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Ep 75: All About Hyperpigmentation
Hyperpigmentation is often associated with aging. However, there are actually many different types of pigmentation that dermatologists encounter. While not all forms of hyperpigmentation on the face are the same, there are a few common pathways that effective treatment options can target.
Melanocytes are the cells that produce pigment, known as melanin. These 3 ingredients work effectively and holistically to regulate melanocyte activity: tranexamic acid, kojic acid and niacinamide. In the formulation of an effective serum to treat hyperpigmentation, addition of 5% sulphonic acid has an added benefit of increasing skincare absorption by exfoliation. This enables the active ingredients to target the various cellular pathways involved in hyperpigmentation.
Science behind hyperpigmentation
Today’s podcast episode is an in-depth delve into the science behind hyperpigmentation. We often associate hyperpigmentation with aging. However, there are actually many different types of pigmentation that dermatologists encounter. It is important for the public to understand that not all forms of hyperpigmentation are the same. The first part of this podcast will give you a fundamental grounding in the actual processes that are responsible for the development of different types of hyperpigmentation.
If you suffer from hyperpigmentation on face, you may have a better idea of why you are developing it. If you suspect that you have certain types of hyperpigmentation that we are discussing in this podcast, it is best that you visit an accredited dermatologist for an accurate diagnosis and treatment.
Hyperpigmentation on face: sun spots
The commonest type of pigmentation we see developing is age-related. This is in the form of sun spots, also known as age spots. In medical terms, we refer to it as solar lentigo. Sometimes these age spots could also be seborrheic warts, which have a warty appearance. Solar lentigo develops due to photo-aging. Ultraviolet exposure plays a direct role. The more sun exposure you have accumulated over the years, the higher the risk of developing solar lentigo.
Individuals who have accelerated skin aging due to biological or environmental risk factors may start developing more hyperpigmentation due to sunspots earlier in their lives. Dermatologists generally regard aging as an event that commences after the age of 25. However, sun protection starts from the moment you are born. It is the years of sun exposure before the onset of your hyperpigmentation that is responsible. Therefore using sunscreen is critical at every stage of your life.
The second type of hyperpigmentation is commonly confused with sunspots. These are actually freckles, or ephelides. These develop in early childhood and are benign. This means that freckles are harmless and do not need to be treated. In fact, treatment outcomes for freckles actually are fairly poor as laser therapies can actually cause scarring. What causes freckles? Your genetics determine whether or not you have freckles. Individuals with red colored hair or light colored eyes may find themselves at a higher risk of having multiple freckles.
The third type of hyperpigmentation on face that we should be aware of is melasma. Melasma is a condition that we often treat simply because it is cosmetically disfiguring. It can affect both men and women, however, is more common in females because of its hormonal link. Women find during various stages in their lives, including pregnancy, post pregnancy and menopause, there is a surge in the hormone estrogen. This can have effects on their skin as well. Melasma is a hormonally influenced condition. Excess sunlight exposure can also affect this. Hence it is important to observe the same photprotection measures as other types of age related hyperpigmentation.
Treatment for melasma is difficult. It combines topical active ingredients that can inhibit melanin formation or remove melanin directly. Prescription medications often include bleaching creams. Creams for hyperpigmentation are used with lasers, such as the 1064 Q switch nanometer laser, often in conjunction with superficial chemical peels.
One type of hyperpigmentation on face that is very common is post inflammation hyperpigmentation. It can be mild in the form of acne scars. It could also arise from chronic inflammation such as moderate to severe eczema of the face.
Drug induced hyperpigmentation
Some types of hyperpigmentation can be due to drugs. If you have been on medications or suspect that you have had exposure to certain environmental toxins, you should have a dermatologist evaluate your condition. Drug-induced hyperpigmentation is generally rare.
