Dark spots, sun damage and melasma are some of the terms used when referring to those stubborn little marks that appear on your skin because of sun exposure, scarring, pollution and pregnancy.
Particularly for people with darker complexions, those so-called blemishes can be tricky to lighten or entirely remove.
"A lot of what we do involves lasers and heat, which can lead to more pigmentation," says Dr. Carlos A. Charles, a New York City-based dermatologist whose practice, Derma di Colore, focuses on the treatment of darker skin, about eliminating hyperpigmentation. "People will typically approach darker skin with a lot of hesitation and with good reason."
Hyperpigmentation or discoloration can be a manifestation of factors, including trauma from injury, acne scarring, hormones or sun exposure, and is essentially the result of inflammation in the skin.
"The pigment cells rev up after any trauma and leave dark skin, post-inflammatory hyperpigmentation," says Charles. "It's more common in darker skin, probably because the pigment cells are more robust. When treated too aggressively or not correctly, hyperpigmentation can come back with a vengeance."
Also, a blemish or dark spot on the skin can return if sun exposure is not limited, and heat or hormones can continue to aggravate inflammation. "Melasma, specifically in and of itself, is a chronic thing," says Joanna Vargas, a celebrity aesthetician with studios in New York and Los Angeles. "In essence, hyperpigmentation is cell mutation just like lines and wrinkles."
Undergoing the correct treatment and avoiding excessive sun exposure can help to keep hyperpigmentation away longer. When seeking out treatment for hyperpigmentation in darker skin, Charles says to try to avoid aggressive laser procedures because lasers use heat, which can cause the discoloration to rebound. Also, avoid very strong peels because they too can worsen hyperpigmentation. "If someone says, 'Skin resurfacing,' I'd be careful of that," he says.
When seeing patients for dark spots, Charles takes a multifaceted approach generally starting with a retinoid to stimulate skin peeling followed by a series of appropriate chemical peels.
This spaced-out method is common among skin professionals, who also address hyperpigmentation in darker skin.
About lightening dark spots on medium to dark complexions, Beverly Hills-based esthetician Sonya Dakar says, "I would definitely say to build up to it — even if it takes six months or a year." Like Charles, she advises staying away from lasers and also to be wary about chemical peels unless you are certain the person doing the procedure is highly experienced with darker skin tones.
Typically, Dakar does a series of nonaggressive treatments, slowly eliminating hyperpigmentation, so there is no adverse reaction and to ensure color is eliminated long term. Her Fade Away serum targets dark spots, brightening and lightening skin through an active ingredient called Belides, which is derived from the daisy flower and is stimulated to work more through increased sunlight exposure.
"Harsh ingredients like glycolic acid and really strong peels can actually thin the skin and make darker complexions even more sensitive to discoloration," says Dakar. "This is a big reason why I'm drawn to Belides and incorporated it into my Fade Away serum since it's gentle and safe enough for everyone to use."
One ingredient Dakar won't use on patients is a common but potentially toxic skin lightening agent called hydroquinone. Usually found in a cream form, some dermatologists treat hyperpigmentation with hydroquinone as a first step. Dakar, however, isn't convinced that using the substance is necessary, considering the possible side effects. "There are all kinds of lightening agents, but I don't turn to hydroquinone because hydroquinone can go through the blood stream to the kidneys, to the liver, and cause liver failure, and you don't want to go to these extremes."
The remedy that most, if not, all skin experts agree upon is sunscreen — and sun protection such as hats, UPF (ultraviolet protection factor) clothing and sunglasses, especially in a sun-drenched environment like Southern California. (Shown here are other products you can try to help hyperpigmentation fade and protect your skin in general.)
"Everyone, across the board, should be wearing an SPF of 30," says Charles. "The zinc and titanium dioxide tend to work better, but often with darker skin, this type of sunblock can be noticeable" because of its opaque, white color. He recommends the brand EltaMD's sunscreen because it is effective but clear and non-chalky when applied to the skin.
Vargas slathers on SPF 50 every day and wears a hat and sunglasses everywhere she goes. However, she reiterates that dark spots or blemishes can quickly return.
"Hyperpigmentation and melasma are about the amount of cell mutation and the amount of sensitivity your skin has to being inflamed," says Vargas. "Some people just have more sensitive skin than others."