Why You Should Be Cocktailing Your Serums to Fight Hyperpigmentation
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In 2006, a study which assessed how the human eye evaluates age was published in Evolution and Human Behaviour. Despite previous assumptions, results showed that uneven skin tone far outstripped wrinkles as a predictor for age. In fact, it could add up to ten to 12 years to someone’s appearance. These results have been confirmed in subsequent trials. The original study was republished by Cosmetics Design Europe in a piece that flagged the area of skin tone as a new category for skincare manufacturers, who had been up until this point focused on concerns like wrinkles.
So began skincare’s hyperpigmentation era, and our appetite for targeted hyperpigmentation solutions has only grown since 2006, with “hyperpigmentation” ranking just below rosacea and blackheads in the most searched terms of the LOOKFANTASTIC 2021 Skinfluencer Report.
Whether described as “dark spots,” “age spots”, “discolouration” or “uneven tone,” addressing hyperpigmentation has become our number one youthfulness skincare goal.
There are plenty of recommended treatments for hyperpigmentation, from ingredients like niacinamide and retinol, to in-clinic treatments. But which of these actually work? POPSUGAR Australia spoke to dermatologists, Dr Cara McDonald and Dr Michelle Rodrigues, about the causes of pigmentation, and why understanding them is essential to successful and safe treatment. Then we checked in with Hannah English, a pharmaceutical scientist and skincare influencer, for an ultimate at-home maintenance program.
Dr Rodrigues (MBBS (Hons) FACD) is a Melbourne-based dermatologist specialising in pigmentary disorders in skin of colour, and founder of Chroma Dermatology.
She says the first thing to understand about hyperpigmentation is it’s not a diagnosis. “Pigmentation is a descriptor,” says Dr Rodrigues, “it describes an area of skin darker than the person’s normal colour.” Dr Rodrigues says she observes a lot of confusion around this in her practice.
“Melasma, for example, is often used [by patients] to describe hyperpigmentation,” Dr Rodrigues says, “but there are well over 45 causes of facial hyperpigmentation.” While all hyperpigmentation occurs when skin cells called melanocytes (which give our skin its colour) are hyperactive, the causes of the injury, from sun exposure to genetic and hormonal factors, are what define the classification. An accurate diagnosis of the cause is essential for effective and safe treatment.
The Most Common Forms of Hyperpigmentation
Dr McDonald, co-director and principal dermatologist at Complete Skin Clinics, says types of pigmentation can often present in specific age groups. The most common in younger to middle-aged women is melasma, which presents as mottled patchy brown pigment on the cheeks, forehead, and upper lip. Melasma is commonly triggered by hormonal factors like pregnancy (sometimes it’s referred to as ‘the mask of pregnancy’) and is exacerbated, like all types of pigmentation, by sun exposure.
In older Australians, particularly those with fair skin, pigmented lesions referred to as “solar lentigines” are seen. “These range from benign freckles to sun-damaged legions called solar keratosis, and malignant legions like melanoma,” explains Dr McDonald.
While we commonly associate hyperpigmentation with fair skin tones and signs such as freckles and moles, Dr Rodrigues says skin of colour (which in dermatology indicates the amount of melanin in a skin type, not an actual shade) is susceptible too. It is the amount of melanin, whether you’re very fair with Chinese heritage or deeper skin toned with African heritage, that makes you more vulnerable to hyperpigmentation thanks to more active melanocytes. This is commonly seen with post-inflammatory hyperpigmentation where even small injuries and blemishes can create hard-to-shift darker marks for some skin types, and leave barely a trace for others.
Treatment for Hyperpigmentation
Both dermatologists agree that the treatment course must be determined by diagnosis. “There is absolutely no one size fits all approach to pigmentation,” says Dr McDonald, “and many clinic treatments [note: a clinic in this context refers to a business that offers skincare treatments like laser or injectables, but is not overseen by a dermatologist] can inadvertently exacerbate pigmentation.”
Dr Rodrigues concurs, saying, “a diagnosis-led approach is essential.”
What is suitable for one type of pigmentation might not be suitable for another. Dr Rodrigues uses the example of picosecond laser, which is an effective treatment for the removal of freckles but a potential disaster for melasma. Meanwhile, a serum isn’t going to do much for solar lentigines.
