Medically reviewed by Dr Jen Haley, Dermatologist on 19 April 2020
Why You Have Hyperpigmentation &
How to Get an Even Skin Tone
Ever looked in the mirror and wondered why your skin tone looks uneven? That’s hyperpigmentation. Hyperpigmentation creates darker patches of skin, standing out against your normal skin tone. Your skin can appear particularly uneven after a bad bout of acne, but don’t worry. While this can be frustrating it is harmless and can be treated.
Hyperpigmentation is more common in darker skin tones, but it can affect any gender, race or skin colour. For many of us, hyperpigmentation can trigger confidence issues. We turn to make-up and other cover-ups to try and hide our patchy skin tone.
We’re going to explore both post-inflammatory hyperpigmentation and post-inflammatory erythema in more detail to give you the knowledge you need to diagnose your hyperpigmentation, choose a treatment plan and achieve that even skin tone you’ve been dreaming of.
Here at Mr Brains and Brawn, we know that not everybody wants to wear make-up. And hiding your insecurities day after day can feel exhausting. So, we use science-backed products to get you good results, fast.
To treat your hyperpigmentation effectively, you need to know what sort you have. There are a few different types, including post-inflammatory hyperpigmentation and post-inflammatory erythema. We’re going to explore each of those in more detail to give you the knowledge you need to diagnose your hyperpigmentation, choose a treatment plan and achieve that even skin tone you’ve been dreaming of.
- Hyperpigmentation definition
- What causes hyperpigmentation?
- How can you tell the difference between PIH and PIE?
- Other forms of hyperpigmentation and skin discolouration
- How do you treat hyperpigmentation?
- Does hyperpigmentation go away on its own?
- How long does it take to clear up hyperpigmentation?
- How can you prevent hyperpigmentation?
So what exactly is hyperpigmentation?
Hyperpigmentation is a common condition that causes patches of your skin to darken. It occurs when skin cells produce too much melanin, the pigment responsible for the colour of your skin. Skin can end up appearing blotchy and uneven. Although harmless, hyperpigmentation can be frustrating and trigger low self-esteem issues.
What causes hyperpigmentation?
Hyperpigmentation is a result of excess melanin production. There are several triggers but the most common culprits are acne scarring and sun damage. These are closely followed by age and hormonal factors.
Head this way to read more about what causes hyperpigmentation.
+ Post-inflammatory hyperpigmentation
One type of hyperpigmentation is post-inflammatory hyperpigmentation, usually grey or brown in colour. Typically seen in darker skin tones, post-inflammatory hyperpigmentation will create patches of skin that are deeper in colour than the surrounding area.
Post-inflammatory hyperpigmentation occurs after your skin has experienced some form of injury, such as a burn, or a type of inflammation like acne or eczema.
+ Post-inflammatory erythema
Post-inflammatory erythema is more common in lighter skin tones, creating distinctive red, pink and purple patches.
You might find that these areas look similar to spots or acne, except they don’t have the blackheads or whiteheads that are typically found on a spot. This is because post-inflammatory erythema is actually a type of acne scarring, caused by inflamed or damaged blood vessels that sit underneath your skin.
Once these blood vessels become inflamed, that damage is shown in flat red marks or patches.
How can you tell the difference between PIH and PIE?
The easiest way to tell the difference between PIH and PIE is to look at the colour of the pigmentation on your skin.
If you have a darker complexion with grey or brown patches, then you likely have post-inflammatory hyperpigmentation. If you have a lighter complexion with red, pink or deep purple areas, then it’s probably post-inflammatory erythema.
- More common in darker skin tones
- Grey or brown
- More common in lighter skin tones
- Red, pink or purple
Other forms of hyperpigmentation and skin discolouration
It’s also important to remember that there can be other causes for discolouration and uneven skin tone; acne isn’t the only culprit.
The term hypopigmentation describes incidences when patches of skin become lighter in response to injury or illness, in contrast with hyperpigmentation, when dark patches form on the skin as a consequence of the skin creating too much melanin.
Although hypopigmentation is more noticeable in darker skin tones, due to the stronger contrast between light and dark skin, it can affect anyone.
Causes of hypopigmentation include:
1. Skin damage
If you’ve ever had a mild burn you’ll notice that you often have a small pale scar that heals with time. When the skin experiences trauma or injury, it sometimes results in a loss of pigment (or colour) as the affected area is healed. Significant inflammation tends to result in hypopigmentation (loss of color), whereas mild inflammation tends to result in hyperpigmentation (increased color). If you pick a pimple aggressively, it will often permanently hypopigment in the center and hyperpigment on the periphery leading to uneven skin tone overall.
