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The different types of hyperpigmentation and how to treat them

Help to even out your skin tone with these effective treatments

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Curology Team
Oct 05, 2022 · 7 min read

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Types of hyperpigmentation - The different types of hyperpigmentation
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.
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Hyperpigmentation happens when your skin produces too much melanin, resulting in spots or patches of skin that look darker than the skin that surrounds them. But hyperpigmentation can look different for everyone—one person might have sun spots and another melasma. 

If that sounds confusing, don’t worry—we’re here to help! Read on to learn about the three most common types of hyperpigmentation and their contributing factors, plus some insightful tips for treating and helping prevent dark spots.

The 3 main types of hyperpigmentation

Hyperpigmentation and Skin Dark Spot Types

Hyperpigmentation is when skin, that’s typically your normal skin tone, has patches that appear darker in color. This is due to extra melanin production, which is triggered by a specific event or cause, like sun exposure, inflammation, or hormones. Three common types of hyperpigmentation include: 

  • Sunspots, age spots, liver spots, or solar lentigines. These are different names for spots that develop because of one thing—sun exposure. Sunspots are most likely to pop up on areas that are commonly exposed to the sun, such as your face and hands. Since you have to spend quite a bit of time in the sun for these patches to develop, many people usually don’t develop sunspots until they’re older.¹ 

  • Post-Inflammatory hyperpigmentation (PIH). This type is more common in people with darker skin. PIH happens when melanocytes (melanin-forming cells) produce too much melanin in response to inflammation, injury, or certain procedures.²

  • Melasma. This skin condition is most common on the face. Melasma has a genetic link and can be triggered by hormones—as in the case with pregnancy and taking oral contraceptives. When melasma appears during pregnancy, some call it the “mask of pregnancy”. It can resolve within a few months after birth, though other cases may persist longer.³ If birth control is the cause, you may see your melasma fade after you stop taking it. Melasma can sometimes go away on its own, but for many people the condition may last for years.⁴

Pigmentation vs. hyperpigmentation: What’s the difference?

Skin pigmentation is just a fancy way of saying skin color—and it’s determined by the amount of melanin your body produces. Your hair and eyes also get their color (or pigment) from melanin. In general, your skin will appear to be its natural color, but pigmentation disorders can occur. These include hyperpigmentation, hypopigmentation, or depigmentation. 

  • Hyperpigmentation describes skin that’s darker in color than the surrounding skin because of too much melanin.

  • Hypopigmentation is caused by a loss of melanin, making the affected skin lighter than your normal skin color. 

  • Depigmentation happens when skin loses its pigment entirely, causing patches of skin to turn white. 

Factors that may lead to hyperpigmentation

Hyperpigmentation on the face has a few common causes—sun exposure, inflammation, and hormonal fluctuations are three of most common.

  • Excessive sun exposure triggers the production of melanin, which acts as a natural sunscreen (although it’s certainly not a replacement for sunscreen!!). Extra melanin gives your skin a darker or sun-tanned tone.⁵ With years of cumulative exposure, the sun can lead to an uneven increase in melanin, resulting in sunspots. (Just to be clear—there’s no such thing as a healthy tan. No matter how much melanin your skin produces, you should always wear broad spectrum sunscreen with a minimum of 30 SPF.) 

  • Hormone levels can affect melanin production—estrogen and progesterone fluctuations are two of the culprits here.⁶ Pregnant people are often susceptible to melasma, and sun exposure can make it worse. That’s just one reason to make some changes to your skincare routine during pregnancy.  

  • Inflammatory conditions like acne and eczema can also lead to hyperpigmentation. Excess melanin is produced in response to the inflammatory process. This is what causes PIH—the darker spots tend to pop up in places where acne once was.

