Uneven Skin Tone: Hyperpigmentation vs Hypopigmentation

Are you tired of investing money into your skincare ritual only to be disappointed by uneven skin tone and a blotchy complexion? We get it; trying to combat hyperpigmentation and not having the results to show for it can be disheartening. 

Whether it’s caused by excessive sun exposure, genetics, acne, scarring, or hormones, there are various underlying reasons why your skin might not be playing fair in the pigmentation department. 

Want to learn more about hypo- and hyperpigmentation causes, characteristics, and treatment options? You’re in the right place. In this article, we will explore the world of pigmentation and how to identify and correct uneven skin tone.

Pigmentation refers to the colour of your skin. Simply put, skin colour is determined by melanin (also known as pigment), produced by cells in the skin known as melanocytes. The exact amount and type of melanin will determine each person’s skin colour; genetics, sun exposure, hormonal changes, and medication can influence this. 

According to the Cleveland Clinic, those who produce more melanin will generally have a darker skin tone, eyes, and hair than those with less melanin, who typically are fairer and lighter in colouring. 

What exactly does melanin do? In addition to influencing your colouring, melanin also plays a vital role in skin health by protecting your skin cells from DNA damage caused by harmful UV sun rays. 

Melanin absorbs harmful rays—such as UVA, UVS, UVC, and blue light—and redistributes them in your skin’s upper layers to help keep you protected. However, it isn’t enough to keep you safe from sun damage.  

[Read Full Article: What Causes Skin Pigmentation and How Can You Correct It?]

While pigmentation refers to the colour of your skin, there are names given to abnormal melanin production, known as hypopigmentation and hyperpigmentation. These two are the culprits behind uneven skin tone. 

As the name likely suggests, hyperpigmentation refers to an overproduction of melanin, resulting in excess pigmentation visible in certain areas of the skin. This will generally make your skin appear patchy and darker in certain regions. 

On the other hand, there is another type of abnormal pigmentation known as hypopigmentation. This refers to a loss of skin pigmentation, characterised by patches of lighter skin. 

As previously mentioned, hyperpigmentation refers to skin that has produced excess melanin, resulting in patches of darker skin. There are a few different types of hyperpigmentation, including:

• Melasma: This form of hyperpigmentation is suggested to be caused by hormonal fluctuations. Thus, it is more commonly seen in pregnant women, during menopause, or for those taking medication that affects hormones. While it can be present anywhere on the body, most people experience it on their face or stomach. 
• Sunspots: This form of hyperpigmentation, also known as liver spots, is due, as the name suggests, to prolonged sun exposure over time. Most commonly, sunspots are more prominent on the hands and face, as these are areas generally most exposed to the sun. 
• Post-inflammatory hyperpigmentation (PIS): This hyperpigmentation occurs due to skin inflammation or trauma, which causes scarring. Most commonly, it results from acne.

[Read full article: Know Your Skin: The Beginner's Guide to Understanding Acne]

From your genetics to your environment, several factors influence how much pigment is in your skin and whether or not you’ll experience balanced pigmentation or an uneven skin tone. 

Let’s take a closer look at the various factors—in and out of your control—that may be impacting your skin’s tone and complexion without you even realising it. 

Unfortunately, some things are out of our control, and your skin’s pigmentation is partially one of them. To an extent, your skin’s natural colour and any pigmentation abnormalities will be largely determined by your family’s genetics. 

While there are always tips, tricks, and products we can use to help minimise the effects, it’s important to note that the cause may result from something entirely out of your hands. Let’s take a closer look at how genetics can dictate your skin tone’s evenness:

• Skin Types — Generally speaking, people with darker skin tones are believed to have higher levels of melanin and more active melanocytes. Due to this, they may be more susceptible to experiencing hyperpigmentation, such as melasma or Post-Inflammatory Hyperpigmentation (PIH). 
• Hereditary Conditions — Studies have shown that certain hyperpigmentation conditions are more likely to run in the family. You’re more likely to experience conditions such as melasma or age and liver spots if someone in your family has them. Pigment-related genes — such as those associated with red hair and fair skin — can also dictate your skin’s pigmentation and susceptibility to hyperpigmentation. 

