Hyperpigmentation Removal

What is Hyperpigmentation and Malasma?

Hyperpigmentation also know as Melasma is a non-cancerous (benign) disorder of unknown cause that causes dark (hyperpigmented) patches, primarily on the face. The condition is marked by brown patches that worsen in response to increases of the hormone estrogen, such as during pregnancy or with the use of birth control pills. Melasma (also called Chloasma or Mask of Pregnancy) is a common skin condition which causes a brownish-colored discoloration on the skin of the face. While the disorder doesn't cause other symptoms, women are often concerned with the cosmetic effects.

What Is Hyperpigmentation Removal? 

Hyperpigmentation is darkened areas of the skin which may result from hormones, sun damage, injuries, skin-type characteristics, medications and more. Hyperpigmentation lesions can be anything from melasma/choalasma often attributed to pregnancy or hormonal imbalances to freckles.

The treatments vary from melanin blocking agents combined with topical medications such as Retin A which causes the body to exfoliate the skin to rid the body of the hyperpigmentation while prohibiting new melanin production to laser treatments. The treatments wholly depend upon your needs and skin type. Some treatments can actually cause hypo- (lack of) and hyperpigmentation problems in some individuals. Care must be taken in proper diagnosis for a successful result.

 Are You a Candidate for Hyperpigmentation Removal?

 This entirely depends upon the cause of hyperpigmentation and the treatment which is suited to your needs and skin type. Some you very well may be able to handle, some you may not be a candidate for. The first step is consulting with a qualified surgeon or dermatologist to determine the cause and then go over your options for a solution. For instance, you may be a candidate for hydroquinone use in hyperpigmentations but not laser resurfacing. Some may only need medication cessation or substitution.

 This is really important as not all skin types and individuals will be a candidate for every technique or treatment. This largely depends upon your skin type, wound type response and the presence of ethnicity in your family history (keloids and hypo- or hyperpigmentations can form in darker skinned individuals).

Your Options for Hyperpigmentation Removal

 Intense Pulsed Light: For increased effectiveness, these products are frequently used before and after Laser surgery or dermabrasion or Intense Pulsed Light (IPL) treatments. Especially in ethnic patients or persons with darker skin tones (significant melanin presence). Usually, standard hyperpigmentations (even freckles) and sun damage can be removed with Intense Pulsed Light without the use of hydroquinone or "peels". You may have heard of PhotoDerm or FotoFacial/PhotoFacial; these machines produce intense of flashes of light capable or removing pigmented areas effectively. Please see our Intense Pulse Light Section for more information.

Laser resurfacing: Sometimes actual removal is needed via laser "peels". These treatments evaporate the first few layers (or even deeper) of damaged or pigmented skin to reveal fresh, even toned skin. Many patients are required to use hydroquinone or Kojic acid before these treatments to prohibit excessive hyperpigmentations post-treatment. Please see our Laser Resurfacing & Treatment Section for more information.

Physician Strength Chemical Peels
Hyperpigmentations can be removed with in-office chemical peels, or with a series of peels. Please see our Chemical Peel Section for more information.

Microdermabrasion
Microdermabrasion is a mini procedure that involves the skin being "sandblasted" by aluminum oxide crystals, vitamin C crystals and other types of mild abrasives to remove the horny (top) layer of the skin; dead skin cells. This process promotes the production of new cells in the basal (deepest) layer of the dermis. A series of microdermabrasion treatments can lessen the look hyperpigmentations in some patients. Please see our Microdermabrasion Section for more information.

Depending upon the cause there are several options. Some consist only of creams or changes of your skin care routine or sunbathing habits - some even substituting or changing brands of hormonal supplements or birth control pills.

Hydroquinone (BLEACHING agent):

For standard non-hormone induced hyperpigmentations Hydroquinone usually reduces or removes hyperpigmentations very effectively. For the person who do not wish to have expensive or invasive procedures or only has slight hyperpigmentations - hydroquinone can be a good option. However, these products may not be suitable for your needs and they will also take longer than some treatment options. Hydroquinone is a melanin blocker. You may have heard it call d "skin bleach" but in actuality it prohibits new melanin production as your body goes through natural or chemical-assisted exfoliation. These products can be obtained over the counter in weak strengths or by prescription for your plastic surgeon or dermatologist. Some formulations are even available on the Internet.

