For many people of color, the biggest skin concern is dark spots and an uneven skin tone. In this post, Dr. Zenovia details the causes of hyperpigmentation and provides top tips to treat and prevent the formation of dark spots. While hyperpigmentation can affect all skin tones, darker skin can be more affected due to the increased presence of melanin in the skin.

Hyperpigmentation Causes

Hyperpigmentation is essentially the overproduction of melanin (brown pigment) in the skin that manifests as dark spots, patches, or an uneven skin tone. The darkening of the skin is due to a multitude of factors including sun exposure, hormones, and genetics. Dark spots or patches like we see with melasma appear darker than the adjacent skin because these areas have a higher concentration of melanin pigment deposited in the base of the skin.

Melanin is our skin’s defense to the sun’s rays. We defensively produce this brown pigment to guard the DNA in our skin cells and prevent DNA damage that leads to skin cancer. Melanin serves as an umbrella to our cells- it shields and absorbs the harmful rays that enter our cells and cause DNA damage. Our skin cells can overproduce melanin both in the sun and when our skin is “traumatized” or inflamed. The skin responds to tissue injury by producing melanin, especially in darker-skinned individuals. People of color have a tendency for hyperpigmentation and skin darkening after inflammation or injury including inflammatory acne, laser treatments, or a scab or cut in the skin.

Heat, hormones, and picking at your skin exacerbate hyperpigmentation, but the sun has the greatest impact. Many patients notice an increase in hyperpigmentation during the summer months due to increased UV stimulation and melanocytes.

Melasma

Melasma, one of the most misunderstood skin conditions, is a common form of hyperpigmentation that manifests as brown spots on the cheeks, forehead, and upper lip among other areas. Melasma is hormonal, environmental, and genetic. Melasma can improve with the right intervention- either topicals, lasers, or chemical peels, but if your body produces melasma it is likely to return. Melasma never goes away forever so you need to learn how to manage and treat it. Melasma is a vascular condition, meaning when the vessels in your skin are dilated, this can cause more blood flow to the melanocyte which produces more pigment.

Many people get fooled by gimmicks and false promises that certain treatments will make their melasma go away forever, but this is not possible. Melasma is a complicated pigmentary disorder that requires both treatments with procedures, topical maintenance, and daily prevention. We know for certain that melasma is a sun-induced condition so sun avoidance and sunscreen are critical to successful therapy.

We also know that hormones play a key role in the development of melasma. During pregnancy, many women start to see brown patches, pigment disorders, and sunspots due to fluctuating hormones in the skin. Oral contraceptives and other hormone replacement medications can cause melasma and pigmentation as well.

Recently considered a vascular disorder, some treatments for melasma work by targeting the blood vessel bed in the skin. The blood vessels in the skin deliver inflammatory meditators and bring blood flow to the melanin-producing cells so the vascular bed is a culprit for this pigment disorder. There are oral medications available, such as tranexamic acid that is used for recalcitrant melasma.

Hyperpigmentation At-Home Skincare Treatments

Dr. Zenovia recommends the following morning and nighttime skincare treatments to help treat hyperpigmentation. If you don’t notice a difference after three to six months, consult a board-certified dermatologist for in-office skin treatments or prescription creams.

AM Treatments

Antioxidation (Vitamin C) and sunscreen should be incorporated into your daily morning skincare regimen to combat hyperpigmentation.

Vitamin C: A powerful antioxidant that protects the skin from free radical damage and promotes collagen synthesis, Vitamin C fights against sun damage and reduces the appearance of an uneven skin tone and hyperpigmentation. However, it's important to note that not all Vitamin C topicals are created equally. L-ascorbic acid is the active form of Vitamin C which can be irritating and very unstable in an oxygenated atmosphere. Many Vitamin C formulations on the market oxidize when you open the bottle and become inactive before they touch your skin. This occurs because Vitamin C is quite unstable and the vehicle or structure isn’t made to protect the fragile molecule. 

Dr. Zenovia’s Vitamin C is created with very mindful chemistry and made to work as a true active on the skin. We use the absorbable, active form of Vitamin C (an esterase form). In addition, our Vitamin C is manufactured using an argon gas hood so that the Vitamin C will not destabilize during the packaging process and when you use the product. “It is really amazing what we have done to create a stable molecule," Dr. Zenovia shares. “The Vitamin C we use is in an esterase form. This is essentially when the esters are in a different form from the L-ascorbic acid so that it is more stable and tolerable to the skin. When it enters the tissue, our enzymes cleave it, and it becomes active Vitamin C. The esterase form also provides a timed-release effect so you don’t get that rush of a harsh, too-powerful molecule which can lead to irritation. The Vitamin C products we created serve as powerful systems in your tissue that will absorb free radical damage and brighten dark spots.”

Dr. Zenovia’s Vitamin C Brightening Toner can be applied morning and night after cleansing. Rich in Vitamins C & E, this antioxidant-rich toner brightens the skin and calms redness while Micronutrient Sea Salt helps neutralize pore-clogging impurities to restore the look of radiant, healthy skin.

Sunscreen: Avoiding the sun is paramount in preventing and treating hyperpigmentation and dark marks! Dr. Zenovia does not recommend sunbathing outside for any length of time. A minimum of SPF 30 should be applied daily, whether you will be spending time outdoors or not. Also, wear a hat outside and avoid tanning beds.

