Facial Hyperpigmentation

Facial hyperpigmentation is one of the most common skin conditions that affects millions of individuals around the world. It often manifests itself as spots or patches of skin that are darker than your natural skin tone. Hyperpigmentation can occur on the skin for several reasons and most often presents in the sun-exposed areas of the face and body. Facial hyperpigmentation can affect all individuals, regardless of age or skin tone. Although this skin condition is cosmetic, it can seriously impact one’s self-esteem. Thankfully, there are many treatment options available, such as chemical peels, Cosmelan, Mesopeels, skin resurfacing lasers, and topical skin care products. If you are suffering from hyperpigmentation, post-inflammatory hyperpigmentation, melasma, sun spots, solar lentigines, or dark spots, board-certified cosmetic dermatologist Dr. Michele Green in NYC is here to help.

Hyperpigmentation is a broad term that describes many skin conditions that leave your skin discolored from a myriad of factors. There are three main types of hyperpigmentation: age spots, melasma, and post-inflammatory hyperpigmentation. Depending on the type of hyperpigmentation you have, there are different causes and treatment options available. Some of the most common factors that contribute to hyperpigmentation include sun damage, acne scars, and hormonal changes. Some patients can also develop hyperpigmentation as a side effect from other treatments, such as Fraxel laser, Intense Pulsed Light (IPL), or Picosure lasers. Therefore, it is imperative to consult with an expert in facial hyperpigmentation, like Dr. Michele Green in New York, to determine the best treatment options to decrease and remove your hyperpigmentation.

Dr. Green has over 25 years of experience in treating facial hyperpigmentation. In her private Upper East Side dermatology office, Dr. Green has treated thousands of individuals who suffer from hyperpigmentation in all skin tones and skin types. By combining noninvasive in-office cosmetic procedures with the best specially formulated skin care from her MGSKINLABs line, Dr. Green is able to offer her patients a customized treatment plan that addresses their body and facial hyperpigmentation. She takes pride in understanding the individual needs and goals of each of her patients to help them look and feel like the best version of themselves. It is no wonder that she is consistently voted as one of the best dermatologists in NYC by the New York Times, New York Magazine, and Castle Connelly. When it comes to treating your facial hyperpigmentation, Dr. Green will help you achieve clearer and more radiant skin.

What causes facial hyperpigmentation?

Hyperpigmentation is a general term that is used by medical professionals to characterize patches of skin that are darker in color than the rest of the skin due to the overproduction of melanin. Dark spots can develop for a wide variety of reasons, though the most common contributing factor to facial hyperpigmentation is overexposure to the sun. Fluctuations in hormone levels, a genetic predisposition to melasma, the healing process of acne lesions, and skin damage caused by laser treatment can also all lead to the development of facial hyperpigmentation. Facial hyperpigmentation can occur in individuals of any skin tone and type and, depending on the underlying cause of the hyperpigmentation, may appear at any age.

What is melasma?

Melasma is a skin condition that is commonly characterized by brown or blue-gray patches. Several factors contribute to melasma, but the two main causes are sun exposure and hormones. Melasma, or chloasma, is often called the “mask of pregnancy” because it commonly occurs in pregnant women due to hormonal fluctuations. Ninety percent of patients who suffer from melasma are women due to both a genetic and hormonal component. Other factors that make individuals more prone to melasma include thyroid disease and having a darker skin tone. Studies have shown that there is a connection between thyroid disease and melasma. There is also an increased presence of melanocytic and lentiginous nevi in patients with melasma. Additionally, melasma is more likely to develop in patients with darker skin types, especially in patients with type IV or darker skin tones. In fact, fifty percent of patients who suffer from melasma also report a positive family history of hyperpigmentation disorders.

There are various treatments currently available to improve facial melasma, including over-the-counter creams, prescription skincare products with hydroquinone, chemical peels, Clear+ Brilliant laser treatment, and Cosmelan peels. In many cases, lasers are not the ideal treatment for melasma since they can cause post-inflammatory hyperpigmentation and worsen existing hyperpigmentation and melasma, ultimately making it more difficult to treat. When other treatment options have failed, Cosmelan peels can often be the best course of treatment. The Cosmelan peel consists of 51 active ingredients that work to depigment the skin, and it is for use in patients of all skin tones. Cosmelan works to remove the accumulation of melanin and inhibit the formation of new pigment.

If you know you have a propensity for melasma or facial pigmentation, preventing new sun damage is key to achieving and maintaining clear skin. You must use sunscreen with an SPF of 50 and higher every day and reapply at least every two hours when outside. Dr. Green recommends layering on two different sunscreens to ensure total sun protection. She recommends using a chemical-based sunscreen, such as one that contains avobenzone, and a physical-based sunscreen, such as one that contains zinc oxide or titanium dioxide. Using sunscreen, as well as practicing sun avoidance and wearing protective clothing, hats, and sunglasses whenever possible, is paramount to preventing melasma and facial hyperpigmentation.

When should you consult a dermatologist for facial hyperpigmentation?

Many individuals notice hyperpigmentation but choose to ignore it, but this can be dangerous since skin cancer in its earliest stages can look just like a sunspot. That’s why it is so important to see a board-certified dermatologist like Dr. Michele Green in NYC early on. Dr. Green can help distinguish whether or not the spot is benign or a skin cancer. When you consult a Dr. Green during the early stages of hyperpigmentation, the hyperpigmentation is less likely to be deeply entrenched in your skin, which can make removing it easier. In addition, Dr. Green can recommend the best skin care products that both treat your hyperpigmentation and prevent it from worsening.

