Hyperpigmentation

Hyperpigmentation is characterized by the presence of brown spots on parts of the body exposed regularly to the sun. The sun is in fact the main cause of hyperpigmentation, combined with other factors specific to each person.

Hyperpigmentation spots are caused by an increase in melanin activity, the biological molecule responsible for skin pigmentation, in other words for skin color.

There are several types of hyperpigmentation:

• Chloasma is characterized by the presence of hyperpigmented marks on the face, in particular the forehead, cheeks, nostrils, upper lip and chin. This type of hyperpigmentation affects mainly women between the ages of 20 and 45 exposed to large amounts of hormones, during pregnancy or due to their contraception or any other hormonal therapy;
• Lentigo is more diffuse and covers all areas exposed to the sun, not only the face but also the neck, décolleté, backs of the hands, forearms, shoulders and back. This type of hyperpigmentation affects both men and women from the age of 45. Lentigo is strongly associated with skin aging. In fact, people with lentigo also have wrinkles and their skin is less firm.
• Post-inflammatory hyperpigmentation develops following a skin lesion or inflammation. The circumstances under which it occurs vary greatly: acne, eczema, psoriasis, a skin wound, a burn, a chemical peel, laser treatment, etc.

Skin hyperpigmentation is a very common phenomenon. It affects 1 in 3 women on hormonal contraceptives, and 90% of women over the age of 50⁽¹⁾.

People with dark, black or mixed skin are more likely to develop hyperpigmentation. This is because they already have pigmented skin that is rich in melanin. Their natural pigmentation is often irregular, sometimes from childhood. The sun, hormones, age and any form of skin inflammation can cause new brown spots to appear.

A pregnancy mask is a particular form of hyperpigmentation. Also called melasma, it’s a group of brown spots that appear during pregnancy, usually from the 4th month. It is estimated that 90% of pregnant women are affected by pregnancy masks(2). To prevent them, women must use a maximum sun protection during pregnancy.

These hyperpigmentation spots appear on the face as well as on the neck and stomach, and are also called “linea nigra”. Moles tend to get darker during pregnancy too, without this being a cause for concern.

The hyperpigmented marks generally fade very gradually after childbirth, but may also remain and pose an aesthetic problem for young mothers. You can use some targeted dermo-cosmetics designed to prevent or correct brown spots during pregnancy and breastfeeding, just remember to read the labels carefully.

Skin hyperpigmentation causes brown spots on the body in numerous places:

• The face, especially the forehead, cheeks, nostrils, lips, chin, eye contour;
• The neck;
• The décolleté;
• The backs of the hands;
• The stomach in pregnant women;
• The forearms;
• The shoulders;
• The back.

Hyperpigmentation therefore affects all areas exposed to the sun. Applying a high protection sun cream is a great way to prevent brown spots.

There are several causes of hyperpigmentation:

• The sun is the main risk factor for hyperpigmentation. It stimulates melanin synthesis, which promotes not only a tan but also the onset of brown spots. And you don’t have to have suffered from sunburn to see hyperpigmented spots appear – repeatedly exposing skin to the sun without protection is all it takes;
• Female hormones promote melanocyte activity. Combined with the sun, they cause pigmentation spots to appear and are therefore a source of hyperpigmentation;
• Skin aging is also a major cause of brown spots. There is a close link between premature skin aging and sun exposure, which makes photo-aging a cause too;
• Skin inflammation of any type (acne, eczema, psoriasis, skin wound, laser treatment, chemical peel, etc.) can leave scars or hyperpigmented marks. To avoid this, it is a good idea to treat skin inflammation, protect injured skin from the sun and avoid fiddling with lesions;
• Other possible causes of hyperpigmentation include medication, chronic diseases, vitamin deficiencies, pollution, blue light, etc.

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Hyperpigmentation rarely disappears all by itself. On the contrary, hyperpigmented marks tend to multiply over time and become permanent. Fortunately, several treatments exist to remove brown spots:

• The first thing to try is an anti-brown spot cream. These creams are available without a prescription and are designed to correct the hyperpigmentation, even out the complexion and protect the skin, particularly from the harmful effects of the sun;
• Medicinal treatments, prescribed by a dermatologist, usually contain hydroquinone, which is the benchmark depigmenting agent;
• There are also treatments that dermatologists can carry out in their office, including laser treatments, chemical peels and cryotherapy.

A dermatologist is a doctor that specializes in the skin, hair and nails. They can confirm the diagnosis of hyperpigmentation and prescribe and/or perform certain treatments. They will regularly monitor a skin condition and moles.