Hyperpigmentation is simply described as a darker focus or patch of pigmentation on any area of the skin. Specific cells in the skin called melanocytes naturally produce melanin - a pigment that your body uses to create skin and hair colors. Melanin production is under very sophisticated and strict control but is influenced by a variety of biological and physiological factors. When there are too many melanocytes attracted to a particular area, or if they are too active, too much melanin production occurs and results in hyperpigmentation.
Understanding hyperpigmentation may be easy but far from easy. A complete medical history and physical examination should form the basis of any treatment plan for hyperpigmentation problems. Work diagnosis is also very important for developing the best strategy. Not all hyperpigmentation is the same. Hyperpigmentation can be associated with specific medical problems and conditions. Different forms of hyperpigmentation will respond better to different types of treatment. Always consult with your doctor for cosmetic skin care.
Without question, each treatment plan will include sun exposure. Sun removal (UV radiation), sun protection and sunblock will always represent the simplest and most important part of any plan for hyperpigmentation treatment. That's because nothing stimulates melanocyte and melanin production beyond UV radiation exposure. And pigment stimulation is the last thing we want when we treat hyperpigmentation!
Coating techniques - "home" mask use (e.g. alpha-hydroxy acid, lactic acid, retinoid), office microdermabrasion, office chemicals (e.g., glycolics, trichloracetic acid or TCA) - are commonly used in most hyperpigmentation-related treatment plans . Redistribution removes dead or dead skin cells (keratinocytes) that allow the skin cells to become less pigmented, fresh, freshly exposed on the surface. Repetition also stimulates cell growth and recovery from deeper skin levels, helping the skin in pigmentation and pigmented keratinocytes that contribute to hyperpigmentation. Some types of lasers can also be used along this line. But be careful - laser therapy is also possible because hyperpigmentation! A series of 5 to 6 in-office chemicals are performed weekly, combined with a home-based regimen tailored to topical agents. Our skin care aesthetics find that once a week a week Obagi Blue Peel Radiance® (glycolic, lactic, and salicylic acid) combined with using the Obagi-C® Rx system (vitamin C, hydroquinone) can be very successful. A series of in-office microdermabrasion treatments are an alternative option for office skin.
The following is a list of some of the topical agents available (lightening, softening, whitening) that are often used in the fight against hyperpigmentation. You will find that many of these compounds are incorporated into one product. The combination of methods and use of topical agents of various substances looks better than single mode therapy or single topical agents. However, no single agent seems to work well in hyperpigmentation because hydroquinone is not alone.
Alpha lipoic acid- It weakens the production of melanin.
Aleosin- It comes from the Aloe Vera plant. Weakness prevents melanin production.
Emblica fruit- Weakly inhibits melanin deposition.
Licorice extract- The active ingredient is glabridin (also known as glycyrrhiza) which reduces melanin production.
Daisy extract (Bellis perennis)- Reduces melanin production.
Willow skin extract- Beta-hydroxy acid; a decomposition agent (disposal) that helps shed dead skin cells, removes surface / pigment keratinocytes, and exposes a lighter, lighter layer underneath.
Acetyl Hexapeptide- Reduces melanin production.
Extract of pelvetia canaliculata- It comes from seaweed. Reduces melanin production. Blocks UV radiation damage to DNA.
Watermelon extract- Blocks UV radiation damage to DNA.
Kojic acid- It comes from mushrooms. Also a by-product made during the production of Japanese rice wine (sake). Reduces melanin production. It also lowers the number of dendrites (the bridge connecting melanocytes is used to inject melanin pigments into the surrounding skin cells).
Azeleic acid- Found in barley and other grains. It is primarily used as an anti-acne agent but has a "side effect" that reduces melanin production.
Hydroquinone- Work by reducing / preventing melanin production and reducing the number of viable melanocytes in a given area. Known as a key component in the development of photography for film and paper! The only real "bleaching" agent recognized by the FDA. There is less than 2% concentration as OTC, up to 4% or more as a prescription. In 2006, the FDA revoked the previous approval of hydroquinone as an OTC, pending further study due to concerns about its absorption and carcinogenic potential. Ochronosis - a black / white complexion - is another concern and potential unwanted side effect that can be seen with long-term use. The final FDA decision on this is still pending. Irritation reactions are very common and occur in ~ 25% of patients who start using hydroquinone - a small test area should be tried first. True allergies to hydroquinone are rare. Hydroquinone treatment makes the skin more sensitive to sunlight and all skin agents / treatments that can potentially stimulate it. Precautions should be taken accordingly.
Bear (Bearberry)- "Natural" form of hydroquinone. Reduces melanin production.
Beta carotene- Reduces melanin production.
Gluconic acid- Binding of copper (micronutrients required for melanin synthesis) which results in decreased melanin production.
Mulberry paper (Mulberry extract)- It comes from Asian roots. Reduces melanin production.
Ascorbic acid (vitamin C)- Reduces melanin production. It can irritate the skin.
Kelp Norway- Reduces dendritic melanin transport.
N-acetyl glucosamine (NAG)- Reduces melanin production.
Niacinamide- Reduces dendritic melanin transport.
UPA (undecylenoyl phenylalanine)- Reduces melanin production.
Steroids- Reduce skin irritation / inflammation, limit the irritation of other products used in combination therapy (eg hydroquinone), also reduce melanin production.
Retinoids- A family removes (peels) an agent that is a vitamin derivative. Retinoids help shed dead skin cells, remove surface pigments and pigment keratinocytes, and expose brighter and fresher layers. Streamlines are "easier" to absorb other agents into the skin when used in combination therapy. Reduces melanin production. Enhancing skin cell growth and promoting the growth of new skin cells, from the skin cells further forces the removal of older, pigmented cells that contribute to hyperpigmentation. Probably the most used: Retin-A®.
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