Dr. Green can help determine the cause of your hyperpigmentation and the best cosmetic treatment. Some patients develop hyperpigmentation as a result of medications they are taking, such as birth control pills, and discontinuing these medications can help the hyperpigmentation fade. During your consultation with Dr. Green, I will suggest various treatment options, such as chemical peels, skin resurfacing lasers, Cosmelan peels, mesopeels, and topical skin-lightening agents. She will help determine the best cosmetic treatment for you, your skin tone, and your lifestyle to bring you beautiful, clear skin.

Before and after Cosmelan Treatment

Sun exposure and facial hyperpigmentation

Melanin in the skin is the principal determinant of skin tone and is also responsible for the appearance of patchy areas of darker skin. Damaging UV rays from sun exposure can cause an increase in melanin production, leading to hyperpigmentation of the skin, which can be extremely difficult to remove. Patients who develop facial hyperpigmentation as a result of sun exposure may manifest dark spots in a few different ways. Some patients with sun damage may experience overall skin discoloration, whereas others can develop distinct age spots or sunspots. In the realm of cosmetic dermatology, sunspots may also be referred to as liver spots or lentigines. Certain medications, like the antibiotics Doxycycline and Minocycline, can increase photosensitivity and put one at higher risk for forming dark patches, sunspots, or macules on the skin.

The best treatment method for facial hyperpigmentation caused by sun exposure depends largely on your specific skin tone. Patients with fair skin may be best treated with chemical peels or laser treatments. Patients with darker skin tones may be best treated with hydroquinone, mesopeels, or Cosmelan chemical peels. During your consultation with Dr. Green, she will evaluate your facial hyperpigmentation and make her expert cosmetic recommendations based on your skin tone and the type of dark spots you have.

Hormonal changes and facial hyperpigmentation 

Facial hyperpigmentation due to hormonal changes is far more likely to occur in women than in men due to hormonal fluctuations as a result of pregnancy, oral contraceptives, or menopause. Fluctuations in estrogen and progesterone have been shown to trigger the overproduction of melanin in women. Melasma, also known as chloasma, is the most common type of facial hyperpigmentation experienced by women undergoing hormonal fluctuations during pregnancy. The ‘mask of pregnancy’ refers to the appearance of melasma that forms on the upper lip, the forehead, the cheeks, and the nose, often resembling a mask. Oral contraceptives (the birth control pill) and some hormone replacement therapies can also exacerbate the appearance of hyperpigmentation or lead to melasma by increasing levels of the hormones estrogen and progesterone.

Female 35-44, Cosmelan, 2 & 1/2 months post treatment

Genetic predisposition causing hyperpigmentation

Individuals with darker skin tones are more prone to hyperpigmentation since they have more melanin, the component of skin that is responsible for producing your skin tone. Skin tone is affected by genes, and certain genes are involved in controlling the overall amount of melanin that is produced by melanocytes. Some genes play a role in determining the total number of melanocytes any individual has. As we age and the skin starts to change over time, the genetic makeup of an individual may make one more or less likely to become hyperpigmented. There is a strong hereditary component to certain forms of hyperpigmentation, such as melasma. Approximately 50% of individuals suffering from melasma report a positive family history of the condition, and many identical twins have been reported to develop melasma.

Acne lesions and other skin conditions that cause post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) refers to the dark spots that may be left behind after an acne lesion or other inflammatory skin condition such as eczema, dermatitis, or psoriasis. Wounds from abrasions or scars from an injury can also heal with discoloration. The color of the dark spots associated with post-inflammatory hyperpigmentation can vary from brown, black, red, pink, or purple patches of skin, depending on skin tone. During the natural healing process of the skin, there is potential that skin cells involved with healing the area are also contributing to the overproduction of melanin, leading to the development of hyperpigmented areas of skin. Although this type of hyperpigmentation may fade over time, it’s more effective and efficient to have treatment with a board-certified dermatologist like Dr. Green in New York. She can help guide you with the best skin care, sun protection, and skin-lightening products.

Hyperpigmentation secondary to medications

Certain prescription and over-the-counter medications may increase the risk of developing facial hyperpigmentation. Antipsychotics, anticonvulsants, antimalarial medicines, and NSAIDS are among some of the different groups of medications that can impact skin tone. Different medications may lead to hyperpigmentation through varying mechanisms. Some medications cause melanin to accumulate in the skin, causing hyperpigmentation. To determine whether the facial hyperpigmentation is related to medications, a thorough investigation of your medical history will take place during your consultation with Dr. Green.

Laser damage causing secondary hyperpigmentation

If laser treatment is used on a skin tone that is not well suited for that specific type of laser, it can result in skin discoloration and hyperpigmentation. In addition, If the energy (or heat) used is too high for a particular skin tone or skin type, the result can be an excess of hyperpigmentation as well. Dr. Michele Green has treated and corrected hundreds of patients with resulting hyperpigmentation from the Fraxel, Picosure, and IPL laser. Special care must be taken when treating hyperpigmentation, especially in patients with darker skin tones, to avoid a worsening of the underlying condition.

Similarly, melasma is an underlying condition that can often worsen from laser treatments, such as IPL, Picosure®, or Fraxel® laser. These laser treatments can potentially exacerbate the patches of hyperpigmentation associated with melasma and make them more difficult to remove. For this reason, Dr. Green always develops treatment plans for melasma that rely on chemical peels, Cosmelan® peels, Mesopeels®, and topical skin-lightening treatments. Dr. Green uses a combination of products that are hydroquinone-based and some that are hydroquinone-free.

