“Dealing with hyperpigmentation is a marathon—not a sprint,” says Dr. Chaneve Jeanniton, a New York based oculofacial plastic surgeon, and we cannot agree with her more.

We have been dealing with skin for almost 50 years and one thing is for sure: there is no quick fix. Skin health is an investment just like your general health. It requires from you to be mindful and consistent. It’s not just sessions (and definitely not a one-and-done) of professional treatments, rather a combinatory approach of in-office treatments with support at home in the form of skin care and lifestyle.

What is hyperpigmentation?

Hyperpigmentation is a common condition that makes some areas of the skin darker than others. “Hyper” means more, and “pigment” means color. It refers to darkened patches or spots on the skin caused by an excess production of melanin, the pigment that gives skin its color. Any skin tone can suffer from hyperpigmentation, but skin of colour (Fitzpatrick skin type III-VI) has a higher risk.

The most common causes and types

Postinflammatory hyperpigmentation (PIH) is the most common variety that involves lingering red or brown spots after skin inflammation as its name states.

The perfect example is an acne breakout where the affected area once inflammation has healed leaves behind a bothersome, darker spot. The more inflammation, the darker the spot. The darker the spot, the longer it typically takes to heal.

Other triggers for this type of pigmentation could be

• chronic skin conditions like eczema, psoriasis

• injuries to the skin - burns, cuts, surgical excisions - where the wound healing cascade is activated and which has an inflammatory phase

• insect bites

• skin or hair products and accessories can also irritate the skin causing dark patches to form.

Photoaging the second most common type is a skin damage caused by the sun. The skin protects itself from the harmful ultraviolet rays (UVA and UVB) by producing more melanin. This over time can leave you with uneven skin darkening that turns into solar lentigines, also called sun spots, age spots or liver spots.

Areas of the body that receive the most sun exposure, such as the face, hands, arms, are more prone to develop sun spots.

It can also show up as melasma: symmetric, gray-brown patches on the face, usually on the cheeks, bridge of the nose, forehead, chin, and upper lip. It is the most challenging type to correct because of its hormonal (estrogen and progesterone) component that leads to vast vascularization and melanin formation in the deep dermal layers. It affects women predominantly, where ultraviolet (UV) radiation and genetic predisposition seem to be the main factors along with pregnancy, endocrine disorders, hormonal therapies like oral contraceptives, cosmetics, phototoxic drugs, and antiseizure medications.

How to deal with unwanted pigmentation?

Keeping skin looking healthy, preventing + correcting hyperpigmentation + keeping it from coming back is a daily endeavor/must. This means consistent care with a less is more approach where you can be sure

• you will follow through the steps (the products are used and not just decor in your bathroom)

• the products serve you at their best and support + maintain any results achieved by professional treatments

At-home routine

1. Cleansing is the first step to happy skin. The right cleanser, used daily, has the ability to remove dirt without stripping it. Another benefit? A clean, balanced canvas as a base allowing the rest of your skin care to work more effectively. Considering environmental pollution can age you + exacerbate skin conditions like eczema, rosacea, acne, and melasma, starting your skin care routine every morning and evening with proper but gentle cleansing is key.

2. Exfoliation removes dead skin cells from the outer layer of your skin - often with the help of a grainy substance, chemicals or exfoliating tool - leaving your skin looking brighter + improving the effectiveness of topical skin care products by enhancing absorption. Regular exfoliation can also help prevent clogged pores, resulting in fewer breakouts, and in the long-term it can contribute to glowing, vibrant skin, and better skin elasticity.

3. Active ingredients that target existing pigments like vitamin C, retinoic acid, arbutin, kojic acid, niacinamide, and azelaic acid.

4. Daily Sunscreen is key for prevention and maintenance. You can’t expect improving the skin or prolong the benefits of professional treatments if there’s continued sun exposure. Wearing a broad-spectrum sunscreen every day, regardless of season or weather, even on a rainy, gloomy day is a must if you have pigmentation and they bother you.

Important note: If you’re sticking to a consistent skin-care regimen with active ingredients along with in-office treatments, three to six (3-6) months is a realistic timeline to see a real improvement in your hyperpigmentation.

In-office treatments

The treatment approach for hyperpigmentation—no matter what kind—is the same and based upon physiology of the skin + how the pigment/melanin is produced and stored.

1. exfoliate to enhance turnover and shed off dead skin cells containing the bothersome pigment/melanin,

2. decrease inflammation - it’s super important to minimize inflammation as any form of irritation can transform into hyperpigmentation

3. break down deposited/existing pigment,

4. stop or inhibit the pigment-production process and avoid new pigment formation

Based upon these we offer

• skin resurfacing procedures (peels, fractionated laser resurfacing)

• mesoneedling,

• laser rejuvenation (IPL, NeoElite, GentleMax Pro).

Please remember, it is the combination of in-office + at-home maintenance that gives you the long-term results you are looking for. You are unique hence so are your needs. Not all in-office treatments work the same on individuals.

Light-based treatments (IPL, laser) work best when the contrast between the base skin and the concerned spot/blemish is bigger. Being said they aren’t meant for every skin tone and every pigment issue. Make sure and get educated of the type of technology, the cumulated experience, and the preventative measures the cosmetic facility provides.

We believe in more conservative, common-sense parameters and we are teaming up with you to provide cumulative success rather than a promised, not delivered one-and-done approach.