Sick of Skin Spots? Obagi Discusses Hyperpigmentation Concerns

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One of the most common pigmentation problems, especially for those with darker skin, is hyperpigmentation, or darkening of the skin. It’s difficult to avoid hyperpigmentation because of its many contributing factors, which may include: acne, genetics, sun damage and skin trauma. What’s worse is that these forms of hyperpigmentation can last months or years and can prevent you from achieving the clear, even complexion so many of you desire.1 We turned to our Obagi Education Managers, Aimee and Perri, to discuss hyperpigmentation, its many causes and how you can reduce its appearance.

What are the different kinds of hyperpigmentation?
Hyperpigmentation can be caused by a number of factors, but in general, most people who are affected by hyperpigmentation will notice one or more of the following: freckling, age spots (sometimes called liver spots), melasma, or post-inflammatory hyperpigmentation (PIH). Our Obagi Chief Scientist and Head of Product Development, Laurence Dryer, discusses these different forms of pigment disorders as well as treatment options in this video: Pigment Problems

Does my skin tone affect the likelihood that I will get hyperpigmentation?
Yes.  Both ancestry (genetics) and outward manifestations of skin color (check to see where you fall on the Fitzpatrick I – VI scale) can affect how susceptible you are to experiencing hyperpigmentation at some point in your life.  However, the amount of UV damage that your skin receives throughout your life is also a significant determining factor in causing hyperpigmentation.2

Are certain types of hyperpigmentation easier to get rid of and what are the treatment options?
Everyone’s skin responds differently to treatment for hyperpigmentation. In general, freckles are sometimes considered the easiest to get rid of or treat, because they can fade to a certain degree on their own when the skin isn’t exposed to UV damage. Conversely, melasma, also referred to as pregnancy mask, is an internal hormonal condition which can require constant treatment for some patients once it appears, and is exacerbated by UV exposure.  For other melasma patients, hyperpigmentation can fade away without treatment in the months following a pregnancy.3

The tricky thing about hyperpigmentation is that some treatments that work very well for certain types of hyperpigmentation can actually make other types worse. If you are concerned about hyperpigmentation, visit a skin care physician who can properly diagnose your concerns and offer a treatment plan. That being said, something every patient can benefit from is using a physical-based sunscreen of SPF 30 or above. Remember… cloudy days only disguise damaging UV rays; they are present every single day, and can even affect us through glass.

Why is my hyperpigmentation worse in certain areas of my face?
When hyperpigmentation is more concentrated in certain areas, it may actually be melasma, which is characterized by a patchy appearance. PIH also frequently occurs in an isolated area, depending on where the skin has experienced inflammation. Targeted sun exposure, for example someone who might drive long distances for work, may also contribute more apparent hyperpigmentation on one side of the face, neck and arm (again, don’t forget that UV rays can reach us through glass).

What causes post-inflammatory hyperpigmentation or PIH?
This is an excellent question. Post-inflammatory hyperpigmentation is probably the least understood by patients because it can be caused by so many things. Basically any type of injury or trauma to the skin that causes inflammation leaves the potential for PIH. 

For example: acne, burns (including sunburn), waxing, harsh facial scrubs, insect bites, abrasions, poorly performed aesthetic procedures and even chemicals in certain products can cause inflammation and in some cases this inflammation causes the melanocytes (pigment-producing cells in the skin) to overproduce melanin. After the inflammation subsides, a darker area appears where the inflammation had been.

What is post-laser (fraxel) hyperpigmentation and how do I avoid it?
Post-laser hyperpigmentation is just a form of PIH.  Nothing can guarantee that it won’t happen, but using a product range like Obagi Nu-Derm®** prior to undergoing a fractionated laser procedure can calm the melanocytes, as well as provide a host of other benefits. This can minimize the possibility for PIH, and actually maximize the benefits of the procedure itself. If a patient is considering a fractionated laser procedure, he or she should ask their skin care physician how to best utilize a Nu-Derm program to optimize their results.

What is hydroquinone and how does it help diminish the appearance of hyperpigmentation?
Hydroquinone is a naturally-occurring substance in many fruits and grains.  Hydroquinone selectively suppresses the melanocytes, which are the pigment-producing cells in our skin. Simply put, hydroquinone “turns down the volume” on melanocytes that are producing too much melanin. Contrary to popular belief, hydroquinone does not remove pigment that has already been deposited into the epidermis (the top layers of skin). It can only prevent new hyperpigmentation. That’s why it takes a few weeks to start seeing the results of usage. The Obagi Nu-Derm System** and the Obagi-C Rx® System both use hydroquinone to help to improve the appearance of your skin.

Is there a “quick fix” to getting rid of hyperpigmentation?
For most patients, no. There are many ways to address hyperpigmentation, and some work much faster than others. However, each treatment choice requires daily usage of a broad-spectrum sunscreen to help ensure that symptoms of hyperpigmentation don’t return. Nothing provides an absolute guarantee that hyperpigmentation won’t reoccur, but being smart about shielding your skin from the sun (even on cloudy days) is your best line of defense.

Do you have hyperpigmentation? Talk to your skin care physician about which treatment may be best for you and how Obagi may be able to help.

References:
1. Skin—abnormally dark or light. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/003242.htm*.Accessed August 30, 2013.
2. Dermatologists shed light on common pigmentation problems and solutions in skin of color. American Academy of Dermatology website. http://www.aad.org/stories-and-news/news-releases/dermatologists-shed-light-on-common-pigmentation-problems-and-solutions-in-skin-of-color* Accessed August 30, 2013.
3. Melasma. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/000836.htm* Accessed August 30, 2013.

*Any links to external or third party sites are provided merely as a convenience, and does not in any way constitute or imply our endorsement or recommendation of such third party, its information, products or services.

** CONTRAINDICATIONS: People with prior history of sensitivity or allergic reaction to this product or any of its ingredients should not use it. The safety of topical hydroquinone use during pregnancy or in children (12 years and under) has not been established. WARNINGS: Avoid contact with eyes, nose, mouth, or lips. In case of accidental contact, patient should rinse eyes, nose, mouth, or lips with water and contact physician. Sunscreen use is an essential aspect of hydroquinone therapy because even minimal sunlight exposure sustains melanocytic activity. Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. PRECAUTIONS (ALSO SEE WARNINGS): Treatment should be limited to relatively small areas of the body at one time since some patients experience a transient skin reddening and a mild burning sensation, which does not preclude treatment. Pregnancy Category C: Animal reproduction studies have not been conducted with topical hydroquinone. It is also not known whether hydroquinone can cause fetal harm when used topically on a pregnant woman or affect reproductive capacity. It is not known to what degree, if any, topical hydroquinone is absorbed systemically. Topical hydroquinone should be used on pregnant women only when clearly indicated. Nursing Mothers: It is not known whether topical hydroquinone is absorbed or excreted in human milk. Caution is advised when topical hydroquinone is usedby a nursing mother. Pediatric Usage: Safety and effectiveness in children below the age of 12 years have not been established.

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