Treated with Cosmelan – 6 weeks

How to reduce pigmentation on face:

There are several treatment options available for the varying types of facial hyperpigmentation. During a consultation with board-certified dermatologist Dr. Michele Green, the appropriate treatment will be determined based on your medical history, past cosmetic treatments, skin type, and the types of dark spots you’re experiencing. From topical treatments, skincare, sunscreen, skin lightening serums, laser therapy, mircroneedling, and chemical peels, Dr. Green will help advise you and create the best skin care treatment for you.

Topical treatments

There are a number of topical treatments available that can help with facial hyperpigmentation, such as hydroquinones, retinoids, retinol, azelaic acid, tranexamic acid, and kojic acid. Hydroquinone is particularly effective in treating varying types of hyperpigmentation and is only available as a prescription from a dermatologist, like Dr. Michele Green in NYC. Hydroquinone is a common ingredient in skin-bleaching creams, which helps lighten areas of hyperpigmentation and melasma. It can be compounded with Retin-A or other active ingredients of varying strengths from 4 to 10 percent for maximum effect in reducing difficult facial pigmentation.

Dr. Green also utilizes retinol and other medications to treat facial hyperpigmentation. Retinol can be found in various over-the-counter skincare products, and retinoids are prescribed by dermatologists such as Dr. Green. Retin -A is a commonly prescribed tretinoin to treat facial pigmentation. Retin-A is a derivative of vitamin A that increases the rate of skin cell turnover. Through this process, retinoids exfoliate discolored and hyperpigmented skin cells and replace them with healthy, new skin cells at the surface of the skin. Other helpful topical ingredients include azelaic and kojic acid, which are both tyrosinase inhibitors. Tyrosinase is an enzyme that is responsible for melanin production, so the use of these ingredients can decrease hyperpigmentation by interfering with melanin production. One of the most popular topical products is Dr. Green’s Vita-C- Serum. Vitamin C serum acts to promote skin cell renewal while decreasing the appearance of dark spots.

Cosmelan Peel

The Cosmelan peel is a professional-grade mask that Dr. Green often uses to treat melasma. The mask is applied to the skin by Dr. Green in her Upper East Side, Manhattan office and worn for a number of hours (which is determined by your skin tone and the degree of hyperpigmentation). The Cosmelan peel works through several mechanisms to effectively diminish the overall appearance of melasma. Cosmelan reduces the production of melanin (responsible for skin pigment) inside the melanocytes (skin cells that are responsible for making melanin) by inhibiting the tyrosinase enzyme. It also blocks the transfer of melanin from the melanocyte to the keratinocyte, preventing the migration of pigment to the epidermal layer of the skin. The result is a reduction in visible melasma and a complexion that is more even in skin tone.

Chemical peel – 2 months before and after

AlexTrivantage Laser to remove sun spots and solar lentigines

Candela’s AlexTrivantage laser is used in Dr. Green’s office to reduce the appearance of undesired age spots, sun spots, freckles, and birthmarks. The laser is able to safely target the excess pigmentation in the skin while leaving the surrounding tissue unharmed, making it a powerful tool in the treatment of facial hyperpigmentation. The AlexTrivantage laser is a Q-switched Alexandrite laser, with the proven 755 nm wavelength, as well as the 532nm and 1064nm wavelength for darker skin tones. The AlexTrivantage laser is ideally suited for removing sun spots or freckles.

Fraxel Laser treatment for hyperpigmentation and sun spots

The Fraxel laser is the “Magic Eraser” and the gold standard treatment for improving skin tone and texture. Fraxel is a fractionated skin resurfacing treatment that is often recommended for patients who suffer from extensive sun damage and facial hyperpigmentation. It can effectively diminish the appearance of dark sun spots in an entire area of the face, neck, chest, arms, or legs, with little downtime. The Fraxel laser creates controlled, microscopic wounds in the skin through the application of highly concentrated laser pulses. As the skin repairs these wounds, new collagen is produced, new skin cells grow, and the damage from the sun begins to heal, revealing a brighter, more radiant complexion that is even in tone. Fraxel, however, should not be used in the treatment of melasma and is best suited for patients with lighter skin tones, particularly skin types I-III.

Intense Pulsed Light for sun damage

Intense Pulsed Light (IPL) is another treatment to remove facial hyperpigmentation and dark spots and improve the overall appearance of your skin. IPL treatment is different from other lasers in that it possesses many different wavelengths of light, whereas most lasers typically release a single wavelength. IPL is able to address a wider variety of skin concerns due to the varying wavelengths of light released. Depending on the wavelength, IPL can treat hyperpigmented skin cells, hair follicles (for hair removal), or facial rosacea (broken blood vessels) and increase new collagen formation for skin tightening. When it comes to treating hyperpigmentation, the pigment cells in the dermis of the skin absorb the light energy released by IPL and are destroyed, while surrounding cells are unharmed.

Clear + Brilliant® Laser

The Clear + Brilliant Laser is a gentle laser treatment that utilizes fractional laser technology to treat facial hyperpigmentation and fine lines, reduce pore size, and improve the overall appearance of skin tone and texture. The Permea handpiece is specifically designed to remove facial pigmentation in 4 to 6 treatments. Clear + Brilliant is commonly referred to as a “mini-Fraxel” laser and will rejuvenate and address the early signs of sun damage and photo-aging in all skin tones.

Chemical peels

Chemical peels are a very popular treatment that Dr. Michele Green often recommends to her patients who are looking to reduce facial hyperpigmentation and dark spots on their face and body. Trichloroacetic acid peels (TCA peels) are used to chemically exfoliate the skin. The chemical peel increases the rate of skin cell turnover, which encourages the dead and discolored skin cells to be more quickly replaced from the top dermal layer with new, healthy, evenly-colored skin cells. Dr. Green often combines different chemical peels with her unique line of MGSKINLAB products to exfoliate, enhance, and remove unwanted pigmentation.