According to Dr Rodrigues, many treatments seen recommended for hyperpigmentation are very much to be avoided for skin of colour. She explains that skin of colour is more reactive to the environment because of “biological and functional differences” that impact the production of melanin which is why heat treatments, deep peels and light therapies are all high risk.
“There is poor awareness, and patients will say, ‘I’ve had laser,’ we ask ‘what laser’ and they say IPL. IPL is not a laser. It’s a broad spectrum of light and can induce or worsen facial hyperpigmentation,” Dr Rodrigues says.
Dr McDonald adds that she also sees rebound pigmentation with energy-based devices and advises against it. She warns, “micro-needling is not an appropriate treatment for any form of pigmentation as it does not specifically target pigment and can worsen post-inflammatory pigmentation.”
What to Do Instead
While there’s no quick fix for pigmentation, an effective skincare regime including sunscreen will help prevent new discolouration and support a dermatologist-advised treatment program.
“A good skincare regime using vitamin C and strict sun protection is the minimum requirement for anyone experiencing pigmentation,” says Dr McDonald. Ingredients that promote cell turnover like retinol and alpha and beta hydroxy acids can be helpful, although being aware to avoid sun exposure when using ingredients like these is important. “Retinoids and kojic acidare effective at targeting melanin production,” says Dr McDonald.
Hannah English, a pharmaceutical scientist and influencer, says recent trends like “skincycling” or “serum cocktailing” can be beneficial when addressing pigmentation, as you may find your skin needs “breaks” from some of the more intensive ingredients recommended for use.
“Many actives that are designed to treat hyperpigmentation can be stressful for your skin,” she explains, “and when your skin is stressed it can produce excess pigment, which is what we’re trying to avoid.”
English breaks the perfect routine into three steps:
The first is sunscreen and vitamin C.
“Sun exposure is the number one cause of hyperpigmentation. Protecting your skin with sunscreen, seeking shade, and wearing a hat, sunglasses, and protective clothing is your best preventative measure,” she says.
The best advice is SPF50+ and a vitamin C serum under it, like La Roche Posay, Vitamin C10 Brightening Serum ($72). “Vitamin C will neutralise any free radicals generated by the sun while filtering pollution,” English explains.
Secondly, encouraging skin cell turnover will then gradually promote the emergence of fresh skin, and reduce the appearance of discolouration.
“You can do that with a retinol product like the La Roche-Posay, Retinol B3 Anti Ageing Serum $72) which has the added benefit of niacinamide known to even skin tone, or AHAs and BHAs, which you can find in the La Roche-Posay, Effaclar Anti-Acne Salicylic Acid Serum ($60).
“The benefit of both chemical exfoliants and retinol is they help promote collagen production. These are best used at night, as AHAs can increase your sensitivity to sunlight, as does retinol which is not always stable when UV is present,” English says.
“Then it would be best if you also thought about a dark spot serum that will encourage your skin renewal and targetexcess pigment production. Ingredients like vitamin C are both evening and exfoliating.”
Finally, English suggests alternating more active skincare ingredients with products that promote hydration, like the La Roche-Posay, Pure Niacinamide 10 Serum for Dark Spots ($72) which contains 10 per cent niacinamide, along with gently exfoliating HEPES and hydrating glycerin and hyaluronic acid. Niacinamide has been shown to reduce the appearance of hyperpigmentation by inhibiting melanosome transfer (that is, the process that creates the dark spots in the first place).
Dr Rodrigues says ultimately though, the must-not-skip step if you’re looking to reduce and prevent dark spots is sunscreen. She recommends a lightweight sunscreen that will be easy to use.
A note on experts:
Dr Michelle Rodrigues is founder and director at Chroma Dermatology, senior consultant at The Royal Children’s Hospital and an Honorary Senior Lecturer at The University of Melbourne. Dr Rodrigues specialises in pigmentary disorders and pigmentary disorders, dermatology in skin of colour (pigmented, brown or ethnic skin) and laser surgery.
Dr Cara McDonald is co-director and principal dermatologist at Complete Skin Specialists. She specialises in skin cancer prevention and treatment, acne scarring, laser, surgical and cosmetic dermatology
Hannah English is a content creator, influencer and pharmaceutical scientist who specialises in breaking down the science of skincare for a consumer audience. She is the author of Your Best Skin: The Science of Skincare, you can follow her on Instagram and TikTok.