Why Your Hyperpigmentation Hasn’t Gone Away

Dr. Andrea Suarez, dermatologist, sheds some light on the dark patches:

The inflammatory truth

Hyperpigmentation is often a mark left after inflammation. In particular, dark spots can remain after acne, eczema, contact dermatitis, rosacea, insect bites, skin injuries, cosmetic procedures, skin-picking, and many other things that “bother” the skin.

However, the inflammation that triggered the pigmentation can continue beneath the skin even after visible inflammation has disappeared, and focusing exclusively on fading dark spots can allow the underlying inflammatory process to continue. Each new inflammatory event can stimulate additional pigmentation and make existing discoloration harder to fade.

For this reason, adding acids, peels, scrubs, vitamin C, retinoids, brightening serums, toners, and masks can compromise the skin barrier and cause irritation. Dryness, itching, flaking, stinging, and increased sensitivity can all indicate subtle inflammation that can worsen pigmentation.

So instead, a basic routine of cleansing, moisturizing, and sunscreen can reduce unnecessary irritation while pigmentation is being addressed.

Some things to watch out for include hyperpigmentation in the wake of…

• Acne: even when pimples, blackheads, whiteheads, cysts, and nodules have disappeared, acne can remain active beneath the surface. Continuing appropriate acne treatment, such as topical retinoids, benzoyl peroxide, azelaic acid, or other prescribed treatments, can help control both the underlying disease and pigmentation.
• Eczema: visible symptoms can improve while inflammation persists beneath apparently normal skin. Treatment will likely therefore need to continue for a period after a flare appears to have resolved, depending on the severity and treatment plan.
• Contact dermatitis: ongoing exposure to an allergen can maintain inflammation even when the cause is not obvious. Potential sources can include skin care, cosmetics, nail products, workplace exposures, or any products whose ingredients have changed.

For more on all of this plus some visual illustrations, enjoy:

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Take care!