What Is Hyperpigmentation: Symptoms, Causes, Treatment, and Prevention

Worldwide, people have skin with a wide range of pigmentation. Regardless of your skin color, you expect the color to be consistent. When you see patches of increased pigmentation, this is called skin hyperpigmentation, and it has multiple causes. Because hyperpigmentation worsens with age, many people seek age-management solutions to even out their skin pigmentation and reduce their risk of hyperpigmentation.

Skin pigment is produced by cells called melanocytes. When melanocytes produce excess melanin, darker skin patches develop. Hyperpigmentation can occur in people of all skin types, but it is more common in people with darker skin tones.

Types of Hyperpigmentation

Besides exposure to ultraviolet light (sun exposure), there are three main types of skin hyperpigmentation—post-inflammatory, age spots, and melasma.

Age Spots

Age spots are flat brown, gray, or black spots in sun-exposed areas. These spots are clumps of excess melanin. They are usually oval, round, or irregular, a few millimeters to a few centimeters in size, and are benign.1 The best way to prevent and treat age spots is to protect your skin from UV light exposure. Before treating age spots, check with your dermatologist to ensure you are not dealing with a more serious condition.

Age spots are harmless melanin collections. Many people treat them because they are not happy with their appearance.

Melasma

Melasma is a brown or gray discoloration that develops on sun-exposed surfaces, especially on the face. While anyone can experience melasma, it is more common in pregnant women and people with darker-pigmented skin. The discoloration is flat, not itchy or rashy, and is symmetrical in distribution. The exact cause of melasma is not known. Triggers for melasma include:2

  • Sun exposure
  • Pregnancy
  • Oral contraceptives
  • Steroids
  • Cosmetics and photosensitizing drugs
  • Ovarian tumors
  • Intestinal parasites
  • Liver disease
  • Stress

Melasma tends to be hard to treat and prone to relapse.3 It is not a harmful condition, but many people seek cosmetic treatment for it. Even though medical care isn’t necessary, it’s important to use sunscreen to protect yourself from UV light. 2

A woman with melasma.

Post-inflammatory Trauma to the Skin 

Minor trauma to the skin can be associated with hyperpigmentation, including:4,5

  • Acne
  • Eczema
  • Bug bites
  • Surgical scars
  • Cuts
  • Reactions to skin irritants
  • Burns
  • Cosmetic procedures

What Causes Hyperpigmentation?

Besides trauma, other potential causes of hyperpigmentation include:4,5

  • Skin irritations
  • Hormonal changes during pregnancy
  • Hyperthyroidism
  • Rashes such as acne, eczema, and psoriasis
  • Autoimmune conditions
  • Fungal skin infections
  • Viral infections
  • Allergic reactions to insect bites or plants
  • Hypersensitivity to medications
  • Chemicals in skin or hair care products
  • Inflamed hair follicles
  • Medical conditions such as Addison’s disease and hemochromatosis

Diagnosing Hyperpigmentation

Hyperpigmentation can be diagnosed visually when patches of more darkly pigmented skin develop. However, diagnosing hyperpigmentation often involves seeing a dermatologist to determine the underlying cause, exclude a more serious diagnosis, such as melanoma, and learn about potential treatment options.

Dermatologist treating melasma.

Treating Hyperpigmentation

Treatment options for hyperpigmentation:5

  • Topical retinoids: vitamin A derivative that decreases abnormal melanin production
  • Hydroquinone: prescription-only skin-bleaching treatment
  • Skin lightening agents: products containing azelaic acid, glycolic acid, kojic acid, or vitamin C
  • Laser therapy: uses specific wavelengths of light to target melanin-producing cells
  • Microdermabrasion: uses small crystals to rub off upper layers of skin
  • Chemical peels: uses acidic substances to cause localized skin injury, may cause hyperpigmentation
  • Cryosurgery: uses extremely cold temperatures to remove skin lesions

Nourishing your skin can help reduce the effects of pollutants on skin cells and speed up repair. Antioxidants neutralize free radicals and nutrients such as protein, vitamins E and C, biotin, and omega-3 fatty acids, support collagen production, and help the skin retain moisture. NAD+  and glutathione are antioxidants that protect the skin from ultraviolet radiation damage and inflammation that may cause hyperpigmentation. Read what others have said about the skin-protecting and healing benefits of glutathione in these reviews.

Skin Hyperpigmentation Prevention Tips

The best prevention for skin hyperpigmentation is regular sunscreen use. Ultraviolet radiation increases inflammation, damages DNA, and causes oxidative cell damage. Follow these tips to protect your skin from ultraviolet damage:5

  • Apply a sunscreen that is SPF 30 or higher every two hours
  • Ensure your sunscreen is broad-spectrum and water-resistant
  • Stay out of the sun during peak hours, 10 a.m. to 2 p.m.
  • Avoid using tanning beds and other sources of UV light
  • Wear a lip balm with an SPF of 30 or higher
  • Wear sunglasses
  • Wear clothing to shade your face and body
  • If you take medications, talk to your doctor or pharmacist to see if hyperpigmentation may be a medication side effects

Age spots, melasma, and post-inflammatory hyperpigmentation are the three major categories of benign skin hyperpigmentation. These conditions are considered to be benign but are often treated for cosmetic reasons. If you are unsure of the cause of your skin hyperpigmentation, consult with a dermatologist to rule out a more serious medical condition. There are several treatment options for skin hyperpigmentation, but the most important is protection from ultraviolet radiation.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References

1.   Braun R, Nouveau S. Solar lentigines. Dermoscopedia. https://dermoscopedia.org/w/index.php?title=Solar_lentigines&oldid=16362

2.   Handel AC, Miot LDB, Miot HA. Melasma: a clinical and epidemiological review. Anais Brasileiros de Dermatologia. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063

3.  Sarma N, Chakraborty S, Poojary SA, et al. Evidence-based Review, Grade of Recommendation, and Suggested Treatment Recommendations for Melasma. Indian Dermatol Online J. Nov-Dec 2017;8(6):406-442. doi:10.4103/idoj.IDOJ_187_17

4. Taylor S, Grimes P, Lim J, Im S, Lui H. Postinflammatory hyperpigmentation. Journal of cutaneous medicine and surgery. 2009;13(4):183-191.

5. Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol. Jul 2010;3(7):20-31.

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Published: Dec 14, 2022

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