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Dark spots, sunspots, liver spots, age spots, discoloration, uneven skin tone - it's all hyperpigmentation. The list of names for this unwanted skin condition is long! Hyperpigmentation is one of my clients' top concerns. While it can be stubborn to treat, it can be corrected and, more importantly, prevented in many cases. Let us dive into what hyperpigmentation is: The three types of hyperpigmentation, its causes, prevention, and treatment. What is hyperpigmentation?Hyperpigmentation is the skin's protective response when the threat of damage has triggered it. This damage can occur from UV rays or other internal and external triggers. This response is called melanogenesis; it is the process in which pigment (melanin) is created by the melanocyte cells within the skin. Melanin production is a protective mechanism of the skin designed to shield the surrounding cells DNA from damage. That tan you work hard to achieve all summer long is DNA damage. Over time, when overused and over-activated, the melanocytes can become damaged and malfunction — leading to varying hyperpigmentation conditions. Knowing which type of hyperpigmentation you are concerned with is essential to treating it successfully. There are three primary forms of hyperpigmentation: Melasma, Post Inflammatory Pigmentation and Photodamage. Each can be differentiated by its causes and associated characteristics or patterns. 
Melasma Melasma appears as a discoloration of the skin in symmetrical, sharply demarcated areas of light and darker pigmentation. It is often seen on the cheeks, forehead, and upper lip. It is also referred to as a "pregnancy mask." Indications that your hyperpigmentation is melasma:
Causes: Hormonal fluctuations in women, pregnancy, postnatal hormone fluctuations, hormonal contraceptives, exposure to extreme heat (increases existing melasma appearance), hormonal therapies, diabetes, or medications (particularly those that are damaging to the liver), auto immune disease, proestrogenic pollutants (such as BPA in plastics) Prevention:
How to correct/treat:
Corrective Homecare Recommendations:
Post-Inflammatory Hyperpigmentation Post-inflammatory hyperpigmentation (PIH) shows on the skin as dark spots you see after picking a blemish or after a superficial scratch has healed. Depending on the type of trauma, PIH is characterized by brown patches or red/purplish circular areas. Indications that your hyperpigmentation is PIH:
Causes:
Prevention:
Treatments:
Corrective Homecare Recommendations:
UV Hyperpigmentation (Photodamage) Hyperpigmentation is one of the most common signs of photodamage — UV aging. We know that UV exposure is one of the biggest triggers of melanogenesis and skin damage. Over time, the photo-protective melanin (aka your tan) becomes the photodamage. Indications that your hyperpigmentation is photodamage:
Causes:
Prevention:
How to correct/treat:
Corrective Homecare Recommendations:
Other Causes of Hyperpigmentation Pollution: Pollutants such as overexposure to smoke, dust, and chemical emissions - especially in larger metropolitan or agricultural areas - have a long-lasting effect on the skin. They compromise the skin barrier, leading to accelerated aging and unwanted pigmentation. Using Epionce Intense Defense Serum combined with an Epionce Renewal, and daily consistent use of broad-spectrum sunscreen will help fight free radicals to improve the overall appearance of the skin and lessen the effects of pollution. Inflammation: A healthy skin barrier is critical when addressing hyperpigmentation. It can be nearly impossible to treat if inflammation within the skin exists and can quite possibly make hyperpigmentation worse. This is why Epionce Renewals and Intensive Nourishing Cream are highly recommended.
 A note on the prescription Hydroquinone: I feel that it is important to address the use of Hydroquinone. Hydroquinone and a retinoid (prescription Vitamin A aka Retin-A or Tretinoin) have for years been the standard treatment for hyperpigmentation. While this can be an effective treatment for some, I have found that many of my clients have difficulties being consistent with this treatment due to the irritation caused by the retinoid. Another issue I see is that clients are not educated on how to properly use hydroquinone. Hydroquinone is not for long term use - it should be used for no more than 8 weeks at a time. And after this time you MUST continue to use a pigment inhibiting product. Especially with melasma! Failure to do so will result in a rebound effect meaning your melasma can come back appearing worse.
Once you narrow down the type and the likely cause of your hyperpigmentation (and understand that it is a protective response), you can work on correcting it. Home care and proper sun protection are a must when trying to tackle hyperpigmentation! And even better, it can help prevent photo damage. You can not treat hyperpigmentation with in-office therapies alone. Using products daily to correct pigment concerns is required to achieve results. Home care and treatments go hand in hand when trying to combat hyperpigmentation. And if you are not using adequate sun protection, then you are just throwing time and money out the window. Another must when treating this concern is patience and realistic expectations. Hyperpigmentation, as I mentioned, is extremely stubborn and cannot be cleared overnight. It is a process that requires commitment, and in the case of melasma - maintenance, even after it has improved. I hope this information has left you with a better understanding of what hyperpigmentation is, how it can be avoided, and how it can be treated. I know how frustrating this condition can be and I am here to help! Send me any questions you have or let me know if you would like me to get you set up with a homecare routine to begin your healthy skin journey.
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