How To Treat Hyper-pigmentation

Hyper-pigmentation (aka “dark spots”) is something I’ve struggled with for years, so in this post I want to teach you different ways I combat it and how I've learned to treat it.

When it comes to hyperpigmentation, this is really a sore topic for a lot of people, because, well, it's your face! It's annoying when you have uneven skin tone or you feel like your skin is a little bit dull or not as bright as it should be. So, I want to go through all sorts of ingredients, starting with the strongest to the most natural, teaching you different ways each combat it.



First, let's just talk about what hyperpigmentation actually is. It's basically an over-formation of melanin. Melanin is formed when you're over-exposed to the sun. Sometimes we want melanin (also known as a suntan) so when you're laying out and your skin gets dark, that's also a form of melanin. Unfortunately, we can't control how it forms, how dark it forms, or if it's uneven in some spots, so in a perfect world, we just get a perfectly even, nice tan. However this is not always realistic. Especially for those of us with olive skin - we are even more prone to sun damage and hyperpigmentation!

You can also get hyperpigmentation from other things besides the sun, too. Just general aging, melasma, and hormone imbalances can lead to a little discoloration in the face. In fact, a lot of pregnant women experience dark patches on their skin, as well as women on birth control (because birth control is just hormone manipulation). When there are higher levels of estrogen sometimes you can get these dark spots.

And lastly, it can be caused from acne. Sometimes you'll notice wherever you had a really bad breakout (especially with things like cystic acne) it can leave a dark spot. I know when I was in college and studying for my boards, I just had the worst skin. I was eating a lot of dairy, I was really stressed, I wasn't getting enough sleep, and I had bad cystic acne like all along my jawline and my cheeks. Then, once I finished, the acne went away but I had dark spots forever, and that's kind of my first experience with hyperpigmentation and how to treat it.

You can tell the difference between an acne spot, sunspot, and that versus melasma or an age spot. Melasma tends to be a little bit bigger and sometimes it appears in patches (versus smaller spots).

So, with all that said, let's talk about the different ingredients, what you can use, and how to actually apply these things to your skin. The first thing you should do before applying any kind of topical medication, skincare product, or anything is to have a freshly cleansed face.

I always like to mix cleanser in my hands first, and when you're cleansing, just make sure it's always gentle. On your skin, gentle is always better. Sometimes, you’ll think you have to really rub, especially if you're exfoliating, and that if it hurts it's better, but that's just not true.

I like using a washcloth to get the cleanser off my face. Sometimes I'll just dampen it a little bit. Water just doesn't always do the trick, but if you are using a washcloth just make sure you're very gentle. Again, that's a general theme with skincare.

I don't know about you, but for a lot of women, I'm sure as soon as you cleanse your face the first thing you want to do is put on moisturizer. It's almost like your skin just needs it. My skin just kind of dries up unless I put moisturizer on. But the important thing is to use the active ingredient first, so whatever you want to have the most effect on your skin, you have to use first before layering over other ingredients, because the more layers you have under it, the less effective it's going to be.



The first thing I'm going to start with is hydroquinone. A lot of times, you will get this compounded at a pharmacy because you can pick what strength you want or what you want to mix it with. So it's not the prettiest, but it still works.

A lot of people have issues with hydroquinone because there were some studies done that showed a lot of side effects that came with using it.

Here's my take on that whole topic: if you actually look at the products that were used with the hydroquinone, some of it was mercury, some of it was glucocorticoids... those ingredients could have been causing the side effects. So it's not 100% that it was the hydroquinone causing it.

On top of that, it all depends on how much you use, how it's formulated, and how often you use it. So if you talk to your doctor and you find a dose and concentration that's right for you, you should be fine. I personally use it myself and I'm okay with it, but of course that's up to you.

Hydroquinone is the gold standard for hyperpigmentation. We're going to go over a lot of different products here, but this is definitely the best one, and nothing will work quite as well as this. The only thing above hydroquinone is going to be a laser IPL or something like that that's much more harsh.

Some medications or some ingredients that we'll get into are a little more gentle, so I would recommend putting them all over your face, but with hydroquinone I would really recommend just doing spot treatment. Unless you have really huge areas of melasma, I like to use as this spot treatment just because it is a little bit stronger.

You don't have to worry about the efficacy of hydroquinone because it does work. There's a lot of data showing it does work so it's a really great one. Again, talk to your doctor about maybe compounding something that works for you.



The next thing I want to talk about is ferulic acid. I love ferulic acid. This is an antioxidant, it's found in different plant cell walls, it's found in oats, it's actually a really amazing ingredient and it has so many benefits.

But the cool thing about it is that it works even better when it's combined with vitamin C and vitamin E. On its own, it's great, but its effects are just enhanced when it's combined with these two. This is called synergy, so when used together they work really well.

There's a couple different companies that have this product. SkinCeuticals has one that i used to use, though I don't think that SkinCeuticals is cruelty-free, so I kind of stopped using their skincare products. But Drunk Elephant is cruelty-free and they have one too, like their C-Firma Day Serum.

Studies have shown that the different concentrations that work with these ingredients are about 15% vitamin C, 1% vitamin E, and like .5% ferulic acid, so when you're looking at products, look out for these numbers because another thing to think about when you're looking at products is even if the ingredients are listed in there it all depends on the concentration,. If there's only like 1% vitamin C, it might not be as effective. Look for those three numbers.

Not only does this help with photo protection, which is an actual biochemical process where your skin is fighting the damaging effects of the sun, but it just helps brighten your skin overall.