Dr. Zenovia’s Vitamin C Brightening Moisturizer SPF 30 delivers highly potent Vitamin C in its active form and combines the added benefit of a powerful sunscreen. Whether you suffer from melasma, acne scarring, sun spots, or have flawless skin everyone can benefit from using this product to even out skin tone and improve texture, while protecting collagen health and brightening the complexion. Clinical-grade Vitamin C-Ester visibly helps minimize the appearance of dark spots, discoloration, fine lines, and wrinkles associated with photoaging. Additionally, transparent nano zinc-oxide offers 360-degree broad-spectrum mineral protection from harmful UVA/UVB rays, free radical damage, and environmental stress for radiant, even-toned skin. This product is a one-stop-shop for your morning regimen!

PM Treatments

Alpha hydroxy acids (AHAs) and Retinol are the best nighttime treatments for hyperpigmentation. These ingredients should not be used during the day as they can increase the skin’s sensitivity to sunlight. It is especially important to use an SPF daily when using actives such as retinol, AHAs, and BHAs!

AHAs: Alpha Hydroxy Acids such as Glycolic Acid help treat hyperpigmentation, enlarged pores, fine lines, wrinkles, uneven skin tone, and texture. AHAs can be applied to all skin types, however, people with dry, sensitive skin should be cautious when using any type of acid to avoid skin irritation.

Dr. Zenovia’s 10% Glycolic Acne Control Peel Pads are specially formulated to promote the skin’s cellular renewal process, unclog pores, accelerate the removal of dead skin cells, and target acne scarring. Dr. Zenovia recommends these pads to acne patients and for anyone with pigmentation issues, scarring, or melasma.

Retinol: Retinol helps fade dark spots caused by hyperpigmentation over time. Retinol also enhances cellular turnover so the top layer of our tissue (stratum corneum) is more smooth and radiant. This is why it is considered the number one anti-aging ingredient in dermatology literature (second only to sunscreen)! If applied consistently, retinol can minimize the appearance of hyperpigmentation, melasma, brown spots, and other pigmentation disorders.

Dr. Zenovia’s Advanced Retinol Night Repair Treatment helps support collagen synthesis and deeply penetrates the epidermis through a unique micro-polymer delivery system to support absorption. “When formulating my retinol, I wanted it to be tolerable so you wouldn’t get red and flaky, but still be effective”, Dr. Zenovia shares. “We have therefore kept our retinol in its original molecular state. Our amazing team of chemists created a powerful retinol technology that is encased in a micro polymer delivery system. This system encases the retinol inside like a sponge, keeping the molecule stable as it travels past the skin barrier, into the tissue, and finally into the cell and nucleus (the retinol receptor is deep inside each cell). The micro polymer system not only improves absorption but also stabilizes the retinol from chemical degradation or molecular transformation. The last bit of creative chemistry was to create a formula that fed the skin a time-release effect of the retinol to avoid the harsh concentrations we see with so many retinol formulations. Bathing the skin in this active molecule over time makes it less irritating and tolerable even to the most sensitive skin types.

With retinol, it's always a very delicate dance. You want to use retinol to the point where your skin is just starting to shed and is a little flakey. This is the point where you know it's working because the desquamation process is taking place and this is a marker for collagen synthesis. If you are using a retinol and are still oily, that’s a sign you're not using enough, or that your retinol is too low a concentration. The goal is to have balanced skin (in terms of oiliness) and slightly on the verge of flakey. When you get to this point, you are stimulating your collagen, desquamating your pores, and achieving that radiant glow we see with retin-ized skin.”

Note from Dr. Zenovia: It is important to gradually introduce actives such as Glycolic Acid and Retinol into your skincare regimen. If excessive dryness or irritation occurs, reduce application.

Hyperpigmentation Professional Skin Treatments

The best in-office procedure to treat hyperpigmentation on darker skin tones is specific lasers and safe chemical peels. With chemical peels, a chemical agent is applied to the skin, which causes controlled destruction of part of the epidermis. This leads to the exfoliation and removal of superficial skin lesions as well as the regeneration of epidermal and dermal tissue. Deep and medium-depth peels should be avoided for patients with darker skin tones because this “trauma” can actually lead to more hyperpigmentation. This is called post-inflammatory hyperpigmentation and is very difficult to treat. Be very cautious about the chemical peel or laser you decide to use because people of color can get hyperpigmentation after procedures. Make sure your practitioner is adept in all the procedures you are paying for. Dr. Zenovia has seen many adverse effects from even the best doctors, nurses, and estheticians.

Dark skin is delicate and needs conservative therapies because aggressive lasers and chemical peels that are too harsh or deep can worsen melasma and pigment. A board-certified dermatologist will be able to recommend an appropriate peel or laser for your skin tone. Laser treatments work well on lighter skin tones, but many are safe for darker skin types too. There are many lasers on the market that can work and are indeed safe for any skin type if used properly and with the correct, safe laser settings. Shorter, pulsed lasers such as nano and pico lasers tend to be the safest options for darker skin types.

Again, make sure you get treatment from someone with experience. It is also important to remember that melasma, dark spots, and pigmentation can come and go regardless of the procedures you try. Daily topical maintenance and prevention are key.

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