Throughout my clinical practice, I have come across many clients with various skincare concerns. “What do you recommend for the dark spots on my face?” is one of the most common questions I got. Evening skin tone and reducing pigmentation are always in trend regardless of age and ethnicity. Before making any suggestion to my clients, gathering pertinent information and medical history that could potentially cause the problem is important.
What are the stimulating factors? / How does hyperpigmentation occur?
Melanocytes are skin cells that produce brown pigment (melanin) which is responsible for our skin color. If melanocytes increase melanin (pigment) production or if the number of melanocytes increase, hyperpigmentation will occur.
Medical condition such as Addison disease can cause an increase in production of melanocyte stimulating hormone. Hormonal fluctuation during pregnancy, post skin inflammation (e.g. acne scar, psoriasis and dermatitis) and UV ray exposure (sun) can contribute to increasing pigmentation of skin. Medications such as amiodarone (drug for regulating heart beat), amitriptyline, minocycline (antibiotic), chemotherapy (e.g. bleomycin, cyclophosphamide) also can cause hyperpigmentation.
HYDROQUINONE (HQ) remains an important role. It is a skin bleaching agent that inhibits the production of melanin which gives the skin its color. 4% hydroquinone has been shown to be clinically effective and safe to use.
Glycolic acid commonly added to HQ formulation to help removing dead skin cells and thus improving the penetration of HQ into the skin. HQ cream with sunscreen +/- glycolic acid can be used twice daily or once daily in the morning.