevent additional brown spots from occurring by stopping the production of melanin. Uva-Ursi also contains three strong antioxidants: ferulic acid, caffeic acid, and chlorogenic acid. These antioxidants neutralize oxygen free radicals that can damage skin. The three
acids also help in the production of which help protect skin.
Kojic acid is a skin lightener produced from fungus. Discovered in Japan in 1989, it has been used with excellent results to lighten skin and reduce brown spots. Like arbutin, it blocks the formation
of melanin pigment in skin cells.
Thyme, an herb plant indigenous to the Mediterranean, is known for its antiseptic and soothing properties. Thyme extract contains thymol, which has strong antiseptic and antioxidant properties, and helps to prevent future oxidative breakdown of cells. Thymol stops the production of melanin.
Cucumber Extract, the bitter part of the cucumber plant which contains curcubitacin known for its emollient and soothing properties. Traditionally, cucumber slices have been used to remove dark circles from the area underneath the eyes.
Whether it is a medial concern or a cosmetic question please see your physician for expert answers. Timely and effective treatment are the keys to obtaining you skin care goals.
Writen by Dr. Edward E. Dickerson, IV, M.D. is the Medical Director of Cape Fear Aesthetics Medical Spa here in Fayetteville. He is double board certified by the American Board of Facial Plastics & Reconstructive Surgery as well as the American Board of Otolaryngology-Head & Neck Surgery.
