In a previous blog post titled, 'Age Spots and Hyperpigmentation: Why do they develop?' we briefly talked about how discoloration develops. To recap, hyperpigmentation can be caused by either 1) skin cells called melanocytes overproducing melanin – the pigment that gives human skin, hair, and eyes their color, or 2) proliferation of the melanocytes themselves leading to an accumulation of melanin. Today, we are going to go a little more in depth and talk about the 4 main types of hyperpigmentation. Knowing which type of discoloration you are dealing with is an important first step to reducing current and preventing future issues with hyperpigmentation.
There are 4 main categories of hyperpigmentation:
1. Post-inflammatory hyperpigmentation (PIH) is a type of pigmentation that develops after the skin has been injured in some way - such as acne lesions, psoriasis, and burns. The good news is that this type of scarring will heal and fade over time as the skin regenerates itself. PIH is typically responsive to treatments such as chemical exfoliation, but it may take months or longer for the discoloration to completely go away.
2. Lentigines is a type of discoloration that is colloquially known as age spots or liver spots. Although they are mainly found in individuals over the age of 60, they are not directly caused by the aging process. Instead, they are related to UV exposure over a lengthy period of time. Lentigines are a little more stubborn to treat and may require the use of more potent formulations and/or laser treatments to diminish.
3. Melasma is a type of pigmentation that is directly related to changing hormone levels. For instance, melasma can develop in some individuals during pregnancy or during hormone replacement therapy. Due to the nature of melasma development, namely that they are influenced by hormonal fluctuations, they may require a multi-level approach to treat. For example, if your melasma is brought on by high levels of the stress hormone cortisol, then you may need to work on managing your stress in addition to using treatments and medications to combat the discoloration.
4. Freckles are small, benign, brown spots that occur on areas frequently exposed to sunlight. In many individuals, freckles present in childhood will fade with age.
Since different types of discoloration require different kinds of intervention for treatment to be effective, it is important to figure out which type of hyperpigmentation you currently have. Consult a physician or dermatologist prior to using formulations with high strength ingredients such as hydroquinone if you’re in doubt about the type of skin problem you are suffering from.
We will be back next time with Part 2 of this series on ‘How to Prevent & Reduce Hyperpigmentation’ with information on things you can do to actively stop hyperpigmentation in its tracks.
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Skin Management System by Dr. Strauss
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