Understanding hyperpigmentation

Hyperpigmentation manifests itself by the appearance of numerous and extensive brown spots, generally concentrated on parts of the body exposed to the sun: face, neck, back, etc. Often considered unsightly, these spots can have several causes.

Submitted on 20/07/2012

 

What is hyperpigmentation?


Pigmentation is a defence mechanism of the skin to the sun: in response to UV exposure, specific cells of the skin called melanocytes produce a brown pigment, melanin, which colours the skin evenly.
But sometimes this colouration becomes anarchic: produced in excess in some areas, melanin accumulates locally and the skin takes on a darker colour. This is known as hyperpigmentation: smallish brown spots form, contrasting with the lighter-coloured surrounding skin. These spots are harmless and painless but they are often regarded as unsightly.


Different types of hyperpigmentation


Various causes may be responsible for the appearance of brown spots: excessive exposure to sun, age, hormonal changes, genetic predisposition or even a skin trauma. According to the trigger factor, hyperpigmentation takes on different forms:
 
  • Freckles: generally observed in people with blonde or red hair, with light-coloured eyes and fair skin, freckles or ephelides are small brown spots that darken and multiply when exposed to the sun. These spots may be charming but not everyone finds them easy to live with and they are genetic. They appear in early childhood and then increase with puberty before declining, often in your thirties.
  • Melasma: associated with hormonal changes and aggravated by sun exposure, melasma is characterised by the appearance of areas of brown pigmentation symmetrically spread over the forehead, nose and cheeks. It occurs more often in people with dark hair and olive skin. Melasma is particularly common in pregnant women: it is called "pregnancy mask" or "chloasma" and it usually disappears a few months after childbirth. It can also form after taking an oral contraceptive, or in connection with certain hormonal diseases.
  • Lentigos: small round or oval brown spots, lentigos may be related to age (senile lentigos or age spots) or excessive sun exposure (actinic or solar lentigos). They reflect the inability of the epidermis to manage the harmful effects of UV. People with fair skin, more vulnerable to the sun, are most affected by lentigos.
  • Post-inflammatory hyperpigmentation: following trauma (cuts, burns), an infection, a skin reaction to medication or skin disorders like eczema or acne, the skin may remain darker in the affected areas. This type of hyperpigmentation is seen especially with olive or dark skin which is richer in melanin.

All types of brown spots become accentuated when exposed to the sun without protection.


Treating hyperpigmentation


Hyperpigmentation of the skin is not harmful. However, many people want to reduce or eliminate their brown spots for aesthetic reasons. Nowadays there are different treatments that have proven their effectiveness: depigmenting creams, cryotherapy with liquid nitrogen, laser, flash lamp, peels, etc. Seek advice from your dermatologist: he or she will talk to you about the methods that are most suitable for the condition of your skin. In all cases, these treatments require strict sun protection for their entire duration, and also afterwards: there is a considerable risk of recurrence in the event of any exposure to UV rays. 

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