Hyperpigmentation: Causes, Symptoms and Treatments

Uneven skin pigmentation, or hyperpigmentation, is a common skin condition in which dark spots and dark patches appear on the face, hands and other parts of the body that are regularly exposed to the sun.

This article outlines the different types of hyperpigmentation and explains what causes them. We look at how you can help prevent hyperpigmentation in the first place, as well as the recommended hyperpigmentation treatment to reduce dark spots and patches once they have formed.

What is hyperpigmentation?

Pigmentation refers to the colouring of the skin, and hyperpigmentation is the term used to describe areas of uneven pigmentation. This occurs when the skin produces more melanin, which is the pigment responsible for your skin’s colour.

Hyperpigmentation can affect your entire body or appear as darkened patches or spots that make the skin look uneven, and these spots are known as age spots or sun spots. This condition is also at the heart of skin conditions such as melasma and post-inflammatory hyperpigmentation.

While this affects people of all skin types, those with dark skin are normally more affected by hyperpigmentation marks than those with a lighter skin tone, because skin pigmentation is stronger in dark skin.

Medical illustration of hyperpigmentation — Hyperpigmentation results in flat, darkened patches of skin that can vary in size and colour.

Age spots

Pigmentation spots such as age spots, also known as sun spots, are caused by exposure to the sun. These normally appear on older adults.

For this reason, they appear mainly on body parts that are frequently exposed to UV light, such as the face, neck, décolleté, hands and arms. They tend to be small, darkened patches of skin and tan, brown or black spots. Read more in What causes age spots and how can I reduce them?

age spots on older woman’s forehead — Age/sun spots are common on the face

Melasma

Also known as chloasma, melasma is a condition where larger patches of hyperpigmentation develop mainly on the face - specifically the mouth and forehead - though it can also appear on the stomach.

Although it can affect both men and women, melasma is most common in women and is thought to be triggered by changes in hormone levels. Melasma occurs in 50% of pregnant women in the UK and in 10-25% of women taking oral contraceptives,¹ and so it is sometimes referred to as “the mask of pregnancy”. You can read more about melasma in What causes melasma and how can I reduce dark patches on my skin ?

The International Dermal Institute, Melasma Unmasked by Dr Claudia Aguirre quoting Kang, H. Y., & Ortonne, J. P. (2010). What Should Be Considered in Treatment of Melasma. Annals of Dermatology, 22(4), 373-378.

Hyperpigmentation on the upper lip can occur due to hormonal changes

Skin hyperpigmentation can develop as a result of pregnancy — Melasma – a form of hormone-induced hyperpigmentation – is common during pregnancy

Post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation occurs when a skin injury or trauma heals and leaves a flat area of discolouration behind, usually appearing on the neck or face.

It’s commonly found among acne or eczema sufferers and can also be caused by cosmetic procedures, such as dermabrasion, laser treatment and chemical peels. Those with darker skin are more likely to develop post-inflammatory hyperpigmentation.

woman with post-inflammatory hyperpigmentation after acne — Acne sufferers commonly experience post-inflammatory hyperpigmentation

There are other factors that can cause patches of skin to become darker, such as scarring, birthmarks, solar or actinic keratoses and skin cancers, but these aren’t considered to be forms of hyperpigmentation.

What causes hyperpigmentation?

While hyperpigmentation is usually harmless, this is more of a cosmetic issue for most people. Hyperpigmentation is caused by an increase in melanin, which is the natural pigment that gives our skin, hair and eyes their colour. A number of factors can trigger an increase in melanin production, including certain medical conditions or medications, but the main causes are sun exposure, hormonal influences, age and skin injuries and inflammation.

Sun exposure and hyperpigmentation

Sun exposure is the primary cause of hyperpigmentation, as it is sunlight that triggers the production of melanin in the first place. Melanin acts as your skin’s natural sunscreen by protecting you from harmful UV rays, which is why people tan in the sun. However, excessive sun exposure can disrupt this process, leading to hyperpigmentation.

Once dark spots have developed, sun exposure can also exacerbate the issue by making age spots, melasma and post-inflammatory hyperpigmentation spots even darker.

woman shielding her face from sunlight — Sunlight triggers melanin production and is the number one cause of hyperpigmentation

Hyperpigmentation and hormones

Hormonal influences are the main cause of a particular kind of hyperpigmentation known as melasma, or chloasma. It is particularly common among women and is thought to occur when oestrogen and progesterone, the two key female sex hormones, stimulate the overproduction of melanin when the skin is exposed to sunlight. Hyperpigmentation can also be a side effect of certain hormone treatments.

Hyperpigmentation and age

As the skin ages, the number of melanin-producing cells, known as melanocytes, decreases. The remaining cells increase in size, however, and their distribution becomes more focused. These physiological changes explain the increase of age spots in those over the age of 40. You can read more about how the skin ages in skin ageing.

Hyperpigmentation, skin injuries and inflammation

As its name suggests, post-inflammatory hyperpigmentation occurs following skin injury and inflammation, e.g. cuts, burns, chemical exposure, acne, Atopic Dermatitis and Psoriasis. The skin is left darkened and discoloured after the wound has healed.

