Hyperpigmentation is one of the most common skin concerns among people of colour, and yet the targeted treatment options available are commonly misunderstood. That’s why we asked world renowned plastic surgeon and aesthetic doctor Dr Maryam Zamani, who aside from having 12 years experience developing her sought after aesthetic techniques, also personally understands the issue. “Being Middle Eastern means I’m able to produce melanin really fast, so I get a lot of areas of hyperpigmentation really easily.”
Hyperpigmentation is a common skin condition when the skin over produces the pigment melanin in certain areas, creating darker patches and an uneven skin tone. While all skin tones can develop these patches, it’s more likely in people of colour. However, the key difference is that treatment should not be the same for all and will depend heavily on your skin tone. Dr Maryam Zamani explains all the options as well as the key ingredients for at-home skincare…
LASER TREATMENTS CAN CAUSE EVEN MORE PIGMENTATION
Many people turn to lasers and other resurfacing treatments to treat scarring, but they can actually cause even more pigmentation and further scarring if administered incorrectly. If you are a darker skin type, anything from a four to a six on the Fitzpatrick Scale, it’s important to pre-treat the skin with a tyrosine inhibitor, which is a topical medication that inhibits the enzyme that promotes pigment production. Application should continue after the treatment as well, so you’re down-regulating the pigment response even further.
ALWAYS WEAR A BROAD SPECTRUM SUNSCREEN
UV radiation causes damage to the DNA of all our cells. A tan is basically the pigment, melanin, in the top layer of your skin trying to protect you from burning. If you are someone who’s prone to getting pigmentation like a melasma or freckles, this melanin response can cause spots of hyperpigmentation. Sunscreen is the most important product to prevent this happening, but it’s also worth using a topical cream before, during and after sun exposure. I recommend a prescription cream called Pigmanorm, which is a tyrosine inhibitor able to inhibit pigment production.
LOOK FOR CERTAIN INGREDIENTS TO TREAT ACNE SCARS
Acne scars can also cause hyperpigmentation, especially in people of colour. I would also recommend alpha hydroxy acids (AHAs), which are a nice way to exfoliate the skin gently without dehydrating it. If you still have active acne, I would recommend a combination of AHAs, and beta hydroxy acids (BHAs) like salicylic acid.
I would also suggest a vitamin C product, which is an excellent antioxidant that protects from UV damage so will also help to prevent new pigmentation from forming. Plus, it’s a great skin brightener so will decrease the appearance of hyperpigmentation over time.
The other ingredient is retinol, which helps increase cell turnover, it helps promote collagen production, it helps decrease pigmentation, and it helps keep even skin while decreasing sebum and oil production. Retinol will help to treat the root cause of acne, and therefore prevent the possibility of scarring.
THERE ARE A VARIETY OF IN CLINIC TREATMENT OPTIONS
To treat pigmentation in skin types one to three, I would start with a series of Intense Pulsed Light (IPL) treatments, administered one month apart. For pigmentation in darker skin types, I would recommend a series of light chemical peels, pre-treating and post-treating with Pigmanorm and prescribing a proper skincare regimen as well.
To treat moderate acne scars in all skin types, I would recommend microneedling and a combination of Vitamin C treatments and Pigmanorm. If a patient had severe acne scarring, I would use more intense laser resurfacing treatments and if the scarring had affected the texture of the skin, I would consider a treatment known as subcision. This is when you put a tiny bit of filler under the skin surface to smooth the texture and tether the scar.
NOTIFY YOUR PRACTITIONER IF YOU ARE PRONE TO KELOID SCARS
It’s really important to tell your doctor or practitioner if you are prone to keloid scars (large, raised and often discloured scars), as it will affect the way they treat you. One option is to inject a small amount of intralesional steroids to decrease cell proliferation, and another option is to integrate massage into the treatment.
BE PATIENT
Non-prescription skincare products can take six to eight weeks to take effect, and many in clinic options require a series of treatments administered over weeks or even months. The skin takes a number of weeks to renew itself and start a new cycle – a process which becomes even longer as we get older. It can be frustrating but be patient. It’ll be worth the wait.