This is an autoimmune disease that causes melanin, the colour-producing pigment in skin, to become inactive, resulting in patches of pale white or pink skin. Vitiligo presents with depigmentation and complete loss of pigment, rather than hypopigmentation. There is no cure for vitiligo and it’s believed to be a hereditary condition, but The British Skincare Foundation reports that it can be triggered by repeated trauma to the skin (e.g. with rubbing or scratching).
Other reasons (apart from acne-related marks and scars) you might experience hyperpigmentation include:
Sometimes a hormonal change or imbalance can result in a form of hyperpigmentation called melasma, which creates a darker patch of skin often over the cheeks and upper lip (it’s sometimes referred to as “the mask of pregnancy” in pregnant women). This condition affects 15-50% of women during pregnancy, according to The Cleveland Clinic. It’s also common amongst women on birth control pills and or hormone replacement therapy, though it can affect men as well. Melasma tends to fade on its own once hormones have settled, though it’s important not to expose the affected skin to the sun without protection. You can read more about what melasma is, here.
Eczema can cause both hyperpigmentation and hypopigmentation. These can come as a consequence of damage from the eczema itself, or from excessive scratching and trauma to the skin, resulting in eczema scarring. The change in skin colour can last for a long period of time after the eczema has gone away, but can be treated in the same way as other surface-level hyperpigmentation.
5. Sun exposure and ageing
Sun damage can result in sun spots and age spots (sometimes called liver or age spots). These are darker patches of skin on areas that have had higher exposure to UV rays, like the face, upper back, forearms and shoulders. Sun spots and age spots form when the skin produces too much melanin (the pigment that protects the skin from UV rays) as a result of sun exposure, and they can become increasingly dark with age. Vitamin C is an effective treatment for this kind of discolouration, though the best protection is prevention by applying sunscreen regularly and avoiding excessive sun exposure. This is especially important in Australia, where the summer sun is up to 10% stronger than similar latitudes in the Northern Hemisphere.
There’s one thing that will never change in our hyperpigmentation treatment recommendations - sunscreen is always a good idea. No matter what type of hyperpigmentation you’re experiencing, you should be using sunscreen as part of your daily regimen.
How do you treat hyperpigmentation?
How you treat hyperpigmentation will depend on what’s causing it. While some types of hyperpigmentation can fade on their own, we know how good it feels to be in control of your skincare with a solid skincare regimen.
There’s one thing that will never change in our hyperpigmentation treatment recommendations - sunscreen is always a good idea. No matter what type of hyperpigmentation you’re experiencing, you should be using sunscreen as part of your daily regimen. Why? Well, inflammation resulting in post-inflammatory hyperpigmentation can cause your melanin to be more active than usual, making it especially sensitive to the sun’s powerful UV rays. So, even if it doesn’t seem sunny outside, be sure to apply a high SPF before you begin your day.
Here’s how to identify what type of hyperpigmentation treatment you’ll need.
Hyperpigmentation treatment: detecting the cause
Before you start treating your hyperpigmentation, try to look for the cause. Have you added anything new to your life that could be leading your skin to react or become inflamed?
While acne scarring is the hyperpigmentation trigger we see most frequently in our customers, if the condition is exacerbated by allergies, reactions to skincare products, or new medications, you'll need to remove these triggers to see the best results from your hyperpigmentation treatment.
If you’re experiencing hyperpigmentation with melasma, which is caused by a change or fluctuation in hormones, it might not be possible to fully eradicate the hyperpigmentation until that hormonal imbalance has settled back down. But, you can still treat your hyperpigmentation to reduce its appearance, helping you to feel calmer and more confident again.
Hyperpigmentation treatment: what level are you?
Now that you know what’s triggering your hyperpigmentation, it’s time to identify the level of hyperpigmentation you’re experiencing. This will help you determine what type of treatment you need, as deep hyperpigmentation is treated slightly differently than surface-level hyperpigmentation.
It can be difficult to know the level of hyperpigmentation without having a consultation, but the information below can be used as a helpful guide.
- Acne scarring
- Normal tanning
- Mild melasma
- Mild injuries e.g. burns, cuts, abrasions
- Mild age spots
Dermal (deep) level hyperpigmentation
- Severe acne scarring
- Brown birthmarks
- Dark cases of melasma
- Severe injuries e.g. burns, cuts, abrasions
- Dark age spots
Not sure what level of hyperpigmentation you’re experiencing? Book a free online consultation to chat with one of our resident experts.
