All About Skin and Dermatology

Melasma appears as brown or gray-brown patches on the face. These patches generally appear on the cheeks, forehead, upper lip, and chin. Melasma is associated with ultraviolet exposure, pregnancy, birth control pills, and hormone replacement therapy.

Postinflammatory hyperpigmentation appears as dark patches that develop from injury to the skin. Postinflammatory hyperpigmentation is caused by trauma to the skin that may be due to inflammatory skin disorders, such as acne, eczema, contact dermatitis, or by cosmetic procedures or reactions to cosmetics.

Only a medical doctor can tell you which type of hyperpigmentation you have and can provide you with options to treat it.

Risks for Hyperpigmentation
Hyperpigmentation is very common. No one knows exactly how many people have it, but some people are at higher risk.

Sun exposure:
Among patients with melasma, a combination of skin type and sun exposure may increase risk. People with light brown skin (eg, Asians, some Hispanics and some African Americans) who live in areas with high ultraviolet exposure have the highest prevalence of melasma. Patients of any skin type who are exposed to ultraviolet radiation may double the amount of pigment in their skin.

Gender:
Women are more likely than men to develop melasma. Hormones associated with pregnancy, birth control pills, and hormone replacement therapy are generally the cause of melasma in women. Melasma may go away after childbirth or after a woman stops taking hormones. Melasma in men appears the same as it does in women, but hormones do not appear to be the cause.

Skin Trauma:
Postinflammatory hyperpigmentation is caused by trauma to the skin that may be due to inflammatory skin disorders such as acne, eczema, and contact dermatitis, or by cosmetic procedures or reactions to cosmetics. Cosmetic procedures that may cause postinflammatory hyperpigmentation include chemical peels, laser skin resurfacing, waxing, and electrolysis. Postinflammatory hyperpigmentation occurs at the site of injury, which can appear anywhere on the body. Men and women have the same risk of developing postinflammatory hyperpigmentation. Other causes of melasma in both men and women include heredity, medications that cause the skin to become more sensitive to solar radiation, nutritional deficiency, and some disorders that affect the endocrine system in the body.

FAQs About Hyperpigmentation

Q: What is hyperpigmentation?
A: Hyperpigmentation is a common condition that produces dark spots or patches on your skin. The spots are caused by excess melanin, the substance in your body that gives your skin its color.

Q: How do I know for sure that I have hyperpigmentation?
A: Only a doctor can know for certain that you have hyperpigmentation. Skin problems can be very difficult to diagnose and should never be self-treated.

Q: I just had a baby and now have dark patches on my face. What caused that, and will it go away?
A: You might have hyperpigmentation—only a doctor can tell for sure. But it is common to develop hyperpigmentation during pregnancy because of hormonal changes in your body. That’s why hyperpigmentation is sometimes called the “mask of pregnancy.” The dark patches may go away over time as your hormone levels return to pre-pregnancy levels. If not, your doctor may wish to treat the hyperpigmented areas. It is important that you consult a doctor about this and not try to treat it yourself.

Q: How long does it take for hyperpigmentation to go away?
A: It depends on the cause and the type of treatment approach your physician chooses. Realistically, it could take from weeks to months before hyperpigmentation disappears completely. It is important that you closely follow the treatment regimen your doctor prescribes and learn how to lower your risk for developing hyperpigmentation in the future.

Q: My doctor told me to use a sunscreen all the time, but I work in an office and don’t see why I have to bother doing that.
A: You’d be surprised at how much ultraviolet radiation you can get, even if you are inside most of the time! Everyone should use sunscreen to protect against damaging ultraviolet radiation, but if you have hyperpigmentation, it is especially important. Even the lights in your office or sunlight coming through a car or building window can expose your skin to ultraviolet radiation. Follow your doctor’s advice and use the sunscreen recommended or prescribed to protect your skin. Sunscreen is not just for the beach!