Now that summer is behind us (or at least the calendar says it is) and we are in the “cooler” months of fall and winter, I thought it would be appropriate to talk about hyperpigmentation. Let’s face it, we live in SWFL where the sun is out probably 90% or more of the time. Many of the activities down here involve the sun, sand and water all year long. All that sun exposure can cause hyperpigmentation. There are other factors that cause hyperpigmentation, but the sun adds insult to injury.
Hyperpigmentation is the darkening of an area of the skin caused by an increase in melanin. Melanin produces hair, eye and skin pigment. When the UV-A rays from the sun penetrate the lower layers of the skin, the body responds by triggering the melanocytes to produce more melanin. Melanin is produced as a defense mechanism to provide photoprotection from UV radiation. We are then left with brown spots wherever our skin was not protected. Overtime, if a person doesn’t get treatments to prevent or correct this pigment, it will continue to accumulate.
The different types of hyperpigmentation include:
- Age spots also known as liver spots (has nothing to do with the liver)
- Post inflammatory Hyperpigmentation
Age spots normally appear after prolonged exposure to the sun. These marks are flat and darker than surrounding skin. They can be tan, brown, or black, and they may resemble freckles. Age spots can form on anyone’s skin, though they are more common in people with lighter skin, which is more sensitive to the sun. These spots tend to form in people over 40, but can also develop in younger people who frequently get sunburned or use tanning beds. Believe it or not, people still use tanning beds, and even in Florida! The spots are harmless, but many people choose to get rid of them for cosmetic reasons.
Melasma is a common skin condition that causes brown, dark brown/ and/or blue-gray patches and spots on the face. Commonly affected areas include the face, cheeks, upper lip, forehead and forearms. Melasma is also known as the “mask of pregnancy” because it frequently affects pregnant women. Melasma occurs most often in people with light brown skin tones, especially if they are in areas with high levels of sun exposure.
Potential triggers for melasma can include:
- changes in hormones during pregnancy
- hormone treatment or taking birth control pills
- sun exposure
- certain skin care products, if they irritate a person’s skin
- some medications e.g., retinoids that make a person more sensitive to the sun
If the melasma is triggered by pregnancy or medication, it could go away once the person gives birth or stops taking the medication.
Post-inflammatory hyperpigmentation (PIH) occurs as a result of a skin injury or irritation to the skin. The skin cells react to the injury by producing extra melanin and so post-inflammatory hyperpigmentation is left as a result. The patches can appear pink, red, brown or black in color. It can be caused by infections, bug bites, burns, acne, rashes, allergic reactions and psoriasis. PIH can affect both men and women of all ages but is more common in people with darker skin.
Next month I will talk about different treatments, contraindications, and explain why post-care is so important. I will leave you with one last thought. The number one prevention or protection from further pigment is SPF. Every time we go outside, we are exposed to the sun. Even if you’re just in the car going to work, the amount of sun you get while driving is enough to trigger those melanocytes to produce more pigment. The old saying goes, “An ounce of prevention is worth a pound of cure”.