Breakouts wouldn’t be so bad if they could let bygones be bygones; if a pimple must exist, it should also do you the courtesy of going away.
But for people with Black skin, very rarely will a breakout, bruise, or sun spot leave your face without also leaving unwanted pigment behind. That extra colour is called hyperpigmentation, and it's one of the most common skin concerns that Black people face.
"Skin with melanin is beautiful,"
QUOTE by Dr Candrice Heath, MD, a board-certified dermatologist.
But having that melanin can also predispose to hyperpigmentation.
Acne, a cut, a burn: All these things can result in excess pigment because we produce more melanocytes, the cells responsible for creating pigment.
Dr Heath explains "When the skin experiences trauma or inflammation, those cells become overactive and you end up with hyperpigmentation,".
But just like the nuanced nature of Black skin overall, not all hyperpigmentation is the same. In addition to the various causes, there are also numerous ways to treat it, from boosting your routine with potent acids to getting laser treatments from a professional. Getting to the specific root of the issue will help you better treat your skin, and prevent the problem from developing in the future.
Ahead, while discussing to dermatologists who specialize in treating hyperpigmentation for their tried-and-true advice on clearing up your spots.
The Cause: Acne
Acne is one of the main culprits of hyperpigmentation in dark complexions."I have many clients come in with hyperpigmentation caused by acne," also known as post-inflammatory hyperpigmentation (PIH), says Corey L. Hartman, MD, a dermatologist at Skin Wellness Center in Alabama.
According to Dr Hartman, many patients visit his practice hoping to get on a spot-clearing regimen right away — but, before you click your heels, there isn't a magic spell that'll clear dark spots caused by breakouts overnight. "In order to successfully treat the pigmentation, you have to treat your acne first," he says.
What To Do About Acne:
There are three main steps you can take to handle the hyperpigmentation that comes with acne: sun care, topical products, and upkeep.
"It's pointless to treat hyperpigmentation without protecting yourself from the sun," Dr Heath says.
"Any pigmentation will become darker or worse with sun exposure," adds board-certified dermatologist Caroline Robinson, MD.
"We have to protect our skin while we correct it."
Dr Robinson recommends using a physical sunscreen containing zinc oxide with SPF 30 or higher to prevent dark marks from worsening.
Sunblock creates a barrier that reflects UV light off of the skin, whereas sunscreen absorbs UV light.
SPF 20,30,50 is protecting skin to absorb 20,30 or 50 times less as compared to normal absorption of UV light.
In addition to sunscreen, dermatologists suggest using products with ingredients that will help keep breakouts at bay, like benzoyl peroxide or a topical retinoid, to kill bacteria and reduce inflammation.
"Topical retinoids are helpful for all types of acne because it helps unclog pores,"
Dr Robinson says. "It also helps control excess oil production related to hormonal acne."
Adapalene, an effective retinoid for treating acne, was approved for over-the-counter use in 2016; you can now find it in products from brands like Differin and ProactivMD.
Treatments containing benzoyl peroxides, like La Roche-Posay Effaclar Duo Acne Treatment and Neutrogena Rapid Clear Mask, are all vetted by top dermatologists with expertise in Black skin.
To keep your breakouts from worsening and therefore causing more hyperpigmentation, it's important to consistently treat it.
"Treating hyperpigmentation isn't a one-way ticket," Robinson says.
Once your acne is under control, you can focus on fading existing spots.
A topical retinoid should help your complexion look more even overall. You may also benefit from using an additional brightening agent, like vitamin C, to kickstart the spot-fading process.
“Vitamin C is a great topical antioxidant that brightens the complexion,” says Dr Heath.
“You can also use products with glycolic, mandelic, and kojic acid to help with fading pigmentation and cell turnover." She also recommends considering glycolic acid peels to further accelerate the spot-fading process.
