Hyperpigmentation Series: What It Is & How To Treat It? Part 2
How Do You Treat It?
Yesterday I covered the three forms of hyperpigmentation in my post on What Is Hyperpigmentation?. If you didn't read it or do not care to, I will summarize it here, the three forms are: post-inflammatory hyperpigmentation (PIH), photo-damage and melasma. These are all very different and caused by three distinct different types of issues. If you have any of these kinds of hyperpigmentation you are probably wondering what the best way to treat it is. And that is a good question. Even though they are all caused by different things, treating them can be very similar in nature since you are treating the root cause, which is the overproduction of the melanocytes.
Treating hyperpigmentation is often frustrating because you may want it to go away faster than it can. There are different methods and they often involve chemical exfoliants, as these generally work quickly and can in fact, work best for most people. AHAs (alpha hydroxy acids) work very well in treating it. Say you are treating PIH. Generally the moment your lesion has healed you want to start treating it, so that you can begin collagen synthesis again. I like to use AHAs to do that. Generally a good AHA can heal the lesion and resulting PIH in record time, without any scarring (as long as there hasn't been any excoriation).
Now, the decision is which one should you use? That depends on your skin type. Every AHA works better depending on your skin type. For example, glycolic acid, which comes from sugar cane, is a general all around good AHA and can work on any skin type (except sensitive skin) but is fairly strong. It is hydrophilic (water soluble) and increases the luminosity of the skin (meaning it will brighten the skin) as it exfoliates. Lactic acid also a good choice for skin, especially dry skin types. It comes from milk and is a bit milder which is why it works well for dry skin, and will not cause as much moisture loss. It also helps to even out texture and tone of the skin.
Some peels that are offered in the salon or in a doctor's office are better for hyperpigmentation. These include a Jessner's peel (combination of lactic acid, salicylic acid and resorcinol), a trichloroacetic acid peel (TCA) and an Obaji peel (salicylic acid). All of these are light to medium depth peels. These are strong and would involve downtime as they "frost" the skin and involve significant peeling of the skin. However, the results make it worth the cost and downtime as they increase collagen production by actually injuring the skin, thus decreasing PIH, increasing luminosity and significantly decreasing fine lines and wrinkles too. These work well for all types of hyperpigmentation and for the most part can be used on all skin tones, surprisingly.
Other choices that are acids, but not AHAs, include the following acids. Azelaic acid, is stronger, has anti-inflammatory properties, speeds up cell turnover rates and is a good choice for any skin type. Made from barley, wheat or rye, it also has the benefit of helping to inhibit the production of melanin in the skin and is a tyrosinase inhibitor. It is one of the best options for PIH if you are prone to acne. It works well for photo-damage and melasma too. Tranexamic acid is not as well known but works extremely well for PIH, photo-damage and melasma. It is a good choice for any skin type and is a synthetic derivative of the amino acid lysine. Kojic acid is also useful and affects the production of tyrosine, which is an amino acid needed to produce melanin. Kojic acid is a fermentation byproduct of saké (a Japanese wine made from rice), as well as soy sauce. The name “kojic acid” is derived from the Japanese word “koji,” which means steamed rice. It is best at treating photo-damage and melasma.
Another treatment for hyperpigmentation is hydroquinone, although it is less popular. There is 2% OTC treatment and a 3%-4% Rx formula available. Hydroquinone works by blocking the enzyme responsible for melanin production, thereby lightening the skin. The main issue people have with hydroquinone is that it will not only lighten the hyperpigmentation but also the surrounding skin too, so only apply it to the hyperpigmentation only. There have been a few concerns with hydroquinone that it might be carcinogenic. These studies are inconclusive still.
Retinoids are a Vitamin A derivative that work very well for hyperpigmentation. These work by increasing the turnover of skin cells and decrease PIH, photo-damage and melasma. They also have the advantage of helping to decrease fine lines and wrinkles at the same time. Some are only available with a Rx, such as Retin-A (isotretinoin), which is used for fine lines and wrinkles. Differin (adapalene) is now available OTC and works wonderfully for acne too. Retinol is OTC and the least strongest out of all the retinoids. The main concern with retinoid use is dryness, redness and irritation. One must start out slow and work up to using them daily over a period of time. You can actually trigger inflammation from using retinoids too quickly and too much at once.
Vitamin C is another popular choice for hyperpigmentation treatment. It has been one of the most popular and easiest treatments for years. I would only recommend it for mild pigmentation issues though or in combination with other therapies. Using a Vitamin C serum is beneficial because it helps to inhibit the enzyme tyrosinase. This prevents melanin production and breaks down built up "patches" of melanin in the skin. It only affects the melanin in the skin, not all the skin, unlike hydroquinone. Another reason to use it is that it helps to increase collagen production and reduces fine lines and wrinkles.
Alpha arbutin is another popular ingredient right now and is quite innocuous. It doesn't cause irritation and is very effective at helping with hyperpigmentation. It is a glycolylated benzoquinone that is a non-phenolic agent. It works best in at least a 2% solution or higher.
Turmeric has been shown to brighten the skin but is only for those who don't have severe pigmentation issues. It works but works only on mild to moderate cases. I would recommend it for PIH and mild photo damage only.
Finally, a very popular ingredient right now is niacinamide (Vitamin B3). When used in as little as a 2% formula, it has been shown to be very effective at getting rid of hyperpigmentation. It is comparable to 4% hydroquinone! It works by inhibiting melanosome transfer from melanocytes to keratinocytes. This is the new miracle ingredient and can be found in a number of products. So much so that they are popping up everywhere. Licorice root is often found in products with niacinamide. They work in conjunction to help lighten up hyperpigmentation and PIH.
And that is where I will leave off...tomorrow I will finish this series with different products that I like and think do a fabulous job regarding helping to get rid of hyperpigmentation. I hope this has been beneficial and educational. If you have any questions feel free to email me at: mariepapachatzis@gmail.com or Tweet me @iammakeupjunkie, subscribe to my Snapchat channel: iammakeupjunkie. Thank you for reading!
Until Next Time~
Marie Papachatzis
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