Finally, we must not forget another category of hyperpigmentation which is very dangerous if misdiagnosed or ignored. This is why having your pigmentation diagnosed by an accredited dermatologist is critical. Certain types of “dark spots” are often misdiagnosed by non-dermatologists as age spots or sunspots, when in fact they are a rare form of skin cancer. Lentigo maligna is notorious for masquerading as a form of hyperpigmentation when in fact it is a form of a very dangerous form of skin cancer: melanoma. While that is fairly rare in our Asian population, there are other types of skin cancers such as non- melanoma type skin cancers, known as basal cell cancers, and squamous cell cancers. All these types of skin cancers may also be associated with hyperpigmentation. It is therefore critical that you should have an accurate diagnosis.
I want to go into sun protection measures in the second part of this podcast episode. All the types of hyperpigmentation we’ve discussed so far have one thing in common, which is that they involve the excess deposition of melanin. Melanocytes are the skin cells that produce pigment- melanin. In addition, sun exposure also activates melanin. Sun exposure can also cause damage on the skin in a cumulative manner. That means the total amount of damaging UV rays you accumulate in your entire life will ultimately show on your skin.
In tropical Singapore, we have constant exposure to 100% of the sun’s harmful UV rays. These are the most intense from 10am to 4pm. Dermatologists generally advise against direct sun exposure during this time frame. Photoprotection can be in the form of wearing photoprotective clothing for the body. On the face, dermatologists recommend a SPF 50 broad-spectrum sunscreen. It is important for you to choose a reliable brand backed by dermatologists because sunscreen is in a sense, to be considered a medical rather than a cosmetic product.
Antioxidant sun protection
I feel that antioxidants in skincare now play a promising role in sun protection as well. Antioxidants actually offer an additional layer of protection when used together with sunscreens. Antioxidant ingredients directly neutralize the damaging free radicals generated at the surface of the skin. This is the process responsible for activation of melanocytes that increase the risk of hyperpigmentation.
Specifically, we also should look for ingredients that research shows proof to work at the level of the melanocytes. Tranexamic acid is a compound that was originally a medication and an injectable for melasma patients. How it works is this: it intervenes in the release of inflammatory compounds known as inflammatory mediators. This prevents the further inflammatory cascade that leads to excess melanin formation.
Skincare ingredients for hyperpigmentation on face
Kojic acid is a tyrosinase inhibitor. Tyrosinase inhibitors are key in the therapeutics of melasma. Essentially tyrosinase inhibitors restrict the production of melanin by inhibiting the enzyme tyrosinase. Kojic acid is an example of a nature-derived active ingredient that works as a tyrosinase inhibitor. It is a natural byproduct of certain fungi. We can also find it in Sake.
Another active ingredient that is worth paying attention to in the treatment of hyperpigmentation is niacinamide. Niacinamide is actually a form of vitamin B, vitamin B3. How niacinamide works is this. It blocks the transfer of melanin. Melanin produced in the deepest skin layers generally migrate to the top layers of the skin over time and this is where we see the effects of hyperpigmentation. Niacinamide works effectively by blocking this movement and transfer.
The potent combination of tranexamic acid, kojic acid and niacinamide make for an excellent holistic serum that can target multiple pathways involved in the various types of hyperpigmentation that we’ve discussed so far.
How to increase absorption of your skincare
It is equally important to consider how to increase the absorption of these active ingredients. In the formulation of an effective skincare product to treat hyperpigmentation on face, it is beneficial to increase absorption with exfoliation. 5% sulphonic acid incorporated in a serum specifically designed to target hyperpigmentation is efficacious. This enables the active ingredients to target the various cellular pathways involved in hyperpigmentation.
Sulphonic acid is an exfoliator that works on a microscopic level using enzymes. This is very beneficial for skin because it increases the rate of cell turnover which means that increases skin radiance and can brighten skin. Microscopic exfoliation is very gentle unlike physical exfoliation methods such as scrubbing. This means that the active ingredients can deeply penetrate to the second layer of the skin, where most of the cell processes resulting in hyperpigmentation are taking place.
I hope you have enjoyed our masterclass on hyperpigmentation today. We have covered the common causes of hyperpigmentation as well as effective topical active ingredients incorporated in skincare products that can be used to treat hyperpigmentation.
This podcast episode is sponsored by SkinCeuticals Singapore as a joint collaboration to create scientific educational content relevant to skincare and dermatology. Images produced as part of editorial collaboration consistent with site policy.