Hyperpigmentation, disease and medication

Hyperpigmentation is also symptomatic of a number of illnesses, such as certain autoimmune and gastrointestinal diseases, metabolic disorders and vitamin deficiencies.

It can also be triggered by chemotherapy drugs, antibiotics, tricyclic antidepressants, antimalarials and anti-seizure drugs, sometimes causing patches to be grey. More serious causes of hyperpigmentation include hemochromatosis and Addison’s disease.

person holding a pill — Certain illnesses and medications are known to cause hyperpigmentation.

How to prevent hyperpigmentation from forming

Sun protection is the most significant step that you can take in helping to prevent hyperpigmentation in the first place. It is important to remember that the sun’s rays affect the skin even on cloudy days, and so it is vital that you give your skin the daily protection that it needs.

As well as reducing hyperpigmentation, Eucerin Anti-Pigment Day SPF 30 offers effective UVA and UVB (SPF 30) protection and prevents the formation of further sun-induced pigment spots.

Limiting the skin’s exposure to the sun will also help to reduce hyperpigmentation. When the skin is exposed to sunlight, apply and regularly reapply a sun protection product with a suitable SPF level (30 or higher) and has been specially formulated for your skin type and condition. Learn more about Eucerin’s range of superior sun protection products here.

Apply sun protection at regular intervals in order to avoid hyperpigmentation — Using a broad-spectrum sunscreen every day can help prevent hyperpigmentation.

Woman applying Eucerin Anti-Pigment product onto shoulder

Unfortunately not all causes of hyperpigmentation can be prevented, but there are a number of ways to help reduce the chance of skin pigmentation from developing:

Try to keep out of the sun between the hours of 10am to 4pm, when the sun's UV rays are at their strongest
Sit in the shade or underneath an umbrella to minimise exposure
Wear protective clothing, such as sun hats and sunglasses
Use a sunscreen product daily, even in cooler months
Regularly moisturise your skin to restore the skin’s lipid (fat) barrier, providing further protection from the sun’s rays
Avoid scratching or picking at acne, scabs or spots, as this can lead to inflammation and darker pigmentation
Ensure your skincare products do not burn or sting, because irritation can increase hyperpigmentation, especially melasma

Hyperpigmentation treatment

While prevention is best, there are steps that you can take to make pigmentation spots fade, and to prevent their reappearance, once they have appeared on your skin.

Skincare solutions for hyperpigmentation

If you are looking for a hyperpigmentation cream, seek skincare products that have been formulated to address this concern and are clinically and dermatologically proven to be effective.

The Eucerin Anti-Pigment range has been specially formulated to mitigate against dark patches and age spots, with years of research dedicated to reducing hyperpigmentation for more even and radiant skin.

All products in the range – a day cream, night cream, serum, pigment control and spot corrector – contain Thiamidol, an effective and patented ingredient that acts at the root cause of hyperpigmentation by reducing melanin production. It has been clinically and dermatologically proven to reduce dark spots and prevent their reappearance. The first results are visible after two weeks, and the skin improves continuously with regular use.

Eucerin Anti-Pigment Dual Serum brings together Thiamidol and concentrated Hyaluronic Acid, one of skin’s moisturising substances, helping attract and retain moisture in the skin as an effective hyperpigmentation cream.

Furthermore, with SPF 30 and UVA filters, Eucerin Anti-Pigment Day offers effective protection from the sun and prevents the formation of additional sun-induced pigmentation spots.

Eucerin offers an extensive range of products that can be used to treat hyperpigmentation — The Eucerin Anti-Pigment range reduces dark spots and prevents their reappearance

image of Eucerin Anti-Pigment Dual Serum — Eucerin Anti-Pigment Dual Serum effectively reduces the appearance of dark spots and helps prevent their re-appearance.

Whilst Thiamidol is Eucerin-patented, there are other active ingredients that are commonly used to treat hyperpigmentation, albeit with varying efficacy. These include: Arbutin, Kojic Acid, other Resorcinol derivatives, such as B-Resorcinol, and Vitamin C and its derivatives.

A dermo-cosmetic solution is non-invasive and can be used year-round, as part of your daily skincare routine, to reduce hyperpigmentation. It can also be used to extend the results of a dermatological treatment.

Dermatological treatments to remove hyperpigmentation

Dermatological treatments such as chemical peels and laser therapy can help to reduce hyperpigmentation:

Chemical peels involve applying a chemical solution to the face, neck and hands to exfoliate the skin, i.e. remove dead skin cells. This, in turn, stimulates the growth of new skin. Read more about chemical peels in What are chemical peels and how do they work ?
Laser therapies have much the same effect, but tend to be more precise. This is because the dermatologist has more control over the intensity of the treatment. These therapies involve ‘zapping’ the affected areas with high-energy light. The mildest treatments work just on the skin’s epidermis (surface layer), while the more intense treatments can penetrate the deepest layers of the skin. Find out more in Laser therapy: how should I care for my skin after treatment ?

Dermatologists may also prescribe and/or use hydroquinone, which is still regarded as the most effective topical agent for reducing hyperpigmentation. It can, however, only be used for limited periods of time because, like other forms of chemical peel and laser treatment, it can irritate the skin and actually cause post-inflammatory hyperpigmentation, especially in people with darker skin.