Hyperpigmentation occurs when the skin overproduces melanocytes, melanin-producing cells that give skin its color. This increase in melanocyte activity has been shown to be stimulated by several inflammatory mediators that are released when inflammation occurs. This is true for all skin colors. Wu IB, Lambert C, Lotti TM, Hercogová J, Sintim-Damoa A, Schwartz RA. Melasma. G Ital Dermatol Venereol. 2012 Aug;147(4):413-8. https://pubmed.ncbi.nlm.nih.gov/23007216/ Professional treatments can be used as a single treatment or paired with a topical medication to target hyperpigmentation in different ways. Often, corticosteroids are included in the skin-lightening regimen to minimize irritation caused by topical skin-lightening products. Peels Topical Corticosteroids on the Incidence of Postinflammatory Hyperpigmentation After QsNdYAG Laser. https://clinicaltrials.gov/ct2/show/NCT02492373

In one clinical trial, researchers found the incidence of PIH decreased by 40% after a topical corticosteroid was applied 2 days before and after ND:YAG laser treatment. Hakozaki T, Minwalla L, Zhuang J, Chhoa M, Matsubara A, Miyamoto K, Greatens A, Hillebrand GG, Bissett DL, Boissy RE. The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer. Br J Dermatol. 2002 Jul;147(1):20-31. doi:10.1046/j.1365-2133.2002.04834.x In one clinical study niacinamide was shown to significantly decrease hyperpigmentation and increase skin lightness. Singh A, Yadav S. Microneedling: Advances and widening horizons. Indian Dermatol Online J. 2016;7(4):244-254. doi:10.4103/2229-5178.185468 Soy extract has demonstrated strong depigmenting activity as well as the ability to prevent sun-induced pigmentationHow Often To Use It: This depends on what other ingredients it's compounded with and the concentration, but generally, it can be used daily. The best treatments are those that offer a low risk of inflammation such as skin lightening creams, retinoids, and light glycolic and salicylic acid peels.

Natural treatments cannot compete with the results of professional in-office treatments but can provide some mild improvements when used consistently: This skin type has a low propensity to burn as well as a very low incidence of cancer as a result of sun exposure. This is due to the role melanin plays in protecting the skin by absorbing and scattering energy from UV light.Topical prescription medication can treat some cases of hyperpigmentation. This medication usually contains hydroquinone, which lightens the skin. I am using it 30 seconds each time, and in the evening after rinsing I am leaving it on my hyperpigmentation areas for another 30 seconds. There are a number of OTC products such as brightening serums and creams that, with consistent use, can fade dark spots. Either can also be used as spot treatments to target individual spots rather than the entire face. Grimes PE. The safety and efficacy of salicylic acid chemical peels in darker racial-ethnic groups. Dermatol Surg. 1999 Jan;25(1):18-22. doi:10.1046/j.1524-4725.1999.08145.x

Works Well With: According to Nazarian, studies have shown that kojic acid works well with and enhances the effects of glycolic acid and hydroquinone. Saeedi M, Eslamifar M, Khezri K. Kojic acid applications in cosmetic and pharmaceutical preparations. Biomed Pharmacother. 2019;110:582-593. doi:10.1016/j.biopha.2018.12.006

Barnes PJ. How corticosteroids control inflammation: Quintiles Prize Lecture 2005. Br J Pharmacol. 2006;148(3):245-254. doi:10.1038/sj.bjp.0706736 Glycolic acid peels have been shown to be the most effective and safe peel for this skin type as well as azelaic acid. Both acids can be combined to attain greater results. Owolabi JO, Fabiyi OS, Adelakin LA, Ekwerike MC. Effects of skin Lightening cream agents—Hydroquinone and kojic acid, on the skin of adult female experimental rats. Clin Cosmet Investig Dermatol. 2020;13:283-289. doi:10.2147/CCID.S233185

Kooyers TJ, Westerhof W. Toxicologische aspecten en gezondheidsrisico’s van hydrochinon in huidbleekformuleringen [Toxicological aspects and health risks associated with hydroquinone in skin bleaching formula]. Ned Tijdschr Geneeskd. 2004 Apr 17;148(16):768-71. https://pubmed.ncbi.nlm.nih.gov/15129564/ Typically, it is the combination of treatments that offer the best results such as hydroquinone or azelaic acid and microdermabrasion. Length of treatment will depend on the cause and severity, as well as individual response. With that being said, it can take from 3–12 months to see significant improvements. Products to Treat Hyperpigmentation Vitamin C is also a tyrosinase inhibitor, and can lighten dark patches and neutralize free radicals to prevent dark spots from forming Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. 2010;3(7):20-31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921758/

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Home care also includes using sunscreen. Sunscreen is the single most important factor in improving most causes of hyperpigmentation. Look for: Huerth KA, Hassan S, Callender VD. Therapeutic Insights in Melasma and Hyperpigmentation Management. J Drugs Dermatol. 2019 Aug 1;18(8):718-729. https://pubmed.ncbi.nlm.nih.gov/31424704/ Main Benefits: Inhibits an enzyme necessary to produce melanin, helping to fade dark spots and discoloration. It also delivers some antioxidant protection.