How to treat hyperpigmentation

How to get rid of hyperpigmentation varies depending on what type it is. But no matter what kind of hyperpigmentation you’re experiencing, sun protection is key!! In combination with sun protection, topical treatments like hydroquinone and topical retinoids are usually used first, followed by more advanced treatments like chemical peels and laser therapy, if necessary.⁷

  • Broad spectrum sunscreen with at least SPF 30 protects sun-exposed skin. It’s your best line of defense against sunspots and melasma, which are triggered by sun exposure. If you’re in need of a new sunscreen, consider choosing one that’s designed for your skin type

  • Topical creams help with different types of hyperpigmentation. Some of these require a prescription. If you’re dealing with hyperpigmentation, a dermatology provider can help get you better—and faster—results. Here are some common prescription and over-the-counter options: 

    • Hydroquinone is currently prescription-only and works to prevent excess melanin formation. When paired with sunscreen, hydroquinone can improve hyperpigmentation from melasma, sunspots, and PIH.⁸

    • Tretinoin increases skin cell turnover, which decreases hyperpigmentation. Tretinoin is used for treating signs of premature aging (dark spots, fine lines, firmness, texutre), and acne.⁹ It’s only available by prescription, but you can find over-the-counter retinoids (like retinol) at your local drugstore.

    • Azelaic acid has anti-inflammatory and antibacterial properties. It’s used to treat inflammation and can help improve melasma.¹⁰ It’s also effective in treating acne-induced PIH.¹¹ Available by prescription and over-the-counter.

    • Glycolic acid chemical peels can be effective for melasma. Glycolic acid is a popular ingredient in skin-lightening creams that are used for treating hyperpigmentation.¹² Studies have shown that glycolic acid chemical peels along with daily topical at-home application of combination hydroquinone, glycolic acid, and tretinoin topical therapy reduce PIH more quickly than topical treatments alone.¹³ But the American Academy of Dermatology says your results may vary depending on the experience of your dermatology skincare professional.¹⁴

    • Niacinamide is a form of vitamin B3, and it’s an effective treatment for facial hyperpigmentation. Niacinamide is a popular ingredient in over-the-counter  skincare products and is sometimes seen in prescription products as well.

    • Vitamin C is an antioxidant that gives your sun an extra boost of sun protection and helps prevent signs of aging, including dark spots. 

  • One study found that intense pulsed light therapy cleared 76-100% of superficial lesions caused by melasma, but it’s not as effective for deeper pigmented lesions.¹⁵ 

  • Laser treatment can successfully treat melasma, sunspots, and PIH. Laser and light therapy treatments have improved results for melasma sufferers who also use sunscreen and other topical creams. 

  • Alternative therapies include licorice and green tea. Licorice has been shown to have anti-inflammatory, antioxidant, and skin-whitening effects.¹⁶ And green tea extracts have been shown to improve hyperpigmentation caused by inflammation. Green tea might also improve melasma.¹⁷ The good news is that you can try either of these extracts. Most people shouldn’t experience any side effects from these natural remedies—used as directed, of course! 

Melasma Image - The different types of hyperpigmentation

Is it melasma?

You might be tempted to lump all types of hyperpigmentation together since hyperpigmentation is used as a blanket term for patches of darker skin. But the different types of hyperpigmentation have different causes. One of melasma’s differentiating features is that it can be triggered by hormonal changes like the ones that happen during pregnancy. PIH and sunspots, on the other hand, aren’t hormone-related. Treatments that fade dark spots, like tretinoin and chemical peels, can be used for all three types. But you may have different options for treating melasma—if your birth control is what is causing melasma, for example, you may see improvement after you stop taking it. Be sure to speak with your doctor before making any changes to your medications.

Regardless, it’s important to cover up—and slather up with SPF—to help prevent and treat all types of hyperpigmentation. Choose a broad-spectrum sunscreen with an SPF of at least 30. Choose the sunscreen you like best—because the best sunscreen is the one you’re actually likely to use regularly!

Does Curology treat hyperpigmentation?

