Disorders of skin darkening, also known as hyperpigmentation, are one of the most common complaints in dermatology offices. Hyperpigmentation refers to skin that darkens in comparison to its natural color. Based on your skin complexion, these areas can appear brown, tan, pink, gray, black, or even purple. This may occur due to hereditary factors, medical conditions, medications, and external influences.
Causes of Hyperpigmentation
The most common cause of hyperpigmentation is sun exposure. The body darkens the skin to protect it from harmful ultraviolet radiation. Ultraviolet (UV) light speeds up the production of melanin, a natural pigment that gives skin its color.
Other factors that can contribute to hyperpigmentation include:
- Hereditary factors
- Medical conditions
- Medications
- External influences
Common Types of Hyperpigmentation
The most common types of hyperpigmentation are harmless skin spots that can occur during childhood, pregnancy, or develop with age. Other types can be due to underlying disorders or previous skin trauma.
Age Spots (Solar Lentigines)
Age spots, also known as solar lentigines, are small, flat dark areas on the skin. They vary in size and usually appear on areas exposed to the sun, such as the face, hands, shoulders, and arms. Age spots are very common in adults older than 50, but younger people can get them if they spend time in the sun. These spots vary from tan to dark brown and are larger than freckles. They occur on skin that has had the most sun exposure over the years, such as the backs of hands, tops of feet, face, shoulders, and upper back. They range from freckle size to about 1/2 inch (13 millimeters) across and can group together, making them more noticeable.
Freckles (Ephelides)
Freckles, also called ephelides, are small tan or brown spots that usually develop in childhood on sun-exposed skin.
Melasma
Melasma usually occurring in females in their 20s and 30s, this condition causes irregular dark patches to occur on the face.
Maturational Hyperpigmentation
Usually affecting the sides of the face, this type of hyperpigmentation refers to gradual darkening of sun-exposed skin in people with darker skin complexions.
Periorbital Hyperpigmentation
This refers to darkened skin around the eyes.
Acanthosis Nigricans
A condition that causes darkening of the skin in areas that rub together, such as the armpits, groin, and back of the neck.
Post-Inflammatory Hyperpigmentation (PIH)
Post-inflammatory hyperpigmentation is discoloration due to skin inflammation or injury, such as burns, wounds, acne, or skin rashes.
Symptoms of Hyperpigmentation
Age spots may affect people of all skin types, but they're more common in adults with skin that sunburns easily. Age spots may grow in size and group together, giving the skin a speckled or mottled appearance. They are flat, oval areas of increased pigmentation that are usually tan to dark brown. When to see a doctor:
- Spots that are black
- Spots that have changed in appearance
- Spots that are increasing in size
- Spots with an irregular border
- Spots with an unusual combination of colors
- Spots that are bleeding
If you have any areas of hyperpigmentation that are more than one color, or that do not respond to treatment, make an appointment with a dermatologist.
Treatments for Hyperpigmentation
True age spots don't need treatment, but they are a sign the skin has received a lot of sun exposure and are an attempt by your skin to protect itself from more sun damage. For cosmetic reasons, they can be lightened or removed. Topical therapies (creams and lotions applied to the skin) are the most common treatment option for hyperpigmentation.
Certain vitamins and antioxidants can also be helpful for hyperpigmentation. These include vitamins A, B, C, and E, obtained either from food or supplements.
If your hyperpigmentation is due to a medical condition, your doctor may be able to prescribe medications to help. Contact your doctor before beginning any new medication or treatment.
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Prevention of Hyperpigmentation
You can help prevent age spots by regularly using sunscreen and avoiding the sun. Because the sun's rays are most intense during midday, try to schedule outdoor activities for other times of the day.
Sunscreen Use
Use sunscreen. Fifteen to 30 minutes before going outdoors, apply a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30. Apply sunscreen generously, and reapply every two hours - or more often if you're swimming or perspiring.
Protective Clothing
Cover up. For protection from the sun, wear tightly woven clothing that covers your arms and legs and a broad-brimmed hat, which provides more protection than does a baseball cap or golf visor. Consider wearing clothing designed to provide sun protection. Look for clothes labeled with an ultraviolet protection factor (UPF) of 40 to 50 to get the best protection.
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