• Hyperpigmentation (and blemished skin) is described by dermatologists as the appearance of darkened patches or spots on the skin that make skin look uneven.
  • It is reportedly one of the leading skin concerns among black women, but it can be treated effectively.
  • Here, we tackle hyperpigmentation with Lamelle's medical trainer Karen Bester and Cape Town-based dermatologist Dr Nomphelo Gantsho. 

I think perhaps many of us have a skin concern that makes us self-conscious, especially when your area of concern flares up during certain seasons or with hormonal changes. 

And for many of us, we haven't found the perfect solution for it yet. 

As I write this article, I'm thinking of the three different eye creams I have on my bathroom stand, which were all bought for the purpose of treating the dark circles under my eyes. 

Spoiler alert: My dark circles are still visible sans concealer, but that's a self-inflicted problem of not actually sticking to one eye cream to see which one will actually work.

Relatable content? I would think so.

READ MORE: Experts share an open secret about preventing winter damage to your skin - yes, it involves water

But aside from my dark circle woes, I'm here to talk about some of the leading skin concerns among black and POC women of colour. These include adult acne, aging, dull skin and hyperpigmentation.

And today we're microscoping in on hyperpigmentation.

According to Environ Skin Care, studies show that 80% of women experience some sort of skin discolouration. 

To address this skin topic adequately, leading women in the skincare and dermatology fields have been referenced and spoken to in order to fully understand hyperpigmentation and the treatment thereof. This includes Harvard-trained dermatologist Dr Susan Taylor, Lamelle medical trainer Karen Bester, and top local dermatologist Dr Nompehelo Gantsho.

Firstly, what is hyperpigmentation?

Speaking at a product launch I attended in 2019, Harvard-trained dermatologist Dr Susan Taylor –  who was involved in the work that went into Eucerin's Thiamidol product range as a hyperpigmentation researcher – said "hyperpigmentation can be described as the appearance of darkened patches or spots on the skin that make skin look uneven".

In addition to this, Cape Town-based dermatologist Dr Nomphelo Gantsho explains the cause of hyperpigmentation in detail as follows:

Hyperpigmentation occurs when the skin produces more melanin. People with darker skin tones are more prone to hyperpigmentation.

Hyperpigmentation can be caused by sun damage, inflammation or other skin injuries, including those related to acne vulgaris and hormones in melasma.

Certain medications, such as antimalarial drugs and tricyclic antidepressants can cause hyperpigmentation. More serious conditions that cause hyperpigmentation include Addison's disease and Hemochromatosis.

READ MORE: Do we still hate the word 'moist'? The meteoric rise of dewy-dumpling skin says 'no'

What are some of the most common causes of hyperpigmentation?

To further expand on the causes of this skin concern, Lamelle medical trainer Karen Bester explains that there are many causes of hyperpigmentation. 

The most common types of hyperpigmented skin that we treat in the medical aesthetic and skin care industry would be caused by three things: 

• Hormones – the fluctuation in hormones can lead to hyperpigmentation. This is called melasma (or chloasma when it happens in pregnancy).

• Sun – repeated sun exposure will cause dark marks that we call sun spots. They are also called age spots or liver spots. This is generally due to frequent sun-induced injuries over a long time period of time, so we generally see this in more mature persons. 

• Inflammation – in, especially darker skins, when there is an injury of the skin, the melanocytes, the cells that make pigment, will respond to the inflammation by making more pigment.

We call this Post Inflammatory Hyperpigmentation (PIH). Some people refer to it as acne scarring. There might be actual scar, but the dark area is actually excess melanin. This is much easier to correct then a collagen-fibre scar. 

Why is hyperpigmentation so common during pregnancy?

"This is due to the fluctuation in hormones," Karen explains.

"We don't understand exactly what hormone causes hormonal hyperpigmentation. What we do know is that it has a specific picture – areas of pigmentation are on both sides of the face and in specific areas on the face. It is also more common where there are fluctuations in hormones.

"In pregnancy, going on the oral contraceptive pill, changing your contraceptive, fertility treatment, etc. These situations can all trigger this form of hyperpigmentation. It is more common in pregnancy, though. 

"In some – and I think probably most cases – the darkened pigment does disappear after the baby is born. In some cases, it does not, and it sometimes worsens with subsequent pregnancies.

"There is also a strong genetic predisposition to this condition. So if your mother had it, you have a higher probability of having it as well."

Real people with hyperpigmented skin

Right on cue - because my mom has actually had hyperpigmentation on her cheeks for as long as I can remember, and because of this, she learnt how to do her makeup very well – beauty vloggers have nothing on her foundation blending skills, I swear.

But even with her flawless makeup, she never skimped on skincare, using Clinique and Estée Lauder products religiously for well over a decade. 

And over the years, the hyperpigmentation has become less prominent. I currently do not exhibit any signs of hyperpigmentation - only dark circles under my eyes - but if my genes do determine that this will be a skin concern of mine in the future, I will be in good company.

READ MORE: Here's what could be causing those unwanted darker marks on your skin 

Last year, at a Eucerin event, beauty media were invited too: TV personality Zuraida Jardine also opened up about her journey with hyperpigmentation and how self-conscious it made her feel, especially given the nature of her work as a public figure. 

She even recalled a time during the prime of her TV career when she would have to get her makeup touched up regularly during shoots due to her pigmentation.

But beyond genetics, are some skin tones or types more prone to developing hyperpigmentation than others? And what can you do to minimise risk?  