How to treat surface-level hyperpigmentation
- AHA (Alpha Hydroxy Acid)
- Vitamin C
- Niacinamide (Vitamin B3)
How to treat dermal (deep) level hyperpigmentation
- AHA (Alpha Hydroxy Acid)
- Vitamin C
- Niacinamide (Vitamin B3)
- Vitamin A (Retinol)
The benefits of Alpha Hydroxy Acid (Glycolic Acid, Lactic Acid and Mandelic Acid)
Alpha Hydroxy Acid exfoliates the skin, gently removing dead skin cells and stimulating skin cell renewal. It then works to create a more even skin tone whilst also boosting the skin’s moisture levels. Alpha Hydroxy Acid works deep into the skin, encouraging fast production of new skin layers which reduces and exfoliates keratinocytes that contain melanin, the cause of hyperpigmentation.
It’s also worth looking for products containing Phytic Acid, which is well-known for its brightening abilities.
The benefits of Vitamin C (Ascorbic Acid, Tetra Ascorbate and Ascorbyl Glucoside)
Topical Vitamin C can reduce hyperpigmentation by reducing the production of melanin, and brightens skin by lightening dark spots and improving overall skin tone. Studies show Vitamin C is also effective in preventing UV-induced skin pigmentation because of Vitamin C's ability to neutralise free radicals. Read our tips on how to use Vitamin C and Retinol together, here.
The benefits of Niacinamide (Vitamin B3)
Niacinamide is clinically proven to inhibit the transfer of pigments within the skin, whilst also increasing collagen production which can help minimise hyperpigmentation.
We recommend Niacinamide to all our customers who are experiencing post-inflammatory hyperpigmentation and post-inflammatory erythema, thanks to its calming anti-inflammatory effect. If your hyperpigmentation is a result of any type of inflammation, Niacinamide is your ingredient of choice.
The benefits of Vitamin A (Retinol, Retinoid, Retinal)
Topical Retinol optimises skin cell regeneration and can therefore work deep within the skin to improve discolouration and even out your overall skin tone.
If you are new to Retinol, start with a lower strength product every second day and slowly increase to daily application. Read our tips for getting started with Retinol treatments, here.
Please note: Retinol can cause your skin to be more sensitive initially and you must wear a sunscreen before sun exposure. We also recommend avoiding Retinol during pregnancy.
Does hyperpigmentation go away on its own?
Hyperpigmentation can go away on its own, but it depends on the severity. If you’re experiencing dermal (deep) hyperpigmentation, it could take a long time for your skin to heal without treatment. This is because of the amount of skin cell turnover you’ll need to generate fresh layers of skin with lower levels of melanin.
If you’re hoping that your hyperpigmentation will go away on its own, it’s important to look for what’s causing your hyperpigmentation.
For hyperpigmentation with hormonal triggers, such as melasma, your hormones will need to return to their normal level before your hyperpigmentation heals fully.
Whilst if you’re experiencing post-inflammatory hyperpigmentation, the cause of that inflammation will need to be eradicated before your hyperpigmentation can begin to heal on its own.
How long does it take to clear up hyperpigmentation?
If you’re treating your hyperpigmentation, you can typically expect to see results within 4-6 weeks. This gives your skin cells time to complete their turnover cycle, whilst allowing products time to work.
Of course, everyone is different. We’ve had some reports of customers noticing changes from just one week of their new skincare regimen! Whilst more severe cases of hyperpigmentation, where the dermal layer is affected, may take a little longer.
How can you prevent hyperpigmentation?
There are some really simple things that you can do to prevent hyperpigmentation that will also help protect the health of the rest of your body too.
Here at Mr Brains and Brawn, our favourite way to prevent hyperpigmentation is through regular use of sunscreen. A good sunscreen should be a part of every skincare regimen. When your skin is exposed to UV radiation, it'll produce more melanin to absorb the rays in it’s attempt to protect your skin. Sunscreen helps prevent that. Since melanin is the main cause of hyperpigmentation, we recommend using a sunscreen with an SPF of at least 50. This applies whether you’re trying to treat or prevent hyperpigmentation.
If you experience acne, you can help prevent post-inflammatory hyperpigmentation or post-inflammatory erythema. Treat your acne right away to prevent any acne scarring or long term damage to your skin. And, of course, don’t squeeze your pimples!
Finally, it’s always good practice to track your skin’s general wellbeing over time. Pay close attention to any reactions or irritations and take action to treat them before they become too severe. The earlier you notice any hyperpigmentation, the milder it’ll be, meaning it’ll be much easier to treat.
Not sure what type of product would work best for your skin? We offer free virtual skin consultation on our website everyday from 9am - 9pm AEST.