The struggle in the battle with hyperpigmentation is a raging war that seems to never end. There are so many factors that determine how we get these darkened stains/spots, but two most common causes which we deal with regularly are Post Inflammatory Hyperpigmentation (usually caused by a pimple or acne), and Melasma (caused by hormones and excessive sun damage).
Most acne sufferers should be relieved to learn that Post Inflammatory Hyperpigmentation is not scarring. Given a little time, PID should eventually fade, even without treatment. Note that it can take three to 24 months for PIH to fully fade, however it may take longer in a few cases. The actual length of time it takes for PIH to fade depends on how dark the PIH macule is compared to your skin tone. (The bigger the contrast between the macule and your natural skin tone, the longer it will take to fade.)
Although there are treatment options available to help fade post inflammatory hyperpigmentation more quickly, your acne should be under control before beginning any treatment for PIH. Otherwise, each new pimple could cause another PIH macule, reducing the effectiveness of treatment.
Whatever treatment option you choose, understand that improvement will take time. Think in terms of months rather than weeks. Also, many dermatologist recommend using a broad-spectrum sunscreen daily. The sun may darken the discolorations and increase fading time
Melasma is hormone-related hyperpigmentation caused by increased hormone stimulation. It is most commonly experienced by women who are pregnant (which is why it’s also known as the “mask of pregnancy”) or taking contraceptives, but can also be caused by cosmetics or medications.
The most common pattern of melasma is centrofacial: on the chin, upper lip, cheeks, nose, and forehead. But it can also show up to a lesser extent on the cheeks, nose, and jaw line.
Studies suggest up to 75% of women may develop melasma during pregnancy and about 33% of women on oral contraceptives show symptoms as well. However, once hormonal fluctuations subside, such as the end of pregnancy or the discontinuing of oral contraceptives, the hyperpigmentation often disappears.
Excess sun exposure is also a strong risk factor for melasma. The condition is particularly common in tropical climates.
Creams containing a combination of tretinoin, kojic acid, and azelaic acid have been shown to improve the appearance of melasma. Occasionally, your doctor may recommend chemical peels or topical steroid creams. In severe cases, laser treatments can be used to remove the dark pigment.
Avoiding the sun and using sunscreen are key to preventing melasma.