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Monday, April 11, 2016

More Questions about Hyperpigmentation

This young lady really just has freckles, not true hyperpigmention. Love your freckles!
I am concerned because I spent a lot of time in the sun when I was younger playing tennis, swimming, and running. As a result, I have brown spots. So what do I do now?

My question to this person would be are you still an active, outdoorsytype person? If the answer is yes, you can spend a lot of money trying to erase the spots you have accumulated from the past, but as long as you are still in the sun to a large (or even a small) degree, the brown spots are going to keep occurring. If you have them now, you are prone to getting them. If you are susceptible now, you probably will be for the rest of your life. Rather than viewing this as a life sentence of irregular pigmentation, accept it as simply a fact and a reality in your life.

If you’ve read any of my articles on hyperpigmentation, you will know that avoiding direct sunlight is going to be your biggest help in stopping the brown spots from occurring in the first place as well as helping lighten the darkness you already have incurred. Several of the newer laser technologies have had good results with existing pigmentation irregularities. But please know that you truly control this situation by controlling the amount of direct sunlight that reaches your face. You probably were not aware of this in the past, but by using this knowledge going forward, you can help the dark spots to fade over time.

I break out and also have dark spots on my skin that I would love to try to lighten. Is there a product I could use for that?

There are several products out on the market that say they lighten pigmentation. Some are actually bleaching creams, and others inhibit melanin production. Many of the creams to reduce pigmentation also contain glycolic acid or even retinol. To any of you who have redness in your skin like couperose and especially rosacea, I caution you against using these types of creams. I see redness worsen when using AHAs (glycolic is an AHA) or retoinoids. Don’t take care of one thing, like hyperpigmentation, and cause another, like redness or couperose.

Even if you successfully use one of these bleaching or melanin inhibiting creams, you still have to be ultra-sensitive to how much sun exposure you are getting. No matter how light your spots get, if you are prone to hyperpigmentation, then you are prone to hyperpigmentation. Lightening the dark spots does not change this tendency.

It’s a drag I know because I have hyperpigmentation. When I was in my early 30s, my fluctuating hormones created for the first time in my life dark spots, sometimes called chloasma, melasma, or hyperpigmentation. Whatever you want to call it, I had dark patches all over my face—mostly on my cheeks and forehead. Now in my 50s, things have not changed; I am still susceptible to darkness unless I am ultra-careful not to get direct sunlight on my face. I wear a water-resistant sunscreen whenever I am out exercising (or in the sun for whatever reason), and still if I’m not careful, I’ll get the dark spots.

If the pigmentation spots this emailer is inquiring about are due to her breakouts, this could be a condition called post-inflammatory hyperpigmentation. For more information, see: