It can be caused by a variety of factors, from pregnancy hormones and birth control pills to acne and sun exposure. Depending upon the cause of your hyperpigmentation, it may eventually go away on its own, but melasma—the type that's caused by hormones—is the most stubborn.
Epidermal: Epidermal melasma has a dark brown color, a well-defined border, appears obvious under black light and sometimes responds well to treatment. Dermal: Dermal melasma has a light brown or bluish color, a blurry border, appears no differently under black light and doesn't respond well to treatment.
The three main types include age spots, melasma, and post-inflammatory trauma. Post-inflammatory trauma can result from an injury, sun exposure, or a skin condition, such as acne.
Epidermal PIH can last for 6 to 12 months or more. Dermal PIH can take years to fade, and spots may be permanent. There is also a chance new spots can show up, or that your PIH will come back again after fading. Treatment for post-inflammatory hyperpigmentation often involves more than one method.
Stubborn pigmentation refers to areas of darker or uneven skin tone that resist conventional treatments or persist despite efforts to lighten them. These pigmentation issues can be challenging to manage due to various contributing factors.
Depending upon the cause of your hyperpigmentation, it may eventually go away on its own, but melasma—the type that's caused by hormones—is the most stubborn. “Melasma is most common in medium skin tones and it's very difficult to treat.
Reason #1: You're Getting Too Much Sun
“Hyperpigmentation can be incredibly frustrating and tough to treat. One of the easiest things you can do at home to help with hyperpigmentation is to be vigilant with sun protection,” says Dr. Camille Howard, a board-certified dermatologist and IT Cosmetics Advisory Board Member.
There are many treatments that can remove existing pigmentation, but they may not be a permanent cure. To keep pigmentation away in the long-term, you will need some maintenance.
Hyperpigmentation can go away on its own, dependent on the cause, but it may take a long time to fade. Some cases of hyperpigmentation may never go away completely.
Topical therapy is the recommended first-line treatment, with the gold standard being hydroquinone, which can be used alone or in combination with other agents.
Darker skin types are more likely to have greater issues with hyperpigmentation compared to lighter skin types.
Hyperpigmentation may be sun damage and sun spots if you have a history of chronic sun exposure and tanning. Melasma often presents as broad patches of discoloration, whereas sun spots and other forms of hyperpigmentation may look like small circles or focused dots.
Can retinol make melasma worse? Yes, if you over cook the application. Retinol & retinoids can be irritating, especially for patients who have sensitive skin, or sensitised skin (using far too many products or the wrong products- product combination).
In mild to moderate cases, post-inflammatory hyperpigmentation is not permanent and the blemishes will fade over time – even if left untreated. In severe cases, it can take months and even years for the discolouration to fade and some traces can remain permanently.
Postinflammatory pigmentation is also called acquired melanosis. More severe injury results in postinflammatory hypopigmentation, which is usually permanent.
As sun exposure worsens hyperpigmentation it is important to protect the skin with sunscreen on a daily basis. Treatment often begins with a skin care regimen composed of a daily sunscreen, moisturizers, and skin care brighteners.
Azelaic Acid's Superpowers
Evens out skin tone: Azelaic acid takes the spotlight when it comes to reducing redness and hyperpigmentation. It's the backstage crew that ensures the show goes on without any uneven tone or blemishes.
The length of time it takes for PIH to fade depends on how dark the spot is compared to the surrounding skin. The bigger the contrast between the dark area and your natural skin tone, the longer it will take to fade. PIH doesn't always fade away on its own. In some cases, it's more or less permanent.
While treatments help remove existing pigmentation, the underlying pigment cells may be hyperactive, and therefore continue to produce excess melanin. Usually, genetic makeup plays a role in such cases.