Skin Discoloration

Hyperpigmentation: Dark discoloration of the skin, often referred to as age spots, brown spots (solar lentigines), or the mask of pregnancy (melasma).

Cause: Some people, especially men and women of color, are prone to uneven skin tone more than those with fair skin, due to the increase in melanin production. Melanin is the pigment that creates the "tan". Everyone has basically the same amount of melanocytes, which are the cells that produce melanin, however people who have darker skin release more melanin into the skin.

The release of melanin is part of the body's immune response. It is nature's way of protecting the skin from further damage after it has been exposed to an excess of ultra violet rays. Darker discoloration usually indicates damage within the deeper layers of the skin and may be more difficult to treat.

Treatment: Start with the least invasive treatment.

1. Over-the-counter products may be an effective treatment. Try lightening creams or gels with 2% hydroquinone, such as Porcelana or Esoteraca. These contain ingredients that inhibit the production of melanin. Follow the instructions on the label (usually applied to affected area two times per day). Try this for at least 6-8 weeks. If it is ineffective move on to the next step.
   
   
2. Hydroquinone 4% is available by prescription only. A stronger formulation may be the required treatment, especially if you noted slight results from the 2% solution.
   
   
3. Some people react adversely to hydroquinone and may want to try other lightening ingredients, such as kojic acid. This can be purchase from an Esthetician or skin care specialist.
   
   
4. Products that exfoliate and slough off the surface layer of skin, such as Retin-A or alpha hydroxy acids, are also worth a try. In addition, these products can improve the overall appearance of the skin.
   
   
5. The next step would be a light chemical peel performed by an Esthetician. Medium to deeper chemical peels are performed in a medical office and can be beneficial for reducing discoloration, softening wrinkles, and treating acne. The Obagi peel or a Jessners peel are two excellent peels for this purpose. Allow four to seven days of down time for healing.
   
   
6. Finally, color specific Lasers can target dark discoloration under the skin and help break up pigment. They are also beneficial for removing tattoos.
   

After a successful treatment and to prevent further damage from occurring, it is imperative to protect the skin from overexposure to the sun. Wear sunscreen or sunblock on a daily basis. Avoid being outdoors for long periods of time, particularly between 10:00am and 4:00pm.

Remember - sun damage is cumulative, be aware of the incidental amount of exposure you incur throughout the day.