Formulations of 4% used to be thought to be the best as irritation would erupt in higher strengths. This has been proven although strengths up to 10% are routinely formulated for patients. However it must be noted that higher strengths of Hydroquinone have caused hydroquinone-induced ochronosis (black speckling in the dermis) in patients with darker skins. And have even been banned in parts of Europe and all throughout Asia due to the belief that higher concentrations are carcinogenic.

Hydroxy Acid "Peels"

The "peels" one can get at an esthetician/aesthetician/facialist ofice can be considered rather mild to slightly invasive. Alternatively, you may visit a dermatologist and they have access to strengths that are much more penetrating - we will cover these as well. These aren't exactly "peels" per se, but cause a reaction in your skin that makes you peel a few days later on your own. They increase cell turnover rate and thicken the dermis as well as correct hyperpigmentation or t exture problems. Of course the amount of improvement depends on the strength or number of treatments you have. The ones that you can get in a spa by a facialist are usually not that strong. However, some aestheticians are offering strengths which should only be offered by a Dermatologist or physician.

Alpha Hydroxy Acids (AHA):

Water soluble, these products such as 8% Glycolic acid cream can help remove hyperpigmentations and help with photo damage, thickening of the dermal collagen and increase cellular turnover. It shows the same type of improvements in other treatments but offer no neoangiogenesis (blood vessel formation) so that telangiectasias are not increased or inflamed. Includes Lactic Acids. Higher concentrations work better, of course. Low PH causes irritation, irritation represents stimulus BUT one needs to change strengths. You must determine if your physician knows the difference about high concentration, high free acid concentration and low ph - irritation is symptomatic of it working. Although extreme irritation should be avoided.

BetaHydroxy Acids (BHA):

(Salicylic Acids are most common); lipid soluble. It is an exfoliant, an anti-inflammatory (acetylsalicylic acid - aspirin family), a comedolytic (de-clogging agent for pores). It is in many products. There are BHAs in Oil of Olay's Age Defying Series, Pond's Prevent/Correct Neutrogena has products with BHA's and are recommend by Dermatologists. They are not particularly known for removing hyperpigmentations but does increase the rate of exfoliation which increases the chance of removal as long as a melanin blocking agent is used in persons who are prone to re-pigmentation of the treatment area.

Topical Vitamin A:

(Retinyl Palmitate) Such as Retinol Products but specifically Vitamin A in OTC (over the counter) creams/lotions such as the popular "night creams" may contain.

Physician-supplied Formulations & Products
These are more expensive but more effective. Some can be found on the Internet, others you simply must get from your surgeon or dermatologist.

Kinerase (N6-Furfuryladenine 0.1%) (KEYEN-er-ace or KINN-er-ace): "Scientifically Proven Results: In clinical studies conducted by a dermatology department at the University of California, Irvine, Kinerase™ was shown to help improve the signs of photoaging. After 24 weeks of treatment, physicians saw improvement in 100% of Kinerase™ patients. Improvement was seen in roughness, blotchiness, and fine wrinkles.

Kinerase™ is not an Acid and Won’t Burn Like One: Unlike many other skin care products, Kinerase™ is non-acidic and won't burn or irritate your skin. In fact, patients using Kinerase™ in clinical studies experienced virtually no side effects."

Click Here to visit the Kinerase Site - ICN Pharmaceuticals, Inc.
Above information was taken from The ICN Pharmaceuticals, Inc. site and all restrictions of the use of this information, in any form, applies. This product can remove freckles and other hyperpigmentations but only very slowly.

Retinol: (aka baby Retin A) Medicus: Affirm is one brand, in 3 strengths, 1X 2X and 3X. This are less irritating but still stronger than OTC Retinol formulas. These products cause exfoliation (peeling)

Retin A: also known as Tretinoin. It is the only FDA approved photo damage treatment lotion/cream. Retin A is a very strong brand, Retin A Micro time released, whereas the Renova is the emollient based and can be too heavy for some and cause break outs.

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