So what exactly is hyperpigmentation? In a nutshell, it refers to excess melanin pigment that shows up as dark spots. This can be a result of sun damage, acne scars, or just part of the good ol’ aging process. Today there are more options (see: azelaic acid, mandelic acid, niacinamide, hydroquinone, etc.) for erasing that troublesome discoloration than ever before. However, lightening skin doesn’t always have one answer. Since hyperpigmentation on darker skin tones poses specific challenges when it comes to treatment, we asked Seemal Desai, MD, FAAD, a board-certified dermatologist and former president of Skin of Color Society in Plano, Texas, to fill us in on how to get rid of those pesky dark spots. Keep reading for everything you need to know about addressing pigmentation problems in different skin tones.
For light/medium skin tones
According to Dr. Desai, people with lighter skin tones have more options for getting rid of dark spots than people with darker skin tones. “There are cosmetic procedures to help with pigmentation, such as microneedling or chemical peels, that are not as complex for them to use, versus those with ethnic skin,” says Dr. Desai. “However, the procedures will always need to be done by a board-certified dermatologist.” Laser treatments and bleaching agents are also options. If you choose to lighten your spots at home, you should use plant-based antioxidants with anti-inflammatory benefits like green tea extract, resveratrol, ferulic acid, and vitamin C. These have powerful skin-lightening properties that can prevent future UVA damage. Try: Dr. Dennis Gross Skincare Ferulic Acid + Retinol Brightening Solution ($88; sephora.com). While more aggressive ingredients like retinol are also helpful for treating patients with pigmentation, Dr. Desai notes that those with sensitive skin may not be able to tolerate a prescription-strength retinoid (like Retin-A and isotretinoin). In this case, products that are formulated for sensitive skin with lower concentrations of retinol are a great option. Try Sente Bio Complete Serum ($110; theskinspot.com), or products with bakuchiol, the natural alternative to retinol that is more gentle on skin, like Olehenriksen Glow Cycle Retin-ALT Power Serum ($58; sephora.com).
For dark skin tones
Darker skin contains more melanin and therefore more natural protection from damaging sun rays, but your skin can’t completely protect itself without a little help. Dr. Desai recommends dark spot correctors containing non-hydroquinone ingredients, such as cysteamine, vitamin C, and azelaic acid. Ask your dermatologist about brands like Cyspera that have topical creams containing cysteamine hydrochloride (HCI), a naturally occurring biological compound. This can help diminish the appearance of stubborn skin discoloration on darker skin tones. He also recommends combining prescription and cosmeceutical ingredients with sunscreen. Professional treatments like bleaching and lasers can actually make discoloration worse on darker skin, or lighten the surrounding areas, says Dr. Desai. Instead, ask your dermatologist about a series of in-office peels to resurface the skin. A vitamin injection, which works to deliver the active solutions directly into the bloodstream and address pigmentation from the inside out, is another potential solution. Most importantly, Dr. Desai recommends seeking out a board-certified dermatologist who specializes in skin of color, and that people with dark skin only consider procedural treatments for getting rid of dark spots after exhausting all topical options.
For everyone
It’s important to understand that hyperpigmentation is a really complex condition, and not all skin tones and types are going to respond to the same forms of treatment for dark spots. Different skin types have different manifestations of the condition, says Dr. Desai. The key to treating dark spots is using a combination of prescription and cosmeceutical products and incorporating SPF. “No matter the treatment or skin tone, it is important for all patients to use life-long sunscreen,” he says. “In general, the longer the pigmentation is present on the skin, the harder it will be to treat.” The sooner you see a dermatologist, the easier the treatment will be.