A dermatologist's guide to hyperpigmentation

What causes hyperpigmentation in melanin rich skin and the absolute best ways to treat it?

By Dr Carlos A. Charles, 4.5.6 co-founder and dermatologist @dermadicolore

Melanin rich skin has so many positive attributes they are almost too many to count. However, with every positive, there is always another aspect that isn’t always so great. One of the most challenging issues encountered in melanin rich skin is that even the smallest amount of inflammation can lead to stubborn and persistent hyperpigmentation. 

So, why is this phenomenon important?

For one, by far and away the most common concern reported by my patients with melanin rich skin is hyperpigmentation. Oftentimes that hyperpigmentation is what is known as post-inflammatory hyperpigmentation, and it is secondary to some other issue, such as acne, eczema, UV light exposure or any other phenomenon that causes inflammation. 

Why does this occur so easily in melanin rich skin? 

There are many factors, but one of the most important ones can be attributed to the beautiful melanocyte. The melanocytes are the skin cells that produce pigment or melanin. In individuals with melanin rich skin the melanocytes are incredibly robust, and capable of easily producing and releasing pigment into the epidermis. Whenever these melanocytes are faced with any form of inflammation they go into a melanin producing mode. This melanin is released into the epidermal cells and can remain trapped within these cells for days, months, or even years. Also, to make matters more challenging, this melanin also can find its way deeper into skin in the layer known as the dermis, as cells called melanophages try to do the work of removing the melanin, leading to deep, recalcitrant hyperpigmentation. 

So how do we treat stubborn and unwanted hyperpigmentation? 

The first point to make clear, no pun intended, when treating hyperpigmentation in melanin rich skin is that the goal should never be to bleach the skin. The aim of treating hyperpigmentation should first and foremost be to obtain a healthy appearing uniform complexion. Also, it is important to point out from the outset that it is rare for any real life person to have skin a complexion that is one hundred percent free of any slight pigment alteration. So while we are striving to achieve the best result possible, attainable expectations must be kept in mind. 

Below I have outlined just a few of the more common methods to treating hyperpigmentation:

 

1. Reversing the pathway responsible for the production of melanin

This is the most common approach used, and it is the mechanism that is used by Alpha Arbutin, Cysteine, Palmaria Palmata extract, Hydroquinone or the likes of Azelaic acid. All of these agents work at different areas of the supply chain so to speak for the production of melanin and they specifically inhibit an important enzyme known as tyrosinase which is chiefly important for the production of melanin. These melanin pathways reversing agents can be found in Sevenly Delight, our potent yet gently brightening serum.

Hydroquinone can however have several deleterious effects on the skin such as irritant or allergic contact dermatitis, uneven skin lightening and even paradoxical hyperpigmentation after prolonged use, so we advise avoiding it as a treatment modality, unless it is used under the care and direction of a medical professional. 

 

2. Treating the inflammation that leads to overproduction of melanin

This is a nuanced approach and one that is particularly important for melanin rich skin. As mentioned above, darker skin tones are particularly susceptible to the ill-effects of inflammation. Any increase in skin inflammation will trigger the melanocytes to produce new pigment which leads to recalcitrant hyperpigmentation. So one of the most important approaches in the management of hyperpigmentation is treat the skin delicately as possible and to efficiently address any potential triggers that could lead to inflammation. One of the best ways to accomplish this is to use a combination of active ingredients that act as calming agents through different mechanisms. Examples of these that are employed by 4.5.6 Skin include antioxidants such as the natural vitamin C from Acerola Extract, the powerful carotenoid Astaxanthin, and natural glutathione. These ingredients can be found in our brightening serum, Sevenly Delight, and our exfoliant mask, To Be Clear. These powerful ingredients help to delicately ward-off inflammation causing free radicals before they have a chance to do damage to the skin which can induce unwanted excess melanin formation.

 

3. Dispersing the melanin and increasing skin cell turnover 

This is a tried and true method and one that I employ everyday in my clinical practice. The main active ingredient for this method is the retinoid. Retinoids are known as our multitaskers in the skincare world because not only do they treat acne, prevent and treat fine lines and wrinkles, but they can also efficiently help to address hyperpigmentation. They mainly do this by increasing cellular turnover which will remove those epidermal cells containing melanin. They also help to disperse the remaining epidermal melanin granules, leading to a more even skin tone and reduced hyperpigmentation. Unlike the agents described above, tretinoin does not inhibit melanin synthesis. Because retinoids work by dispersing and exfoliating melanin granules in the deepest layer of the epidermis, they can significantly improve skin hyperpigmentation when used appropriately. The main downsides to using retinoids is that they can be difficult to tolerate in some individuals because of irritation and skin peeling.

 

4. Mechanical Exfoliation 

Mechanical exfoliation can take the form of abrading the skin with various products, anything from topical skincare products with artificial beads, to facial towels, to the now defunct Clarisonic- RIP. While mechanical exfoliation tends to be the go-to method for most people, and for many of my patients they feel that it will solve all of their skin problems, it is fraught with peril for those with melanin rich skin. Once again, inflammation is the bane of existence for darker skin, and of course, any sort of trauma can lead to inflammation. So while mechanical exfoliation is used by many, we rarely advocate its use for melanin rich skin.

 

5. Chemical Exfoliation 

Chemical exfoliation can take various forms with the most commonly employed technique being the chemical peel. There are a bevy of commercially available chemical peels. As the name implies, they mostly work gently stripping away a layer of the epidermis. Additionally, several peels also have active ingredients that also also work as antioxidants or disruptors of the pathway of melanogenesis such as vitamin C. Peels are typically categorised as superficial, medium and deep peels. Superficial peels are typically the safest in melanin rich skin as the medium and deep peels can cause oftentimes permanent unwanted results such as hyperpigmentation and scarring. Some of the more commonly used agents in superficial peels include various acids, such as Salicylic and Glycolic. These along with other powerful ingredients such as green tea glycoproteins and papaya seed oil can be found in To Be Clear, our exfoliant mask.

To conclude, hyperpigmentation in melanin rich skin can be challenging to treat because of the powerful and reactive nature of the pigment producing melanocyte. Any form of inflammation can trigger the melanocyte to quickly overproduce melanin that then may become difficult to treat. The key tenant to treating hyperpigmentation in melanin rich skin is first and foremost, approach the skin gently. At all costs avoid any method that may traumatise the skin or increase inflammation such as mechanical exfoliation, the use of high percentage acids or aggressive ingredients. A delicately balanced combined approach is always better than an aggressive treatment plan, and early intervention employing calming agents and antioxidants to curtail inflammation before it triggers melanin production is key. 

Learn more about how you can treat your hyperpigmentation by exploring the 4.5.6. Skin full range of products. They all have been formulated with melanin rich skin in mind. Also to receive more information like this about your beautiful and powerful melanin rich skin subscribe to our newsletter for regular content delivered directly to your inbox. Merci! 

Dr Carlos A. Charles