Hyperpigmentation and darker skin
November 28 2015 by
Ray Sahelian, M.D.

 

Hyperpigmentation is the medical term for patches of skin that are darker than normal skin tone. These hyperpigmentation patches or "spots" are usually harmless and painless, but most people find them unappealing.


Hyperpigmentation treatment
Hyperpigmentation skin care products abound on the internet, but do they really work? A consumer has to be cautious before purchasing a hyperpigmentation skin care product since many of them may not have undergone much testing.
     Microdermabrasion and retinoic acid can sometimes help hyperpigmented skin. There are simple skin bleaching creams and gels which can lighten some areas.

 

J Drugs Dermatol. 2013. Retinoids and azelaic acid to treat acne and hyperpigmentation in skin of color. In this review, we examine published data reporting the efficacy of pharmaceutical agents to treat associated postinflammatory hyperpigmentation commonly seen in skin of color. Retinoids and azelaic acid have been widely used to treat acne. Now there are increasing data describing their use in skin of color for the treatment of both acne and the subsequent postinflammatory hyperpigmentation. Historically, some dermatologists have been hesitant to use retinoids in skin of color because of perceived hypersensitivity in this patient population. However, recent data support the use of retinoids and azelaic acid in skin of color as both safe and beneficial.


Skin Hyperpigmentation types

There are several types, including:
 

Freckles - These are small brown or tan spots most common in children and individuals with blue eyes, red hair or fair skin. They occur in areas exposed to the sun.

Melasma - This type looks like irregular streaks, spots or patches that appear in a symmetrical pattern on your cheeks, nose and upper lip, or on the neck, chin and around the eyes. Melasma is most commonly a result of hormonal changes during the aging process (age spots) or sun exposure, but can also occur during pregnancy or in women taking birth control pills. For more information on melasma.

Solar lentigines - Also caused by the sun, these round, brown spots can take years to develop and can be quite dark (sometimes called "beauty" spots). They appear mostly on areas exposed to light, such as the face, back, chest, arms and hands.
     First-line therapy for solar lentigines was ablative therapy with cryotherapy. Lasers are an effective treatment. An alternative to ablative therapy is topical therapy and there is good evidence to support the use of a fixed double combination, as well as retinoids, such as adapalene and tretinoin.

Post-inflammatory hyperpigmentation is often caused by various preceding disease processes that affect the skin; these processes include infections, allergic reactions, mechanical injuries, reactions to medications, phototoxic eruptions, trauma (eg, burns), and inflammatory diseases (eg, acne, lichen planus, lupus erythematosus, atopic dermatitis).

 

Research
Food Chem. 2013. Hordenine, a single compound produced during barley germination, inhibits melanogenesis in human melanocytes. Melanin plays an important role protecting skin against ultraviolet light injury. However, increased production and accumulation of melanin results in a large number of skin disorders. Here, we identified hordenine as an active compound from germinated barley (Hordeum vulgare L.) and investigated the effects of hordenine on melanogenesis and its mechanisms of action in human epidermal melanocytes. We measured melanin content, tyrosinase activity, expression of melanogenesis-related proteins, and cAMP production. Melanin content was significantly inhibited by hordenine. The intracellular cAMP level was also reduced by hordenine. In addition, expression of microphthalmia-associated transcription factor (MITF), an upstream transcription factor of tyrosinase as well as tyrosinase, tyrosinase related protein (TRP)-1, and TRP-2, was inhibited by hordenine. Taken together, these results show that hordenine inhibited melanogenesis by suppressing cAMP production, which is involved in the expression of melanogenesis-related proteins and suggest that hordenine may be an effective inhibitor of hyperpigmentation.

 

Questions
Q. I have severe hyperpgmentation on the face - I am a 38 year old male. I read a few resources that said DIM, IP6 and Gamma Oryzanol is good. Do you know and if so how effective they are?
     A. We are not familiar with these nutrients for use in skin hyperpigmentation.