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Clinical Procedures and Topics

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Additional clinical skincare topics.

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Hyperpigmentation is the name given to abnormally increased skin pigmentation and may appear anywhere on the body, but is usually limited to those areas which have received the most unprotected sun exposure.

Among the most common expressions of this phenomenon are the primary, severe symptoms of photoaging:

• "age spots";
  
  
• "sun spots";
  
  
• melasma;
  
  
• chloasma and
  
  
• freckles.

Each year, more than 80,000 individuals attempt to treat (lessen or eliminate) hyperpigmentation with over-the-counter skin care products which simply aren't up to the task.

Generally, such purported hyperpigmentation treatments use nomenclatures of:

• "whitening" (for example, Decleor Whitening Cleanser);
  
  
• "brightening" or "clarifying" (for example, Darphin Clear White Clarifying Mask) and
  
  
• "lightening" or "illuminating" (for example, Bremmen Lumedia).

These and all similar hyperpigmentation products produce temporary superficial cosmetic improvement only by coating the epidermis (the upper layer of the skin) with white, reflective substances such as zinc oxide, titanium dioxide and mother of pearl.

Racist, social and cultural tendencies drive a large proportion of the demand for hyperpigmentation skin care because individuals with skin colour other than plain white (Asians, Indians, African-Americans) frequently use these skin care products in an attempt to generally lighten their complexion in the absence of actual hyperpigmentation.

Most hyperpigmentation or broadly "whitening" skin care is clearly tuned to a desire to simply look whiter (and not to eliminate dark patches or mottled hyperpigmented spots), because their ingredients are:

• unable to penetrate to the extent required to modify the chemical reactions responsible for permanently hyperpigmented skin states;
  
  
• not only not recognised as therapeutic in the treatment of hyperpigmentation, but are generally limited to optically white fillers typically found in makeup (foundations and powders).

Accordingly, most hyperpigmentation skin care is a form of colourless makeup and not a bona fide treatment per se.

Clinically, optimal actual treatment of hyperpigmentation varies according to:

• skin type;
  
  
• skin condition;
  
  
• hormonal characteristics;
  
  
• gender and
  
  
• age.

Post-inflammatory hyperpigmentation is managed distinctly.

General Additional Notes on Hyperpigmentation

Frequently sensitized or damaged skin is especially prone to developing hyperpigmentation.

Hyperpigmentation can develop after such seemingly insignificant events as:

• waxing;
  
  
• unprofessional glycolic acid peels;
  
  
• electrolysis;
  
  
• acne breakouts;
  
  
• pregnancy;
  
  
• intake of medications which affect hormonal balance (primarily contraceptive medications), and even
  
  
• periods of sun exposure greater than ten minutes where photoprotection isn't ideal.

Although effective hyperpigmentation treatment and prevention has been available for more than two decades, the presence of a vast and broad swathe of ineffective yet pleasant-to-use skin care products has made effective therapy all but impossible for the public at large.