Microneedling with depigmentation serum

Microneedling is a non-invasive procedure that uses surgical-grade needles that are passed along the skin to create microscopic injuries. Microneedling stimulates the body’s natural healing process to produce new collagen and elastin. Microneedling evens the skin tone and texture and reduces the appearance of fine lines and wrinkles. For patients suffering from facial hyperpigmentation, microneedling can be enhanced with a special depigmentation serum to treat PIH and dark spots from acne scars. The micro-injuries created from the procedure allow the absorption of this special depigmentation serum, improving areas of discoloration and lightening the skin. Microneedling with depigmentation serum is safe for all skin types with no downtime after treatment.

Microdermabrasion for improving skin pigmentation

Microdermabrasion is a cosmetic procedure that targets the epidermis, the top layer of your skin. During the procedure, a special applicator gently exfoliates the top layer of skin. This minimizes the appearance of skin discoloration and dark spots while improving the appearance of fine lines, texture, and tone through the induction of collagen synthesis. Alternatively, aluminum oxide or sodium bicarbonate crystals can be used through microdermabrasion to renew the top layer of your skin gently. There is no recovery time associated with either type of microdermabrasion. Careful sun avoidance and the proper sunscreens are always recommended when treating hyperpigmentation.

HydraFacials to reduce pigmentation

The HydraFacial is a three-step medical-grade facial that helps to improve the overall look and feel of the skin. The HydraFacial focuses on deeply cleansing, gently exfoliating, and intensely nourishing the skin. The gentle, unique vortex fusion technology of the Hydrafacial allows for the powerful extraction of impurities from the pores while simultaneously infusing beneficial antioxidants into the skin. The result is a radiant and healthy glow in just one thirty-minute treatment with no downtime involved. By customizing your HydraFacial treatment with a Britenol booster, you can further improve your complexion by evening and brighten your skin tone. The Britenol booster is formulated with Vitamin C, bearberry extract, and alpha-arbutin to effectively provide the skin with radiance while minimizing the appearance of hyperpigmented spots.

VBeam Laser for pigmentation

The VBeam laser works by releasing a burst of light at a wavelength of 595 nanometers to target the red pigment in blood vessels. The energy is converted into heat in the skin and absorbed by the atoms responsible for color. As a result, the VBeam laser does not interact with other parts of the skin and successfully treats the redness that forms in patients suffering from post-inflammatory hyperpigmentation. Typically, 4 to 6 laser treatments will help remove the inflammation from melasma and other disorders of hyperpigmentation.

VBeam 4 sessions, 2 months before and after

Mesopeels for body and facial hyperpigmentation

Mesopeels are specially formulated chemical peels that can address varying types of hyperpigmentation, fade pigment, and decrease the activity of melanocytes. They are designed to diminish the overall appearance of skin discoloration and dark spots in a gentle but efficient manner. Dr. Green typically uses the mesopeel to treat patients who are concerned with facial hyperpigmentation in the delicate eye area, where traditional chemical peels may be too irritating.

Other delicate areas of the body that may be hyperpigmented and more sensitive to a traditional chemical peel, such as the axillae, groin, inner thighs, and buttocks, can be treated with mesopeels, too. Mesopeels induce the production of new collagen and elastin as a result of chemo-exfoliation for brighter and healthier-looking skin. One of the key advantages of Mesopeels is that there is absolutely no recovery time with this special type of chemical peel.

Treating facial hyperpigmentation with patients with skin of color

In general, laser treatments such as the Fraxel laser, Picosure, and IPL often worsen melasma and hyperpigmentation. These lasers often make it more difficult to remove and treat melasma effectively in the future. If you are of Asian, Mediterranean, Hispanic, or African descent, it would be best to avoid these lasers when you have melasma. For patients of color, the best treatments include chemical peels, mesopeels, Cosmelan peels, and topical treatments. These products work on all skin tones and can effectively treat melasma, sunspots, dark spots, and other pigmentation disorders without worsening your underlying skin condition. It is especially important to seek out a board-certified dermatologist, like Dr. Green, who has years of experience in treating patients of all skin tones.

How much does treatment for facial hyperpigmentation cost?

The total cost of treating facial hyperpigmentation will vary depending on a number of factors. The severity of the hyperpigmentation and the chosen method of treatment (skin-lightening products, chemical peels, laser treatments, or a unique combination of treatments) will all need to be factored in when determining the cost of your treatment. Additionally, the experience of your treating physician and your geographical location can affect the total cost of your treatment. A board-certified dermatologist like Dr. Michele Green, who is an expert in the treatment of melasma and hyperpigmentation, will be more expensive than a nurse at a medspa.

It is inherently important to select a board-certified cosmetic dermatologist, like Dr. Michele Green in New York, with both the experience and expertise to help you achieve the best cosmetic results. The incorrect treatment of facial hyperpigmentation can exacerbate the issue, making your hyperpigmentation even more difficult to remove. Treating melasma with the Fraxel laser, IPL, or Picosure may ultimately make it more difficult to remove this facial hyperpigmentation or melasma. Dr. Green is a board-certified cosmetic dermatologist with over 25 years of experience in treating melasma and disorders of pigmentation with the best skin care, chemical peels, and laser treatments. During a consultation with Dr. Green, the most suitable cosmetic treatment for your specific type of facial hyperpigmentation and skin tone will be determined, and the total cost will be discussed.

