Dark hyperpigmented marks, referred to as post-inflammatory hyperpigmentation, is due to enhanced melanin (pigment) production typically as a result of an inflammatory process in the skin (i.e. acne, wounds, rashes, bug bites).
Acne breakouts that penetrate the skin unfortunately may result in hyperpigmentation of the skin and sometimes results in scarring. Acne scarring occurs when the tissue is damaged. As our body attempts to repair the damage in the skin it produces collagen and over-production or under-production of collagen may result in scarring. In contrast to hyperpigmentation which is solely a change in the skin’s pigmentation, scarring occurs as a result of either over production or under production of collagen resulting in thick, hypertrophic scars or keloids, or ice pick scars, rolled scars, or box-car scars, respectively.
Treatment & Management:
There are various ways to treat hyperpigmentation of the skin. Cosmetic skin lightening products are a common way in which hyperpigmentation can be treated overtime. In fact, the global production and marketing of skin lightening products has emerged as a force to be reckoned with, a multi-million dollar industry worldwide.
The most common ingredients in skin lightening products include retinol, Vitamin C and hydroquinone.
Hydroquinone remains the worldwide gold standard for topical skin lightening in spite of the safety concerns posted by European, Japanese and U.S. regulatory agencies. Hydroquinone works by blocking the synthesis of melanin (pigment) and is available in 2% and 4% concentrations in both over-the-counter and prescription formulations. Overuse of high concentrations of hydroquinone leading to paradoxical irreversible darkening of the skin has been increasingly reported in African individuals.
Retinol is chemically derived from Vitamin A and plays an important role in regulating cell growth and proliferation. Retinols have been used since 1971 for treatment of acne, skin aging as well as treatment of certain types of cancers of the skin and psoriasis. Retinols help promote and hasten skin turnover, thus aiding with evening out skin tone, dyspigmentation and non invasively smooth fine lines and wrinkles overtime.
Vitamin C is a powerful antioxidant that is quintessential in one’s skin care regimen as it prevents sun damage, increases collagen production, brightens the skin and most importantly, improves skin tone. The key to choosing a Vitamin C serum is to look for serums that contain L-ascorbic acid, the most active form of Vitamin C.
Other less commonly used ingredients that may be helpful in the treatment of hyperpigmentation are:
Alpha-hydroxyacids which includes glycolic and lactic acid, which is used for fine wrinkles, dyspigmentation and melasma (a skin condition, most commonly occurring in females, wherein hyperpigmentation involves the forehead, temples and sides of the face; also referred to as the “mask of pregnancy” as it frequently occurs during and/or shortly after pregnancy as a result of hormonal changes). This ingredient is often incorporated in various in-office and over-the-counter facial peels.
Trichloroacetic acid (TCA) is an ingredient used in over-the-counter peels and in-office peels for the treatment of fine wrinkles, acne, dyspigmentation and melasma.
Discussion with your dermatologist regarding topical lightening products for hyperpigmentation is critical as many of the above listed ingredients may have potential side effects. The deleterious effects of skin bleaching practices from misuse of over-the-counter and prescription or imported skin lightening products has been increasingly prevalent and necessitates a heightened awareness nationally and globally.