Hyperpigmentation refers to areas of skin that appear darker than the surrounding skin due to increased melanin production. While typically benign, these changes in skin tone can be cosmetically distressing and may persist for months or even years without targeted treatment.

Several forms of hyperpigmentation are frequently encountered:

Melasma

Melasma presents as symmetrical, blotchy brown or gray-brown patches, most commonly on the cheeks, forehead, upper lip, and nose. Contributing factors often include:

• Hormonal influences such as pregnancy, oral contraceptives, or hormone therapy
• Ultraviolet (UV) and visible light exposure
• Genetic predisposition

Melasma is often chronic and prone to recurrence, especially in warm climates or with ongoing sun exposure. Successful management typically requires both active treatment and careful maintenance.

Sun-Induced Pigmentation

Sun-induced pigmentation, often referred to as “sun spots,” “age spots,” or “solar lentigines,” results from cumulative UV exposure. These flat, tan to dark brown lesions appear most commonly on photo-exposed areas such as the face, chest, shoulders, and hands. Over time, repeated sun exposure stimulates melanocytes to overproduce melanin, leading to well-defined dark patches that tend to increase with age.

Post-Inflammatory Hyperpigmentation (PIH)

Post-inflammatory hyperpigmentation develops after the skin has been injured or inflamed. Common triggers include:

• Acne lesions
• Eczema and dermatitis
• Insect bites, burns, or trauma
• Aggressive cosmetic or laser procedures

Once the initial inflammation resolves, residual brown or reddish marks may remain. PIH is particularly persistent in medium to dark skin tones and often requires a structured treatment plan for optimal fading.

At Peak Skin Center, treatment is individualized based on clinical examination, patient history, and skin type. Combination therapy is frequently recommended to achieve more complete and sustained results.

Topical Prescription Medications

Retinoids

Topical retinoids (vitamin A derivatives) promote increased cell turnover, helping pigmented cells to shed more rapidly. They also support collagen production and can improve overall skin texture. Because retinoids may cause initial dryness or irritation, therapy is usually introduced gradually and adjusted according to skin tolerance.

Hydroquinone

Hydroquinone is a widely recognized depigmenting agent that works by inhibiting the enzyme tyrosinase, which is involved in melanin synthesis. At Peak Skin Center, hydroquinone is often prescribed:

• In controlled treatment cycles
• As part of combination formulas with retinoids and, in some cases, mild corticosteroids

Use is closely monitored to minimize side effects and ensure appropriate duration, particularly in patients with darker skin types.

Kojic Acid and Other Brightening Agents

Kojic acid, derived from certain fungi, also inhibits melanin formation. It is commonly combined with other brightening medications such as:

• Vitamin C
• Azelaic acid
• Niacinamide

These agents may be used as primary treatment in sensitive skin or as maintenance therapy to support results after stronger depigmenting regimens.

Chemical Peels

Chemical peels utilize controlled application of acids to exfoliate the outer skin layers and stimulate renewal. For hyperpigmentation, clinicians may recommend:

• Superficial peels (e.g., glycolic, lactic, or mandelic acid) for mild to moderate discoloration and minimal downtime
• Medium-depth peels for more resistant pigmentation or more extensive sun damage

Chemical peels can:

• Accelerate removal of pigmented keratinocytes
• Improve texture, clarity, and radiance
• Enhance absorption and effectiveness of topical treatments

Peel strength and type are carefully selected, especially for patients with darker skin tones, to reduce the risk of post-inflammatory hyperpigmentation or scarring.

Consistent photoprotection is a critical component of every hyperpigmentation protocol. Without it, even the most effective treatments can be undermined. Peak Skin Center emphasizes:

• Daily use of broad-spectrum sunscreen SPF 30 or higher
• Preference for mineral formulas and, when indicated, products containing iron oxides
• Complementary measures such as hats, shade, and avoidance of peak sun hours

Ongoing maintenance with gentle brightening agents and strict sun protection helps prevent recurrence and supports long-term skin health.

Recovery time and visible results depend on the specific treatment plan, the cause of hyperpigmentation, and the individual’s skin characteristics.

• With topical therapies, improvements typically begin to appear within 6–12 weeks, with continued lightening over several months. Temporary dryness, mild peeling, or increased sensitivity are common early effects and are managed with moisturizers and regimen adjustments.
• Following chemical peels, patients can expect transient redness, tightness, and flaking for several days as the treated outer layers shed. Most individuals can resume normal routines relatively quickly, provided they adhere to post-procedure care and strict sun protection.