How to best treat facial hyperpigmentation from Melasma

Melasma should be approached in a different manner than other varieties of facial hyperpigmentation. Too often, patients have laser treatments to remove melasma and the result is a worsening of the overall appearance of the melasma and hyperpigmentation. Melasma is a type of pigmentation that is more difficult to treat as the hyperpigmentation becomes more entrenched in the deeper layers of the skin. Dr. Michele Green specializes in treating patients whose melasma and pigmentation were worsened by ablative and non-ablative laser treatments. Dr. Green prefers to treat melasma with Mesopeels, chemical peels, VBeam laser treatment, and Cosmelan peels, preventing exacerbation of the existing hyperpigmentation. Cosmelan was initially developed to treat melasma. However, Dr. Green has expanded its use to also treat acne scars, post-inflammatory hyperpigmentation (PIH) from lasers, sun spots, sun damage, and discoloration on the face, neck, chest, back, and other areas of the body.

How to treat hyperpigmentation during pregnancy

During pregnancy, hormone levels, specifically the female hormones estrogen and progesterone, are in flux. Increased levels of these sex hormones have been found to be tied to the overproduction of melanin, increasing the chances that a woman may develop melasma or ‘the mask of pregnancy,’ especially when combined with sun exposure. While one is pregnant, cosmetic treatments designed to treat melasma and facial hyperpigmentation, such as the Cosmelan peel and trichloroacetic acid chemical peels, can not be used. Additionally, the majority of topical skin-lightening products (such as hydroquinone) are not to be used when pregnant. Therefore, the best way to manage any facial hyperpigmentation or melasma that you have during pregnancy is to use the proper sunscreen and avoid sun exposure. This can help prevent the worsening of any hyperpigmentation during your pregnancy. Once you are no longer pregnant, you can discuss with Dr. Green the best combination of in-office cosmetic treatments and at-home skin care products to treat your hyperpigmentation/melasma.

How to treat post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) can result as a side effect from inflammatory acne, rash, or other cutaneous injury. If the hyperpigmentation is related to post-inflammatory hyperpigmentation and the dark spots are brown, black, red, or violaceous in color, Dr. Green often suggests a combination of treatments for the best cosmetic results. In-office trichloroacetic acid (TCA) peels help to increase the rate of skin cell turnover, sloughing off the discolored skin cells, revealing new, healthy skin cells, and creating an overall improvement in both tone and texture. Often, Dr. Green will recommend that patients supplement the in-office chemical peel treatments with powerful yet gentle topical skincare products, including antioxidants such as MGSKINLABs Vita-C serum, retinol such as in her unique Antioxidant Infusion, and skin lightening creams which are both hydroquinone based and hydroquinone-free. Patients who prefer not to have any peeling may prefer the Clear+Brilliant laser to remove the pigmentation or Mesopeels. In your consultation with Dr. Green, you will discover which combination of treatments and products is best suited to minimizing the appearance of your post-inflammatory hyperpigmentation.

Post-inflammatory hyperpigmentation may cause areas of skin to become hyperpigmented, such as brown, black, or purple spots, but it can also cause erythema. Red or erythematous patches of facial discoloration can be effectively treated with the VBeam laser. Dr. Green uses the VBeam laser on patients who are suffering from facial rosacea, acne marks, broken capillaries, sun damage, port wine stains, stretch marks, and post-inflammatory hyperpigmentation. The VBeam laser operates on a wavelength that only targets the skin cells that are red or erythematous, leaving the surrounding tissue untouched. The VBeam is extremely safe and effective and has no recovery time.

How to get rid of hyperpigmentation mustache

Hyperpigmentation of the upper lip typically results as a symptom of melasma. Dr. Green loves the results that the Cosmelan peels provide her patients who are struggling with melasma and often suggests Cosmelan treatment to anyone who is dealing with stubborn hyperpigmentation on the upper lip area. Having a Cosmelan peel followed by maintenance products provides outstanding results with essentially no downtime. In addition, skin-lightening products, with and without hydroquinones and light chemical peels, can hasten the removal of stubborn upper lip hyperpigmentation.

Cosmelan – 8 months before and after

How to treat discoloration, post-inflammatory hyperpigmentation, and dark spots from acne

Hyperpigmentation due to acne breakouts is called post-inflammatory hyperpigmentation, or PIH. As the acne lesion heals, the pimple often leaves behind areas of discoloration, which are cosmetically troubling. Dr. Green often employs chemical peels and mesopeels to treat and remove dark spots on the face. Chemical peels work to increase skin cell turnover rate and remove these dead, pigmented skin cells to reveal new healthy cells underneath. In many cases, Dr. Green will combine chemical peel treatments with hydroquinone or other skin-lightening creams to brighten the skin

How to treat hyperpigmentation from laser treatments?

Hyperpigmentation caused by laser treatment is caused by inflammation of the skin after treatment when inappropriate laser settings or types are used on a patient. This inflammation stimulates melanocytes and increases melanin production. Chemical peels such as the Cosmelan peel, mesopeels, and microneedling with the depigmentation solution can help to treat this hyperpigmentation. Topical creams such as hydroquinone, tretinoin, vitamin C, kojic acid, and azelaic acid can also help to lighten and treat post-laser hyperpigmentation. Practicing proper sun protection and using a broad spectrum sunscreen with an SPF of 50 or higher will also help to treat hyperpigmentation from lasers, as UV radiation can cause worsening of the hyperpigmentation.

Is Total body skin lightening safe?

