The desire to have clear, glowing skin is present in every culture. Even, bright skin without blemishes or areas of hyperpigmentation gives an impression of youth and health. The overwhelming number of products and devices on the market which are targeted towards both brightening and lightening attests to the growing popularity of this issue in skin health.

Discoloration is an area of abnormal darkening of the skin, and can occur in specific spots or within larger patches. Skin can produce excess pigment in response to sun exposure, hormone fluctuations or injuries such as acne, cuts or burns. There are several types of hyperpigmentation:

1) UV induced hyperpigmentation occurs following overexposure to the sun, tanning beds, and fluorescent or ambient lighting. Patients may have diffuse spots which are evenly distributed on the face.

2) Hormonally induced hyperpigmentation occurs secondary to hormonal fluctuations, including pregnancy, oral contraceptives, thyroid dysfunction, menopause, and hormone replacement therapy. It tends to worsen with exposure to the sun. It tends to appear in large patches, located on the jawline, upper lip, cheeks, and forehead.

3) Post-inflammatory hyperpigmentation occurs following an injury to the epidermis, such as a cut or burn, and looks like a dark area at the site of trauma.

To understand what works in treating hyperpigmentation, and what doesn’t, it’s helpful to understand the pathway in the formation of skin pigmentation.

Melanocytes are cells located in the bottom layer of the skin’s epidermis, and produce melanin, the pigment responsible for skin color. Within the melanocyte, cutaneous inflammation can trigger a chain reaction of events beginning with the enzyme tyrosinase. Tyrosinase acts on the amino acid tyrosine and converts it to L-dopa. Copper binds to tyrosinase to act on L-dopa and converts it to dopaquinone, which triggers the deposit of the melanin-filled melanosome into the keratinocyte. The result is hyperpigmentation.

There are several ways to lift hyperpigmentation:

1) Exfoliation: Pigment appears darker when it sits closer to the surface of the skin. Gentle exfoliation and chemical peels can be very helpful in lifting the pigment and allowing it to be removed. I have been very pleased with the results of SkinCeuticals’ Advanced Corrective Peel, which uses a blend of salicylic acid, lactic acid, phenylethyl, and resorcinol to brighten and exfoliate the skin.

2) Increase cell turnover: By increasing the turnover rate of cells with topical agents, healthy cells can be brought to the surface of the skin more efficiently. Vitamin A derivatives, including Retin-A, are particularly useful in this regard.

3) Inhibit tyrosinase production: Tyrosinase inhibitors in both daily care products and professional treatments can help to stop the chain reaction which results in the deposition of melanin. Some of the most common and effective tyrosinase inhibiting ingredients include hydroquinone (derived from plants or chemicals), kojic acid (from soy, mushrooms, and rice bran), lactic acid (from milk and sugars), ascorbic acid (from citrus fruits), azelaic acid (from grains), arbutin (from bearberries, blueberries, and cranberris), (from Yellow Dock herb), Morus bombycis root extract (from mulberry root or the white mulberry tree), and Glycyrrhiza glabra root extract (from licorice root). Anokha Skin Care’s Black Tea & Licorice Root Brightening Cleanser contains the tyrosinase inhibitor licorice root, and the Amla Skin Brightening Lotion contains vitamin C from the Amla fruit, vitamin E, and licorice root. I do not recommend or use hydroquinone given safety issues with this ingredient.

4) Protect from UV exposure: Sunscreen with an SPF of at least 30 and all exposed areas is mandatory, every day. You are exposed to UV rays even from fluorescent lights bulbs. UV exposure will worsen hyperpigmentation. I particularly like SkinCeuticals’ sunscreens, which come in both tinted and transparent versions, and which are light and easily absorbed by the skin.

Seeing your skin become clearer and brighter can be incredibly rejuvenating, both physically and mentally. However, it can be an ongoing battle, and periodic treatments and the use of sunscreen daily are critical.