Types of Hyperpigmentation – Skincare Masterclass

What is melasma?

Melasma is a disorder of hyperpigmentation- it looks like a mask because it spreads over large areas of the face such as the cheeks, forehead, nose bridge and the chin. UV exposure, hormonal and genetic factors play a role, although its etiology is complex.

How is melasma similar or different to hyper pigmentation?

Melasma is quite distinct in its appearance and distribution. Some dermatologists also use a wood’s lamp to aid in diagnosis.

What are the best ways and most proven ways to treat hyperpigmentation?

Treatment options are fairly limited- lasers, peels, cosmeceuticals, prescription hydroquinone/retinoids, usually a combination. Oral tranexamic acid is quite effective for melasma, especially in asian skin types. Prevention and maintenance takes the form of sun avoidance, sun protection with broad rimmed hats, minimum SPF 30 broad spectrum sunscreen and use of antioxidants. Vitamin C serums (L-ascorbic acid, Sodium Ascorbyl Phosphate) are commonly prescribed as adjunct cosmeceuticals. They work by reducing oxidative stress on skin (caused by environmental damage).

Are more intensive treatments (lasers, etc) better treatments or are serums and at-home, topical treatments better at treating hyperpigmentation?

Prescription topicals include hydroquinone, a depigmenting ingredient often used in combination with retinoids/steroids to counteract inflammation- these are routinely used in melasma treatment. Under medical supervision, as there is a risk of rebound or paradoxical hyperpigmentation with use beyond 6 months. Lasers/peel regimens must be individualised.

Traditionally, over the counter options are regarded as quite limited, although there is emerging data on plant- based alternatives such as licorice root, scutellaria baicanlensis, improvised from asian ethnobotany – an area of my research.

How can you prevent hyperpigmentation and or melasma?

While genetic factors are at play for most forms of hyperpigmentation, environmental exposures such as UV, pollution do affect the progression of most forms of hyperpigmentation. Prevention isn’t just about sun protection, but also about building a regimen for resilient skin. Adaptogenic skincare such as those containing desert plant extracts i.e. portulaca oleracea helps with antioxidant reserves. In turn, there is less oxidative stress/damage and skin is also better equipped to repair damaged cells.

What is the ideal skincare regimen for treatment and prevention of pigmentation?

General Skincare Regimen

There is no need to have a skincare regimen specifically tailored to your skin concern—this is a marketing fad. Dermatologists usually recommend a universal skincare regimen for those with problem skin, this means that the products use are suitable for all skin types and skin concerns. Most importantly, dermatologist-recommended skincare products are suitable even for those with sensitive skin types. You can use the following template in the context of your preferred skincare brands:

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