No! Total body skin lightening is a popularly sought-after procedure in many countries around the world. While there are many methods for diminishing the appearance of dark spots and hyperpigmentation on the face and body, total body skin lightening can be risky and requires a lifelong commitment to maintain results. The in-office procedures and at-home products used to achieve full body skin lightening can be dangerous to patients, and Dr. Green has not advised them. However, if there is an area of the body that is darker than the rest, an “even” skin color can be achieved through the correct skincare and chemical peels.

One particular treatment that seems to be consistently popular for total body skin lightening, despite numerous potential and dangerous side effects, is the use of intravenous glutathione. Glutathione is an antioxidant that is naturally found in the human body and is said to help lighten the skin. Glutathione is recognized as a skin-lightening agent because it deactivates tyrosinase (the enzyme responsible for stimulating melanin production in the skin). It is thought that intravenous glutathione treatments enhance the inhibition of melanin production and can be used to lighten the entire body. In her office, Dr. Green does not offer glutathione injections for skin lightening as it has not been clinically proven as an effective and safe treatment.

Glutathione injections for skin lightening are growing in popularity around the globe, but have not been approved by the FDA for cosmetic use in the United States. There can be severe side effects associated with total body skin lightening via glutathione injections, including various skin disorders, thyroid function problems, kidney malfunctions, and possible cancers. Dr. Green does not recommend total body skin lightening with glutathione injections.

Can Vitamin C help treat hyperpigmentation?

Vitamin C is often touted as the powerhouse of skincare. As a strong antioxidant ingredient, vitamin C is able to help combat the negative effects of harmful free radicals that contribute to premature skin aging. Vitamin C also helps to treat the appearance of hyperpigmentation by inhibiting melanin production in the skin and working to brighten overall skin complexion. Vitamin C also plays a role in the synthesis of collagen in the skin. Collagen is a protein in the skin that gives it a firm foundation and contributes to a youthful, supple appearance. By promoting skin cell regeneration and inducing the production of collagen, vitamin C improves the texture and tone of skin. By incorporating a vitamin C serum into your regular skincare routine, you can effectively diminish the appearance of redness, hyperpigmentation, and dark spots to reveal a more radiant, youthful, even-toned complexion.

Dr. Green often incorporates her high-potency Vita-C serum into the skin care regimen for her patients suffering from facial hyperpigmentation. Applying this high-concentration vitamin C serum to the skin both morning and night will improve skin tone, texture, and overall radiance. The Vita-C serum is a great supplement to in-office procedures, which are targeted at diminishing the appearance of facial hyperpigmentation and can also work well with other skincare ingredients like hyaluronic acid, niacinamide, and retinol.

What other skincare essentials should I incorporate into my routine to treat hyperpigmentation?

Retinoids are a class of topical creams that are derived from vitamin A, such as tretinoin. Retinoids are available at lower concentrations over-the-counter but can also be prescribed at higher strengths by a medical professional. They help to further diminish any facial hyperpigmentation by increasing the rate of skin cell turnover. The dead skin cells at the surface layer of the skin are more quickly sloughed off, and healthy, new, even-toned skin cells are encouraged to come to the surface more rapidly. Patients with sensitive skin types should always consult with Dr. Green prior to incorporating a retinoid product (even if it is an over-the-counter purchase) into their skin care regimen, as retinoids can potentially cause skin irritation.

Beta Hydroxy Acids (BHAs) and Alpha Hydroxy Acids (AHAs) are ingredients that act as chemical exfoliants, helping to rid the skin of dead and hyperpigmented skin cells and contributing to the formation of new, even-colored skin cells. Salicylic Acid, Kojic Acid, and glycolic acid are some of the more common AHA and BHA skincare ingredients found in different cleansers, serums, moisturizers, and more, which can help remedy the appearance of facial hyperpigmentation. When using any chemical exfoliants, it is always important to remember that sunscreens are a daily necessity.

Sun protection is a lifelong priority if you have facial hyperpigmentation. Sun exposure has the potential to exacerbate the appearance of your hyperpigmentation. Melanocytes, the skin cells responsible for melanin production and skin pigment, can be retriggered by sun exposure. This means that excess melanin is likely to be reproduced and the excess pigmentation returned if triggered by the sun, even if the skin has been treated for hyperpigmentation in the past. To prevent this, select a sunscreen that offers broad-spectrum coverage, protecting against both UVA and UVB rays. Religiously apply SPF daily, and be sure to reapply often when spending time outdoors. For best protection, wear a hat and sunglasses to further prevent your hyperpigmentation from worsening or reappearing.

Hydroquinone is the gold standard ingredient in many skin-lightening creams. There are currently no hydroquinone-based creams that can be purchased over the counter. Dr. Michele Green can prescribe hydroquinone-based skin-lightening creams with a concentration of 4 percent and greater.  Dr. Green has created a special at-home pigment protocol for her patients to lighten dark spots and even out the skin. Most patients use this pigment protocol to treat skin problems such as freckles, melasma, age spots, sun damage, discoloration, and hyperpigmentation from acne scars. Special care is needed to use the correct sunscreens, and sun avoidance is needed to prevent exogenous ochronosis. Skin-lightening creams can also naturally lighten dark skin. Skin bleaching is a cosmetic treatment that reduces the prominence of skin discolorations and evens out the overall skin color to achieve skin brightening.

Are skin lightening creams safe to use on the face?

Using skin-lightening creams to diminish hyperpigmentation and dark spots is safe as long as they are used appropriately and are under the supervision of a qualified dermatologist, like Dr. Michele Green in NYC. Skin bleaching creams must be used correctly and cautiously so as not to over-bleach the skin. Incorrect use of skin-lightening creams can cause skin irritation and sensitivity as well as leave the skin hypopigmented, hyperpigmented, discolored, or inflamed. If you are considering incorporating a skin-lightening cream into your treatment regimen for facial hyperpigmentation, be advised that it is always best to do so under the supervision of a dermatologist. During your consultation with Dr. Michele Green, you will have the opportunity to learn about what skincare products would benefit your unique situation and the proper use for each product.

