Pigmentation Treatment

Sun Damage Causes Pigmentation Problems in Lihnt-Skinned Individuals

The main cause of dark spots in light-skinned individuals is sun damage. Years of sun exposure can result in spotted hyperpigmentation, a condition marked by increased pigment production that results in patchy skin color or a blotchy complexion. The extent of sun damage depends largely on a person’s skin color and his or her history of long-term or intense sun exposure. To treat pigmentation problems due to sun damage in lighter-skinned individuals,

  • Superficial chemical peels containing salicylic acid and glycolic acid may be used in combination with topical therapies to enhance results and improve the skin’s appearance.
  • Intense Pulsed Light (IPL) devices and Q-switched lasers also may be used alone or in combination with topical therapies to selectively target dark spots.
  • Daily sun protection with a sunscreen that provides broad-spectrum protection from UVA and UVB rays and has a Sun Protection Factor (SPF) of 30 or greater is essential in preventing further sun damage and resulting dark spots.

Dark-Skinned Individuals more Prone to Hard-to-Treat Pigmentation Problems

Two of the most common pigmentation problems that occur in people with darker skin tones are melasma and post-inflammatory hyperpigmentation. Melasma is a patchy brown discoloration that occurs on sun-exposed areas of the face and is commonly referred to as “the mask of pregnancy” because it often occurs during pregnancy. Those with light skin can develop melasma, but the condition is more common in dark skin. Because a deeper skin layer (the dermis) may be affected, melasma can be difficult to treat and requires a multifaceted treatment regimen.

Post-inflammatory hyperpigmentation (PIH) is a condition in which an injury or inflammation to the skin causes increased pigment production. PIH occurs in darker-skinned individuals and, like melasma, can be difficult to treat when it involves a deeper skin layer. The most common cause of PIH is acne, but it also can result from psoriasis, a burn, or an injury.

It is important to address the underlying cause of the pigmentation problem. For example, to treat PIH due to acne, treat both problems simultaneously with topical retinoids, a group of medications derived from vitamin A.

People with melasma or post-inflammatory hyperpigmentation can benefit from the following therapies:

  • A combination of over-the-counter topical products containing active ingredients such as soy or niacinimide have been found to help brighten the skin and can be used daily.
  • For melasma, hydroquinone therapy is used as a mainstay treatment.
  • Darker-skinned patients resistant to over-the-counter therapies may be good candidates for microdermabrasion or chemical peels in addition to topical therapy.
  • Combination chemical peels, which contain higher concentrations of active ingredients than those used for lighter-skin tones, allow the active ingredients to reach the deeper, affected pigment. Some of the active ingredients currently used for darker-skinned individuals include salicylic acid, lactic acid, resorcinol, kojic acid, mandelic acid, and tretinoin.
  • Non-ablative fractionated lasers and very low-level Q-switched Nd:YAG lasers can be used in difficult to treat or resistant cases.
  • Daily use of a broad-spectrum sunscreen with an SPF 30 or greater is highly recommended to prevent further darkening of the skin. The newest sunscreens are not as opaque or difficult to apply as in the past and are working well for darker-skinned patients.


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