Pigmentation spots and uneven skin tone
Pigmentation spots appear when our skin gathers more natural pigment in some areas than the others. This is called "hyperpigmentation" (from "hyper" = "excessive", "more than normal").
Can topical skincare help? Yes, but there is no one "silver bullet". You need to build a good skincare regimen and stick to it for a couple of months to get good results. And yes, you will need to use a proper sunscreen daily ☀️. Keep on reading to learn more.
Why does hyperpigmentation happen?
Pigmentation spots can appear because of a few different reasons:
"Errors" in the natural skin pigment (melanin) production and storage because of sun damage accumulated over time. In other words, photo aging.
Results of a skin trauma. Areas of the old skin traumas often get darker than the rest of the skin. This can happen after acne spots, insect bites, ingrown hair, cuts, scratches, burns, irritant or allergic skin reactions, eczema flairs, overdone cosmetic peels and other procedures like laser skin treatments.
Hormonal changes. Uneven pigmentation can appear in or after pregnancy, with start of hormonal contraceptions or in menopause. Symmetrical areas of hormones-related hyperpigmentation are often diagnosed as "melasma".
Side-effects of oral medication.
Regardless of the underlying reason, sun radiation is always the trigger for the pigmentation.
The less sun exposure your skin gets, the less likely you are to get pigmentation issues from the causes above. (And the less sun exposure you get, the less dark the pigmented areas will be if you get them).
All skin tones can suffer from uneven pigmentation, but it is more frequent and more visible in darker skin. It also often takes longer to see improvements from anti-pigmentation regimen for darker skin.
The skin pigment, melanin, is in both the top layer of our skin (epidermis) and in the deeper one (dermis). Pigmentation spots often affect the both layers of the skin. If the pigmentation spot has a bluish undertone, it is a sign that it originates in the deeper layer of the skin. This type of pigmentation spots takes longer to heal.
What skincare can help with hyperpigmentation?
Here is what you need in terms of skincare to reduce pigmentation spots:
A daily broad spectrum sunscreen with SPF 30 or more.
A lot of patience: it usually takes 3 to 12 months to see good results from anti-pigmentation topical skincare.
1-3 topical skincare actives used regularly that help reduce melanin production and/or storage (see below).
Gentle chemical exfoliation 1-2x a week if you'd like to speed up the process and your skin is resilient enough to tolerate it. You do not want to overdo it with your anti-pigmentation actives and exfoliants. They can lead to irritation (and irritation, in turn, can trigger more pigmentation).
Top anti-pigmentation actives
Skincare actives that targets pigmentation can work in a few different ways. Some ingredients can get make skin cells produce less melanin. Actives like Hydroquinone, Arbutin, Kojic Acid, Azelaic Acid, Tranexamic Acid work this way (in dermatology, they are called "tyrosinase-inhibitors"). Other actives, like Niacinamide can make skin store less melanin. Anti-oxidants like Ascorbic Acid help reduce the damage skin gets from sun exposure and reduce melanin production this way (it also works a tyrosinase inhibitor). Chemical exfoliants like Glycolic or Lactic Acids remove the surface layer of the skin cells. This way skin gets to shed the cells with bigger melanin deposits faster. Retinoids help reduce pigmentation in a few different ways at once.
Overall, it is a good idea to combine 2-3 different anti-pigment actives in your regimen. Important warning: do not overdo it with actives and exfoliation. You want to avoid skin irritation, because irritation on its own can result in more pigmentation. This is especially important if your natural skin tone is dark.
UV filters & sunscreens
Niacinamide
Retinoids
Thiamidol
Alpha-Arbutin
Ascorbic Acid
Azelaic Acid
Kojic Acid
Exfoliating Acids
Example anti-pigmentation routines
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