Black women more likely to have hyperpigmentation 

This is what the Lamelle medical trainer shared with regards to the two questions above;

The darker your skin type, the more prone you will be to getting hormonal or inflammatory-caused hyperpigmentation. Sunspots are more specific to more mature skin that is lighter in colour. 

Sun exposure is a determining factor. In our sunny environment, we are all more prone to get hyperpigmentation, regardless of our skin colour and genetic make-up. This is due to the fact that all forms of hyperpigmentation are exacerbated by sun exposure.

The challenge with hyperpigmentation is that the tendency is generally based on your genetic material. So, you have a genetic predisposition to get it. Avoiding the sun is always a good idea. Generally, we manage hyperpigmentation when it happens. 

The good (and obvious) news is that this skin condition can be treated, but there may be some challenges. 

These are the challenges you may encounter on your treatment journey, as detailed by Karen Bester: 

• It takes time – many months of commitment to a strict programme will be required. If you have hyperpigmentation caused by hormones (melasma), you will probably need to stay on some form of pigment inhibition until you go into menopause.  

• It takes commitment to a programme – this would include peels and in-salon treatments, twice daily application of products that inhibit the production of hyperpigmentation. 

• It takes adjustment of your lifestyle – you will have to be careful of the sun and religious about applying sunscreen daily and re-applying it often if you are spending time outdoors. It is also important to avoid activities that include heat, like saunas and heated yoga, for example.  

• You will need to budget – some treatments may be costly. 

• It is individual – we do see great results if you are able to commit time, routine and money. The challenge is that each person's skin is different and sometimes (in about 10% of cases of melasma), even with this commitment, a little bit of hyperpigmentation might remain. 

• Maintenance is important – with each type of hyperpigmentation there is a cause that will need ongoing management:

- With hormonal hyperpigmentation, you will always need to inhibit the melanocyte as it is genetically over stimulated.

- With inflammatory hyperpigmentation, it is important to have treatments that heal the injuries as quickly as possible - e.g. acne treatments.

- With hyperpigmentation caused by the sun, it is important to use sunscreen daily and add antioxidants to your skincare and supplementation routine.  

READ MORE: Your protective face mask might be causing your skin to breakout - How to deal with 'Mask-ne’ 

Treatment 

This is what Karen Bester suggests;

"We do advise the use of a combination of peels with topical products. The peels remove the pigmentation that has already been formed and the topical products, specifically the Lamelle Luminesce range, combined with Correctives Brightening Serums, inhibit the overproduction of melanin by the melanocytes.

"Importantly, though, this is done without affecting normal pigmentation production (constitutive pigmentation). This means that our peels and products can be used on all skin colours and all types of hyperpigmentation knowing that it is safe," she adds.

There are also products you can purchase without medical prescriptions that have been approved by the experts.

But before we get you shopping for the best products on the market, these are the treatment options Dr Nomphelo shared:

"If a person wants to treat hyperpigmentation for cosmetic reasons, they can seek advice from a dermatologist who will be able to advise them on the best treatment methods available," she says before offering options.

"There are a range of possible treatment methods and home remedies that people can try, such as avoiding the sun, using sunscreen SPF >30, and, if you have acne, avoid picking your skin," she says. 

We recommend Dermalogica's Prisma Protect SPF30 sunscreen, which defends against UV rays, free radical damage and pollution. I've been using this sunscreen since it was released last year - and, as a black woman, I also appreciate that it doesn't leave grey residue after application. 

It retails for R1 100 (50ml) or R475 for 15ml at Dermalogica.

hyperpigmentation treatment

"For skin inflammation, use corticosteroids under the supervision of a dermatologist," advises Dr Nomphelo.

Topical treatments include ingredients that lighten the skin, such as:

- azelaic acid

- hydroquinone - kojic acid

- retinoids, such as tretinoin

- vitamin C

Other treatments include chemical peels and needling. 

Now, you can try these products below that are formulated to treat hyperpigmentation specifically: 

Lamelle Correctives Brighter Serum – R879.00 from Cosmetology

Lamelle Correctives Brighter Serum contains ingredients that optimally inhibit the production of melanin, treats hyperpigmentation, with the added benefits of anti-oxidant protection, while calming inflammation and having no irritating effect on the skin.

hyperpigmentation treatment

Eucerin Thiamidol range 

Try their Anti-Pigment dual serum, which includes thiamidol and hyaluronic acid as ingredients. R619.95 at Foschini Beauty

Other products included in this range are the Even Pigment Perfector day and night creams, which are available at Clicks and DisChem stores. 

Environ: Focus Care Radiance range

With the revolutionary 3-step Mela-Smart System, this range includes four products "that work together to help inhibit the six complex steps involved in the formation of hyperpigmentation".

The Focus Care Range is available at Environ stockists nationwide.

Clinique Even Better Skin Tone Correcting lotion - R700 at Woolworths beauty counters

Refreshing, oil-free hydrating lotion for oilier skins creates a more even skin tone, while protecting skin from future darkening with high-level UVA/UVB defence. Specialised ingredients break apart surface darkening and exfoliate it away.  

hyperpigmentation treatment

Can hyperpigmentation disappear completely over time?

Dr Nomphelo says that treating the underlying cause of hyperpigmentation can make it disappear completely.

Additionally, avoiding the sun and wearing sunscreen daily (even indoors) can help clear the hyperpigmentation.

What other treatments and products have worked for you? Tell us here. 

Follow us on social media: Facebook, Twitter, Instagram

Sign up to W24's newsletters so you don't miss out on any of our stories and giveaways.