Hyperpigmentation Removal – Understand Your Options

Reviewed by Yael Halaas, MD

Concerned about uneven, dark patches on your face? If so, the good news is that porcelain skin — or close to it — is within your reach thanks to new options in hyperpigmentation removal.

Hyperpigmentation is defined as excess pigmentation in a bodily part or tissue, including the skin. Hyperpigmentation removal treatments target darkened areas of your skin, which may be a result of hormones, sun damage, injuries, your skin type, medications or acne. For example, melasma — sometimes called "the mask of pregnancy" — is marked by brown to gray-brown patches on the face that occur as a result of hormonal changes associated with pregnancy.

Courtesy of AAFPRS

How you treat your hyperpigmentation is based on its cause, your aesthetic goals and your skin type. The first step is to consult with a qualified facial plastic surgeon to determine the cause of your hyperpigmentation. Finding the right surgeon can be difficult, as there are many physicians promoting their services. To help you find a surgeon you can trust, All About Facial Rejuvenation has created a directory of surgeons with advanced training, years of experience and superb surgical skills.

At your initial consultation, your surgeon will examine your skin, take a thorough medical history and suggest a treatment strategy based on these findings. Your doctor should discuss the risks, costs and recovery period associated with any recommended hyperpigmentation removal procedures.

Treatment options may involve the use of bleaching creams or a change in your skin care routine.  Some options may be as simple as switching your current medication to an alternative that does not affect your skin tone; others may be more invasive.

Here's a snapshot of currently available treatments for hyperpigmentation:

Hydroquinone. This bleaching agent blocks melanin, which are the pigment cells that give our skin color. These products can be obtained over the counter in weak strengths or by prescription in higher doses. Sometimes they are combined with other products such as Retin-A to achieve the desired effects. Risks may include irritation, permanent hypopigmentation (diminished pigmentation), increased pigmentation if you do not use sun block, and ochronosis (black speckles or discolorations) if a high dosage is used for long periods of time. Follow your doctor's instructions carefully to maximize your results and minimize your risk of complications.

Retin-A is a prescription topical retinoid (derived from Vitamin A) that exfoliates skin and speeds up new skin cell growth, diminishing dark, uneven skin patches along the way. It is available in several strengths and is often prescribed in a step-up fashion. It may be prescribed with hydroquinone or another bleaching agent. For example, TriLuma is a prescription topical skin lightening product containing hydroquinone and Retin-A.

Lumixyl is a new brightening cream that can help reduce age spots and hyperpigmentation. An alternative to hydroquinone, Lumixyl is based on a series of naturally-occurring peptides. It is applied topically and sold in physicians' offices. It works by reducing melanin, but does so without the irritation or other side effects associated with Hydroquinone or Retin-A.

Elure is the latest player in the hyperpigmentation treatment arena. The active ingredient, Melanozyme, is based on the naturally occurring enzyme lignin peroxidase. The Elure trio includes a foaming facial wash, lotion and night cream that temporarily reduce melanin, the pigment responsible for dark and uneven skin tone. Results are visible within one month, and there is low risk for skin irritation. Elure is available exclusively at physicians' offices.

Chemical Peels

Alpha hydroxy acids, such as 8 percent glycolic acid, are exfoliants and can help remove hyperpigmentation.

Beta hydroxy acids, such as salicylic acids, are also exfoliants that can help address hyperpigmentation.

Intense pulsed light (IPL)
Laser resurfacing

Many of these same treatments may also help with birthmarks removal.

What to Expect at Your Consultation

You should be given a preoperative information packet that explains everything you should do and know before your treatment. Depending on the procedure, your hyperpigmentation may be removed either all at once or gradually. Your recovery period will vary significantly based on your chosen treatment.

Visit the specific procedure pages noted above for information on treatment costs. The cost of prescription medications used to treat hyperpigmentation will vary based on your insurance plan's prescription coverage policy.

  • Halaas 58x57

    Yael Halaas, MD, FACS

    60 E. 56th Street
    3rd Floor
    New York, NY 10022
    (332) 239-6439

  • P

    Mune Gowda, MD

    3270 West Big Beaver
    Suite 415
    Troy, MI 48084

  • P

    Sean Maguire, MD

    Physician's Center for Beauty
    24 Chenoweth Lane
    Louisville, KY 40207
    (866) 774-9105