The Cause: Melasma
If the discolouration on your skin appears in wide patches along the forehead, mouth, and cheeks, you might have melasma."While the specific cause of the condition is currently unknown, hormonal shifts or imbalances we see during pregnancy, hormonal therapies, and contraceptives have been associated with the development of melasma over time," Dr Robinson says.
In addition to the hormonal triggers, UV light and heat are also culprits for triggering the condition, especially in skin of colour.
“UV light and heat — think saunas, hot yoga, and even just being outdoors in high-temperature climates — can cause melasma to appear,” says dermatologist Melissa K. Levin, MD.
“A lot of people don’t realize that heat drives pigmentation.”Dr Hartman adds that melasma may also be an indicator of stress or thyroid disorders. “If you are adherent to a regimen but still don’t see improvement, consider incorporating relaxation techniques to manage your stress levels,” he says. "You might also want to get your thyroid levels checked to rule out any imbalances.”
What To Do About Melasma:
Because of melasma's complex nature, a gentle at-home skin-care routine paired with sun protection is the best plan of attack for treating it. Professional treatments, like laser and chemical peels, are also great for fading pigment but should be performed by a doctor.
According to Dr Robinson, a general treatment regimen for her patients starts with a series of chemical peels or laser sessions. "I prefer to start out with a procedural approach for maximum effectiveness vs. doing a trial on topical treatments,” she says. That doesn’t mean you shouldn’t turn to topicals for treatment, too:
Dr Heath usually recommends using prescription hydroquinone or seeking out products with alpha-hydroxy acids (like mandelic or glycolic) to continuously even out pigment beyond the doctor’s office.
To avoid making your condition worse, Dr Levin recommends using sunscreen on your face regularly — and if your melasma is in your surrounding eye area, keep your sunglasses close. “You may not realize that we have melanocytes, which are pigment-producing cells, at the back of our eyes,” she says. “So protecting your eyes is equally as important as your skin.”
However, before you diagnose yourself with melasma, be sure to consult with your doctor, who can keep a careful eye on any other changes in your skin.
The Cause: Sun Damage
One common misconception is that Black skin is better protected from the sun by nature — but according to pros, that couldn't be further from the truth. Not only can the sun make existing post-inflammatory pigmentation and melasma worse, but it can also create hyperpigmentation on the skin that didn’t already exist.“Sun damage may appear in the form of freckles, especially during our younger years,”
Dr Robinson says. “As we get older, sunspots may also show up as hyperpigmentation especially on the sides of the cheek.”
A sunspot will usually be flat and skin-like in texture and concentrated in colour, similar to post-inflammatory hyperpigmentation, but the clear difference is its origin.
What To Do About It:
The best thing anyone can do to treat and prevent damage from the sun is to make using sunscreen a priority.“Even if it’s gloomy or if you don’t live in an area that is very exposed to sun, those UV rays we don’t pay attention to can still be harmful,” Dr Heath says.
“Sunscreen is the cornerstone of any better-skin regimen." Dr Robinson says, "Look for formulas containing iron oxide, an ingredient that provides additional protection against visible light, like fluorescent bulbs, which can also impact dark spots."
Aside from sunscreen, chemical peels using AHAs (like glycolic acid) and laser treatments are also proven methods for fading pesky sunspots.
However, Dr Heath warns that peels can make your skin even more sensitive to sunlight, so protecting your skin will ensure your condition doesn’t worsen.
At home, Dr Robinson recommends over-the-counter products containing vitamin C to target pigmentation and brighten your complexion overall. She says to look for formulas containing Tetrahexyldecyl ascorbate (THD) as the active ingredient, as THD tends to be more stable and potent than other forms of vitamin C — and therefore leads to better results.
Above all, Dr Heath says to think about your approach to treating hyperpigmentation as a journey. “Many times patients come to me and request a quick fix,” she says. “The truth is, there is no quick fix.”
Dr Heath says that the best way to treat unwanted pigmentation is to talk to a professional who can help you get to the root of the issue. “If you take your time to treat what is causing your pigmentation,” she says, “you can not only improve your skin but improve your emotional relationship with it, too.”