[Read Full Article: How to Determine Your Skin Type: The Ultimate Guide]

Unlike your genetics, this one is completely within your control! Did you know that overexposing your skin to UV rays (or tanning beds, for that matter) can result in hyperpigmentation? 

Melanocytes are the cells that produce melanin, which is the pigment that gives your skin colour. As previously mentioned, melanin helps protect your skin cells from UV damage caused by sun exposure. 

However, UV radiation stimulates melanin production to defend and protect your skin against harmful rays. This is what causes some people to experience a tan when exposed to the sun. While this may look nice, the excessive exposure to sun can result in hyperpigmentation as melanin production increases and accumulates. 

This overproduction of melanin over a prolonged period can show itself as age spots, characterised by brown, flat spots on the skin, and melasma, characterised by blotchy, brown pigmentation. Plus, did you know that freckles are also a form of hyperpigmentation? 

One lesser known area is post-inflammatory hyperpigmentation (PIH). This condition—characterised by dark spots on the skin in areas that have been injured or inflamed, such as acne, eczema, or scars—is worsened by the impact of sun exposure. 

Ongoing UV damage worsens and darkens these spots by encouraging melanin production in inflamed areas of the skin. 

Hormonal imbalances — caused by certain diseases and thyroid disorders — and hormonal shifts — like those caused by pregnancy, birth control, or hormone therapy — are known to cause melasma. 

Why does this occur? It is believed that increased levels of oestrogen and progesterone may increase melanin production by potentially enhancing melanocytes’ sensitivity and reactivity to UV exposure. As a result, you are more likely to experience melasma when pregnant or taking birth control. 

It’s important to note that other conditions and hormones caused by thyroid hormones, androgens (e.g., testosterone), melanocyte-stimulating hormones, and prolactin are all suggested to influence melanin production, with changes potentially making you more susceptible to skin pigmentation, namely melasma.  

As aforementioned, PIH occurs when your skin produces additional melanin after it has experienced irritation or injury. Simply put, this process is your skin’s response to damaged or irritated skin, and is often characterised by brown, dark brown, or blue-grey patches of skin.

Several different types of irritation or injury can cause this. While acne and eczema are among the most common causes, some skin will endure the same reaction from infections, bites, burns, rashes, psoriasis, and allergic reactions.

While anyone can experience post-inflammatory hyperpigmentation, research does suggest it is more prominent in people with darker skin.

[Read Full Article: Acne Skincare That Works: Dr Tanya’s Top Tips for Acne-Prone Skin]

Other reasons outside the four prominent reasons above may result in hyperpigmentation. Other causes may include:

• Medications—Certain medications, including some types of antibiotics, chemotherapy drugs, and anti-seizure medication, are suggested to cause changes in skin colour. 
• Nutritional deficiencies — If you’re deficient in certain minerals and vitamins linked to a reduced intake of meat and vegetables, like Vitamin B12, you may be more susceptible to hyperpigmentation. 
• Health conditions and diseases  — Bacterial and fungal infections, autoimmune diseases like Lupus, and diseases like diabetes can all result in hyperpigmentation. 

Simply put, hypopigmentation occurs when your skin cells do not produce enough melanin. 

As we’ve already delved into, melanin is what gives your skin pigment. Too much of this, and you’ll experience hyperpigmentation, characterised by patches of darker skin. Too little of this, and you’ll experience hypopigmentation, which presents as areas of lighter skin, including small patches over your body or your entire body. 

Scars most commonly cause hypopigmentation, but it can also result from rare genetic conditions and skin disorders. Let’s take a closer look below. 

Most people will experience hypopigmentation due to injuries that have caused scarring — including burns, infections, blisters, and exposure to chemicals. 

As a result of the natural healing process, scars will form, which may cause the surrounding skin to lighten. 

