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 Hyperpigmentation Series: What It Is & How To Treat It? Part 1

What is Hyperpigmentation?

Probably one of the most frustrating things for most people, besides persistent acne, is hyperpigmentation. In this series on hyperpigmentation I will discuss what exactly is hyperpigmentation & how it is commonly treated. I will also discuss some good products and treatments for each type of hyperpigmentation. There are 3 types of hyperpigmentation: post-inflammatory hyperpigmentation (PIH), photo damage (sun damage) and melasma. First let's discuss each type separately and then how to treat each one. Then I will discuss some products for each type. 

PIH is usually, but not limited, to acne lesions. It is commonly due to picking and scarring. Picking is called excoriation. It can also be caused by just having a lesion. PIH can also be caused by lesions like cysts, nodules, papules and pustules. If you are more interested in acne lesions, see my treatise on acne entitled: What Is Acne? How Do You It Treat It?. PIH is red and angry looking and often fades to a pink, light brown or white scar after a certain length of time. Basically PIH is damage to the dermis or epidermis with a deposition of melanin to the keratinocytes (skin cells). Inflammation in the epidermis causes the melanocytes (pigment producing cells) to increase melanin synthesis and transfer it to the surrounding keratinocytes, as seen in the first photograph. It can also occur when the skin is burned though, as seen in the second picture below. This one is more severe and usually leads to skin that scars differently. It might produce a keloid scar or a slightly raised white scar when it is finally healed. 

Next, there is photo damage (sun damage), another form of hyperpigmentation, which is the most common kind. This occurs when melanin in the skin is exposed to UV radiation from the sun. It is the structural and functional deterioration of sun exposed skin resulting in freckling, fine lines, wrinkling, roughness, altered texture, discolorations, lentigines, mottled hyperpigmentation, epidermal thickening, degeneration of the dermis, degeneration of collagen and elastin, damage to dermal vessels, the presence of skin cancer, and sun spots. Damage to the skin results from prolonged exposure to UV irradiation. It damages the skin's fibers and is the cause of up to 90% of skin aging. Sunscreen use EVERYDAY, rain or shine and use indoors & outdoors can prevent photo damage to the skin. It is recommended that one wears a broad spectrum sunscreen (covering UVA/UVB rays) of at least a SPF30 daily and reapplied every 2 hours. Also, it is best to avoid the sun's rays between the hours of 12-4 pm when they are the strongest, especially during the summer months. 

Below you can see two types of  photo damage, freckling and more advanced photo damage that has accrued over time. Freckling may look cute but it is photo damage all the same and it dangerous. It results from UV exposure and is not good for the skin. Even those with highly pigmented skin can experience freckling and photo damage, and should wear sunscreen everyday. Skin cancer, especially melanoma, is on the rise in younger people. For example, I am only 49 and have already had skin cancer twice. Once on the end of my nose and once on my upper arm. Granted I have a fair amount of photo damage and I am a Fitzpatrick I on the dermal scale (what dermatologists use to describe susceptibility to sun damage). I never tan, only burn in the sun and have very fair skin with light hair and blue-green eyes. The scale goes from a I to a VI and assesses your skin cancer risk. 

Melasma is the third type of hyperpigmentation. It is seen often in women of color, pregnant women (called the mask of pregnancy) or women experiencing menopause. It is thought to be triggered by UV exposure. It is often due to hormonal changes in the body. This latter aspect is what makes it difficult to treat. Below are some photographs of melasma showing how it is different than regular hyperpigmentation. 

In conclusion for Part 1, these are the three forms of hyperpigmentation. I will go into greater depth on how to treat them in Part II. 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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