This is something to consider when you're using one of these products. If you just solely want to focus on hyperpigmentation and that is your thing, hydroquinone would be a better answer. But if you want to do like 50% hyperpigmentation and the other half you want to focus on just overall skin health and anti-aging, then something like this would be a good idea.

You can also use both in the same day or even alternate sometimes, so this is also something you can talk about with your doctor. With serums, this should always be your number one or number two step because they're thinner.



I also want to talk just about vitamin C on its own for a quick second. Vitamin C on its own is a really great ingredient. I feel like that's something a lot of people know, that eating citrus foods with vitamin C can help brighten your skin, so it's something that I recommend using regardless.


Even if you don't have hyperpigmentation, I would say to still use vitamin C. The cool thing about that is not only do the antioxidant effects brighten your skin, but it also helps you form new collagen. Whenever you have new collagen, you have fresh new skin cells that are forming, and new skin is never going to contain sun damage.


So, vitamin C is also something I highly recommend putting under your eyes to brighten up dark circles. It can help build collagen under your eyes, so you get less loss of volume and maybe less wrinkles and fine lines under your eyes. It’s something you should be adding in either way.



The next product I want to talk about is retinol, and this could be retinoic acid and it comes in so many different brand names. Retinol and retinoic acid are skin cell communicators, so what this means is they help your skin cells function at the best, highest level they can.


Honestly, there are receptors all over your body. That's how medication works and it's how our body functions, so when retinol hits these receptors that helps them function better.


Basically, as you age, nothing is working quite as well as it used to. Things start to slow down and your retinoid receptors start to get a little bit erratic, meaning they don't do as much cell turnover, there's not as much collagen being formed… so when you use a retinol or retinoic acid this is basically just going to help your skin cells function better.


It can help with clogged pores, it can help with acne, it can help build more collagen. So, really, when you're doing this and, again, more skin cell turnover and more collagen are being produced, it's just going to help your overall skin texture and pigment in general.


Again, apply a thin, even layer over your skin. If you are layering products, wait a good few minutes in between, so that one can get absorbed and it's not sitting as a thick top layer on your skin.


I think retinols are amazing. They're great for anti-aging, there's so much data to show how much collagen they help produce, so this is something you should add into your regimen.


It can make you peel, which is why a lot of people think that retinols are an exfoliant, but they're actually not. It's just that if you're using it too often, they can be a little stronger and then your skin might start to peel from irritation. But don't be fooled, because it's not an actual exfoliant. You could even use this in combination with any of the other ones here. You'd just have to work with your doctor to figure out the best regimen for you.



Speaking of exfoliants, the next thing I want to talk about is alpha and beta hydroxy acids!


These, actually, are exfoliants, so these are just going to work gently under your skin to replace old skin cells and dead skin cells. With this, it's a common theme that you're just going to have fresh, new skin that's forming.


A lot of people use retinol and AHA or BHA in combination, and hyperpigmentation or not, it's just going to give you a really great glow. For alpha hydroxy or beta hydroxy, this is something I really like using at night. I think it does its job over night and I just don't like having it on during the day. If I'm going in the sun, sometimes I just think it makes my skin a little more sensitive, so this is one that you can actually apply all over your skin. I think it's a little more gentle.


When it comes to most skincare products, usually I would say to bring it down to your neck, chest, and/or shoulders, but when it comes to these medicated ones, 1.) they're pretty expensive, so you can't be putting it all over your body, and 2.) I just feel like putting them in concentrated areas is better. If I'm using something more gentle and nourishing, then for sure I'll put it everywhere I can, but for these I just like to stick to target areas.



Now that we've gotten the medicated and stronger ingredients out of the way, I want to go into two different natural product lines that I think could help. The first one is Sulwhasoo.

So, I talk about Sulwhasoo a lot. The one I normally use is their standard line, but they also have one that's called the Snowise Collection, and this is specifically meant to help brighten skin, to get rid of uneven skin tone, and to just help you have a more even overall complexion. They have a serum, they have a face cream, they have a whole line just for the Snowise Collection you can try.

This is a much gentler approach. I'm not saying that it doesn't work, but it's just going to take longer. If you don't have that much hyperpigmentation but maybe you just feel like your skin is a little bit dull, maybe using like a vitamin C and Sulwhasoo would be the best choice for you.



There is one more product line I want to introduce you to. This one is called Yon-ka Paris.

The hero ingredients in this are vitamin C, vitamin A, and vitamin E, and retinol is really just a form of vitamin A, so you can see why this works. There's actually a lot of great data on Yon-ka that shows after eight weeks of continued use anywhere from like 30-50% reduction in dark spots and brightness.


I actually haven't fully experimented with this, but this is also a little bit more of a gentler product. This whole line is really dedicated to brightening your skin, so I'm excited to check it out. The data and all the ingredients look really great so it's something I definitely consider.


Yon-ka Paris also has this kind of invigorating mist. If you were going to use this product I would say to cleanse first, then do the mist all over your face. It works as a toner but because it's water-based, that's technically the thinnest ingredient and we always go thinnest to thickest.



Lastly, we've got lemon. If you really, really want to go the natural route, lemon is something that people have been using for years. Its natural acidity can have a lightening and whitening effect, so if you just don't want to do these ingredients, lemon can definitely help.

I would recommend washing it, cutting it, squeezing it on like a cotton pad or a gauze pad, and just applying it to your face. It can dry you up a little bit so definitely follow up with a moisturizer.

So we've covered the strongest to the most natural here. Of all the ingredients that are out there, these are what I've seen work the best, and I think they are things you should consider if you're trying to battle hyperpigmentation or dark spots.

If you have any questions, please leave them in the comments!


Dr. Mona Vand