How to remove dark spots on your face quickly and naturally

There are many different ingredients and skin care products found over the counter that can help remove dark spots without the need for cosmetic procedures. Vitamin C is a powerful antioxidant that can inhibit the production of melanin and brighten the skin’s complexion overall. Beta hydroxy acids (BHAs) and alpha hydroxy acids (AHAs) are chemical exfoliants that work to remove dead, pigmented cells to reveal healthy, even-colored skin cells underneath. Salicylic acid, glycolic acid, and kojic acid are common BHAs and AHAs used in skin care products to reduce the appearance of facial hyperpigmentation. Sunscreen is an incredibly important product to help remove dark spots from the face. Improper sun protection and excessive sun exposure can trigger melanocytes and lead to the worsening of hyperpigmentation. Dr. Green will also recommend specially formulated skin-lightening serums to help remove hyperpigmentation and brighten the skin. For maximum protection, it is essential to use a broad-spectrum coverage sunscreen with an SPF of 50 and to reapply throughout the day.

Can facial hyperpigmentation return after it has been treated? 

Melanocytes, the skin cells responsible for producing melanin, have memory. Our skin cells absorb UV radiation, which causes mutations and long-term damage that remains even after treatment. For that reason, the importance of sun protection for individuals who have suffered or do suffer from facial hyperpigmentation can not be understated. Exposure to the sun after completing treatment for facial hyperpigmentation or melasma can encourage melanocytes to produce melanin, causing the uneven pigment to return. In order to maintain the cosmetic results of your hyperpigmentation treatment, always remember to use a broad-spectrum sunscreen with a minimum SPF of 50, reapply generously, and wear protective clothing to shield your skin from the sun (like a hat and sunglasses).

What is the best sunscreen to minimize sun exposure and facial hyperpigmentation?

When considering the best sunscreens to use to prevent sun damage, pigmentation, and melasma, it is very important to remember two facts. First, it is important to use the correct sunscreen and SPF. Secondly, it is important to remember to reapply sunscreen. All too often, patients will say that they applied sunscreen once in the morning and forget to reapply sunscreen during the day, after sweating, or after swimming. It is vital to remember to re-apply sunblock, even on a cloudy day, to prevent the sun’s damaging UV rays from causing sun spots, melasma, hyperpigmentation, and sun damage.

Secondly, if your skin is prone to pigmentation or melasma, it is best to layer sunscreens for the very best protection. It is vital to apply a chemical sunblock first to your face. After the sunscreen penetrates, a layer of a physical sunblock containing zinc oxide should be applied. By layering both of these two different types of sunblocks, your skin will have the best protection against sun exposure and the least chance of developing sun damage or hyperpigmentation.

Frequently Asked Questions & Answers

What is facial hyperpigmentation?

Many factors contribute to hyperpigmentation, including genetics, sun exposure, and hormonal fluctuations. The main culprit of hyperpigmentation is sun exposure. As your body tries to protect itself from the sun’s damaging UV rays, the body produces more melanin. Melanin production gets stimulated by the melanocytes within the skin, resulting in hyperpigmentation. Melasma also tends to be genetic and is much more common in women than in men. Over 50 percent of patients reported a positive family history of melasma. One reason that women are more prone to melasma lies in the fact that estrogen and progesterone are linked to melanin production. Elevated levels of these two sex hormones are common during puberty, pregnancy, and menopause and will contribute to a greater likelihood of women developing hyperpigmentation.

Hyperpigmentation on the face is most likely a result of sun exposure. When the skin cells on your face are exposed to the sun’s harmful UV rays, the melanocytes increase melanin production. Melanin is the pigment that gives our skin, hair, and eyes their color, but overproduction of it in certain areas but not others will result in hyperpigmentation. Hormonal fluctuations can also contribute to hyperpigmentation. It is common for pregnant women to develop melasma, a type of hyperpigmentation that is characterized by brown or blue-gray patches on the skin, typically on the face.

Are freckles a form of hyperpigmentation?

Yes, freckles are a form of hyperpigmentation. They are most commonly found on individuals with fair skin or red hair but can occur in other skin tones as well. Individuals with freckles have uneven melanin production across their face, which causes tiny areas of discoloration, which is known as freckles. These small dark spots are usually less than 5mm in diameter and are typically harmless. Sun exposure can result in an increased amount of freckles and can coalesce to form larger sunspots. It is essential to use a broad-spectrum sunscreen with an SPF of 50 or greater to ward against forming sun spots, freckles, or hyperpigmentation.

How to permanently remove facial pigmentation?

The ability to remove pigmentation permanently varies from patient to patient, depending largely on what triggered the onset of the hyperpigmentation. For patients who experience hyperpigmentation in the form of melasma during pregnancy or as a result of taking oral birth control pills or other hormonal therapies, melasma may naturally subside either after pregnancy or once the hormonal medications have been discontinued. However, for many patients, melasma is a chronic condition that will require some type of treatment in order to reduce the associated hyperpigmentation. Sunspots, overall sun damage, and age spots typically require chemical peels or laser treatments to remove, and removal can be permanent so long as the patient undergoes strict sun avoidance and maintains a proper skincare routine.