Yes! Your Curology personalized prescription formula and Curology’s dark spot formula can treat hyperpigmentation. Dark spots won’t fade overnight, but the right products can make a difference. That’s where we come in. Sign up for Curology to get expert skincare guidance from a licensed dermatology provider and a customized treatment to address your skin concerns. We won’t just load you up on products and send you on your way—we’re here to help you in the long run. As a Curology member, you can reach out to your licensed dermatology provider—your partner on your skincare journey—any time you have a question.

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FAQs

What are the 3 main types of hyperpigmentation?

What’s the difference between pigmentation vs. hyperpigmentation?

Skin pigmentation is just a fancy way of saying skin color—and it’s determined by the amount of melanin your body produces. Your hair and eyes also get their color (or pigment) from melanin. In general, your skin will appear to be its natural color, but pigmentation disorders can occur. These include hyperpigmentation, hypopigmentation, or depigmentation. 

What factors may lead to hyperpigmentation?

  • Excessive sun exposure triggers the production of melanin, which acts as a natural sunscreen (although it’s certainly not a replacement for sunscreen!!).

  • Hormone levels can affect melanin production—estrogen and progesterone fluctuations are two of the culprits here. That’s just one reason to make some changes to your skincare routine during pregnancy.  

  • Inflammatory conditions like acne and eczema can also lead to hyperpigmentation. Excess melanin is produced in response to the inflammatory process.

How to treat hyperpigmentation?

  • Broad spectrum sunscreen with at least SPF 30 protects sun-exposed skin.

  • Topical creams help with different types of hyperpigmentation. Here are some common prescription and over-the-counter options: 

  • One study found that intense pulsed light therapy cleared 76-100% of superficial lesions caused by melasma, but it’s not as effective for deeper pigmented lesions. 

  • Laser treatment.

  • Alternative therapies include licorice and green tea.

• • •

P.S. We did the homework so you don’t have to:

  1. Wang, R. F., et al. Disorders of Hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. Journal of the American Academy of Dermatology. (2022). 

  2. Silpa-Archa, N., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. Journal of the American Academy of Dermatology. (2017).

  3. Gupta, A.D., et al. The treatment of melasma: A review of clinical trials.Journal of the American Academy of Dermatology. (December 2006). 

  4. American Academy of Dermatology. Melasma: Overview. (n.d.).

  5. Skin Cancer Foundation. Tanning & Your Skin. (2022).

  6. Gupta, A.D., et al. The treatment of melasma: A review of clinical trials. Journal of the American Academy of Dermatology. Ibid.

  7. Desai R.S. Hyperpigmentation therapy: A review. Journal of Clinical and Aesthetic Dermatology. (August 2014).

  8. Schwartz, C., et al. Hydroquinone. In StatPearls. StatPearls Publishing. (2022).

  9. Baldwin, H. E., et al. 40 years of topical tretinoin use in review. Journal of drugs in dermatology. (2013).

  10. Gupta, A.D., et al. The treatment of melasma: A review of clinical trials.Journal of the American Academy of Dermatology. Ibid.

  11. Chaowattanapanit S., et al. Postinflammatory hyperpigmentation: A comprehensive overview.Journal of the American Academy of Dermatology. Ibid.

  12. Gupta, A.D., et al. The treatment of melasma: A review of clinical trials.Journal of the American Academy of Dermatology. Ibid.

  13. Chaowattanapanit S., et al. Postinflammatory hyperpigmentation: A comprehensive overview.Journal of the American Academy of Dermatology. Ibid.

  14. American Academy of Dermatology. Chemical peels: FAQs. (n.d.). 

  15. Gupta, A.D., et al. The treatment of melasma: A review of clinical trials.Journal of the American Academy of Dermatology. Ibid

  16. Ciganovic P., et al. Glycerol licorice extracts as active cosmeceutical ingredients: Extraction optimization, chemical characterization, and biological activity.Antioxidants. (October 2019). 

  17. Hollinger, J.C., et al. Are natural ingredients effective in the management of hyperpigmentation? A systematic review.Journal of Clinical and Aesthetic Dermatology. (February 2018).

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• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Shannon Gunderson, NP

Shannon Gunderson, NP

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