Certain genetic conditions are characterised by patches of lighter skin over sections or the entirety of one’s body. Thisincludes:

• Albinism: This condition occurs when someone is born with lower melanin levels. Albinism most commonly presents as extremely pale skin, light eyes, and white hair. However, this isn’t consistent across all cases. 
• Vitiligo is a condition in which the body’s immune system attacks and destroys melanocytes (the skin cells responsible for producing melanin). As a result, the skin turns white because there isn’t enough melanin to produce darker skin.  

Similar to how injuries and scarring result in hypopigmentation, certain skin disorders and infections result in lighter patches once healed. Some of the most common skin disorders and infections include the following:

• Pityriasis Alba: This condition is characterised by scaly patches on the skin. While the scaly skin isn’t technically considered hypopigmentation, what occurs once it is healed is. Generally speaking, once the scaly skin has subsided, hypopigmentation is visible on the affected skin. 
• Dermatitis: Also known as eczema, dermatitis is a skin condition characterised by itchy, red patches over different areas of the skin. Once healed, the patches may become white. 
• Tinea Versicolour is a type of fungal infection that occurs when yeast is overactive on the skin. It most commonly affects people living in tropical or subtropical areas. 

While not all forms of hyper or hypopigmentation have quick fixes, several causes can be treated or avoided from the comfort of your own home. Let’s quickly touch on a few of the areas within your control: 

No amount of skincare will outperform minimising sun exposure. Preventing sun damage is, without a doubt, the most effective way to prevent and lessen the severity and appearance of hyperpigmentation.

Wondering why exactly? The sun is the number one leading cause of hyperpigmentation. When exposed to the sun, your skin produces more melanin to help protect itself from the harmful effects of UV rays.

While we understand that avoiding the sun altogether is unrealistic in our Australian climate, there are plenty of ways to be more thoughtful about it. For example:

• Sunscreen: Get serious about your sunscreen usage, adding a broad-spectrum SPF50+ to your daily skincare routine. 
• Outdoor time: Where possible, be selective about what times you’re outdoors basking in the sun. The hottest and most damaging part of the day is between 10 a.m. and 2 p.m. We recommend planning outdoor activities outside of these times for maximum protection. 
• Wear protection: Equip yourself for the outdoors with a hat, sunglasses, and a long-sleeve shirt to help protect your skin. 

Many over-the-counter skincare products can be added to your skincare ritual to help minimise the presence and appearance of pigmentation. 

Various skincare products on the market are designed to help minimise uneven skin tone, from encouraging cell turnover to help shed pigmented cells to inhibitors of tyrosinase (the enzyme responsible for melanin formation). 

While hyperpigmentation should be looked at on a case-by-case basis to understand the root cause, generally speaking, the following products and ingredients are suggested to be particularly beneficial for treating it:

• Acids: AHAs, kojic acid, salicylic acid, and azelaic acid. You'll find these in Dr Tanya's Radiant Day Cream and Miracle Cream Cleanser. 
• Retinol (like Dr Tanya's Advanced Retinol Serum) 
• Vitamin C (like Dr Tanya's Super C Serum)
• Niacinamide (found in Dr Tanya's Miracle Cream Cleanser, Radiant Day Cream, Eye Lift Tightening Serum, and Night Repair Serum)

[Read full article: 2024’s Best Face Products for Pigmentation]

As always, we recommend seeking professional advice from a skin consultant to ensure you’re using the right products to maximise your results and avoid skin damage. 

Some types of pigmentation may require a more involved approach that combines topical treatments with in-clinic procedures. 

Treatments such as chemical peels, microdermabrasion, skin needling, and laser therapies are shown to be particularly beneficial in treating uneven skin tone, particularly different types of hyperpigmentation, such as melasma. 

However, it’s important to note that skin procedures for hyperpigmentation can do more harm than good if not conducted by a professional. 

At Dr Tanya Cosmetic Clinic, our experienced team of trained clinicians and qualified doctors specialise in advanced skin procedures to deliver quality services and exceptional results. To enquire about our pigmentation treatments, please contact our team today.