How to remove dark spots on your face with home remedies

Many home remedies for removing dark spots on the face are anecdotal, and there have not been many clinical studies performed to research their safety and effectiveness in treating pigmentation. Aloe vera gel is a popular home remedy that is applied to the pigmented areas at night and washed off the next morning. There are a few clinical studies that have suggested that aloe vera may help with pigmentation as it contains aloin, a compound that can break apart melanin, and aloesin, a compound that inhibits tyrosinase and prevents melanin production. Some studies have demonstrated that green tea extract and turmeric help treat melasma and hyperpigmentation due to their antioxidant properties. It is important to note that while home remedies may be “natural,” they can also lead to irritation and inflammation of the skin. If you are considering using any natural or home remedies to treat your dark spots on the face, consult with a board-certified dermatologist, such as Dr. Michele Green in NYC, who can guide you in the right direction for a safe and effective dark spot removal treatment.

How to get rid of dark spots on your face overnight?

Currently, there are no topical or in-office treatments available to get rid of dark spots overnight. Topical products work gradually to fade dark spots, and it can take months to see the desired cosmetic results. In-office treatments, such as chemical peels, laser treatments, and microneedling typically require a series of sessions for dark spot removal but will achieve faster results than with topical treatments alone. If you are interested in getting rid of your dark spots as soon as possible, consult with Dr. Michele Green in her private Upper East Side office for a treatment plan best suited for your skin type and tones.

How to remove dark spots from your face instantly?

For faster results, patients can turn to laser treatments such as the Alex Trivantage and Fraxel laser, which can remove hyperpigmentation and sun spots in as little as one treatment session. Unfortunately, no treatment is available to remove dark spots on the face instantly. If you have darker skin tones, these lasers may not be effective in removing your dark spots. Prescription topical creams such as hydroquinone or over-the-counter ingredients such as vitamin C are excellent for treating pigmentation on the face. They will work to lighten the dark spots over time and are often combined with chemical peels or microneedling.

What is the best treatment for facial hyperpigmentation?

There are a number of different treatment options available for treating facial hyperpigmentation. Topical skin lightening products, chemical peels, Cosmelan peels, Mesopeels, HydraFacials, microdermabrasion, Fraxel laser, eMatrix laser, Clear + Brilliant laser, AlexTrivantage laser, and the VBeam laser are just a few of Dr. Green’s favorite ways to address dark patches of skin caused by hyperpigmentation. Ultimately, the right treatment for your hyperpigmentation will depend on your skin type, skin tone, and the type of hyperpigmentation you are experiencing.

Which facial is best for reducing facial hyperpigmentation?

The HydraFacial is the best facial for reducing hyperpigmentation on the face. The HydraFacial is a three-step medical-grade facial that helps to improve the overall look and feel of the skin. The HydraFacial focuses on deeply cleansing, gently exfoliating, and intensely nourishing the skin. The gentle, unique vortex fusion technology of the Hydrafacial allows for the powerful extraction of impurities from the pores while simultaneously infusing beneficial antioxidants into the skin. The result is a radiant and healthy glow in just one thirty-minute treatment with no downtime involved. By customizing your HydraFacial treatment with a Britenol booster, you can further improve your complexion by evening and brighten your skin tone. The Britenol booster is formulated with Vitamin C, bearberry extract, and alpha-arbutin to effectively provide the skin with radiance while minimizing the appearance of hyperpigmented spots. The HydaFacial detoxes your skin, exfoliates dead skin cells, and keeps the skin hydrated. Your skin is infused with various serums and antioxidants that leave it glowing and help with hyperpigmentation. The HydraFacial can be supplemented with a Britenol booster, a retinol-based skin brightener that minimizes the appearance of dark spots and sun spots. It contains ingredients like alpha-arbutin, vitamin C, and bearberry extract.

Are facial peels worth it?

Yes! Facial peels like HydraFacial are great at addressing a wide range of skincare issues, from acne to rosacea to hyperpigmentation. In addition, they are one of the most affordable non-invasive skin treatments on the market and cost significantly less than a chemical peel or other alternative cosmetic procedures. This multi-step process will work to cleanse, exfoliate, and infuse your skin and is beneficial for all skin types. HydraFacial can also help with dry skin, enlarged pores, blackheads, general facial redness, wrinkles, fine lines, and poor circulation, among other skin care concerns. If you have deeper hyperpigmentation, other cosmetic procedures may also be recommended to remove it more effectively.

How do you get rid of discolored skin?

Skin discoloration can result from a multitude of factors, including excessive sun exposure, age, acne scarring, and hormonal changes. Discolored skin can affect individuals of all ages and skin tones and impact one’s self-esteem. Luckily, various types of non-invasive cosmetic procedures and topical skincare products are available to treat and improve the appearance of hyperpigmentation. These procedures and products can be used in combination with one another to create clear, beautiful skin. Whether it’s a skin resurfacing laser, chemical peel, microneedling procedure, or targeted topical products, Dr. Michele Green in NYC can create a customized treatment plan to reduce your facial hyperpigmentation.

Dr. Michele Green is a world-renowned expert in cosmetic dermatology with over 25 years of experience treating varying types of facial hyperpigmentation in the world’s most discerning men and women. She has been consistently voted as one of the best cosmetic dermatologists in NYC by Castle Connolly, the New York Times, New York Magazine, and Super Doctors due to her expertise and dedication to her patients. An expert in cosmetic and medical procedures such as dermal fillers and skin biopsies, Dr. Green customizes each patient’s treatment plan to meet their particular needs and goals. If you are struggling with melasma, post-inflammatory hyperpigmentation, sun spots, sun damage, or other forms of hyperpigmentation, Dr. Green is here to help. To schedule a consultation to treat your facial hyperpigmentation, please contact us online today or call our New York City-based office at 212-535-3088.