Exactly what to do about those dark spots on your face
Factors like the UVA rays in sunshine "turn on" your pigment-making cells called melanocytes, which then pump out melanin to protect your skin.
Hyperpigmentation is relatively common. For example, melasma, which is a type of hyperpigmentation that manifests in dark patches on the cheeks and chin, affects 5 million Americans according to the International Dermal Institute.
And while the excess pigmentation is not generally harmful, it can be stubborn to treat. We asked New York City dermatologist Debra Jaliman, M.D., to shed some light on this dark situation, as well as share advice on how to kick this annoying issue to the curb.
"When there's dark discoloration on the skin, too much melanin has been produced," says Jaliman. Factors like the UVA rays in sunshine "turn on" your pigment-making cells called melanocytes, which then pump out melanin to protect your skin. While that means a tan for many, the process can also cause dark spots and patches to crop up in over-exposed areas. Sometimes, spots can take a decade or two to show up, so if you've got hyperpigmentation making an appearance now, the damage may actually have come from your child or teen years.
Too much time in the sun is the leading cause of hyperpigmentation. The condition can also be exacerbated by hormones combining with sun exposure, as well as hormones from pregnancy or birth control pills, explains Jaliman. A 2016 study of women in Germany and China has also linked air pollution gases with the formation of dark skin spots, which is concerning news for city-dwellers in particular.
Due to the influence of hormones, women tend to get hyperpigmentation more commonly than men, says Jaliman. Sun spots and uneven patches usually sprout up on the cheeks, forehead, upper lip, nose, chin, and other areas of the face that are exposed year-round to sun rays. On the body, it's common to see it in areas of thin skin first that has less natural protection, like on the decolleté and backs of hands.
Lotions containing niacinamide, vitamin C, or the skin lightening agent hydroquinone are Jaliman's preferred ways of treating hyperpigmentation. These skincare products can be prescribed, or many options containing these ingredients exist over the counter, too. Jaliman likes MURAD Rapid Age Spot and Pigment Lightening Serum($65, sephora.com) Either way, it's crucial to apply the treatment daily to see results, says Jaliman. For a more aggressive in-office approach with dramatic results, Jaliman recommends the Revlite laser to her patients, which uses light treatments to promote natural collagen growth and cell turnover.
Whatever route you choose, a prevention plan is essential to enjoying your results and guarding against re-emergence—a very common issue that comes with treating dark spots. "Most importantly, use sunscreen with a high concentration of zinc oxide everyday, rain or shine, to prevent hyperpigmentation!" says Jaliman. Also, practice sun-safe behaviors like wearing a sun hat in the summer to shade your face and not laying out during the peak hours of midday, when rays are strongest.
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