So the rain has lifted, the sky is clear and your breakout is over—life is peachy. Or not. Acne can sometimes leave you with a dark mark that’s even more persistent than the damn spot in the first place.
If acne scarring is the textural aftermath you see on your skin after dealing with a bout of breakouts, acne-related hyperpigmentation is the discolouration or dark mark. It affects some skin more than others—it’s more common for people of colour with darker skin.
Those same things that make people more predisposed to hyperpigmentation can impact what treatments are suitable for them… we got that double whammy, yeehaw.
Syrup chatted with specialist dermatologist Dr Philip Tong MBBS (Hons) PhD FACD and member of All About Acne, who has a particular interest in the management of acne and acne scarring as well as Asian aesthetics to get the info about all things hyperpigmentation.
What is hyperpigmentation?
When we’re talking about hyperpigmentation in regards to acne, what’s usually being referred to are the darker marks that remain after the acne has gone. This type of hyperpigmentation is called ‘postinflammatory hyperpigmentation’ can occur after any inflammation or injury (acne and other things that damage the skin, like mosquito bites or scratches) to the skin.
This happens because as well as the inflammation or acne-causing a reaction from immune cells in the skin, immune cells can also affect the pigment-producing cells.
Research shows that while this can happen to all skin types, it more frequently affects people of colour including people of African American, Hispanic/Latino, Asian, Native American, Pacific Islander, and Middle Eastern descent.
Why are some people more affected by hyperpigmentation than others?
Basically, it boils down to your cells.
“Hyperpigmentation is basically what we see on the skin. The cells that produce skin’s pigment are called melanocytes and it’s due to these producing pigment and depositing it into the top layer of the skin that causes hyperpigmentation,” explains Dr Tong.
While research shows that most people have roughly the same number of melanocytes in their skin, regardless of their skin colour, the size, spread and tint of the melanin that those melanocytes produce can vary.
“It’s not that certain people have more of them it’s that they have the type of pigment within them produce hyperpigmentation,” says Dr Tong—that is brown tinted pigment.
On the other hand, “Caucasian skin types do have melanocytes but they produce a different coloured pigment, a red tint. It’s not necessarily an increased number of pigment-producing cells, so much as it is the cells themselves that are producing differently coloured pigment. Therefore, postinflammatory hyperpigmentation look different between different races”
Can you prevent hyperpigmentation?
When dealing with hyperpigmentation, Dr Tong stresses that while general lifestyle factors are important for minimising potential damage and dark spots—like the consistent use of sun protection, that doesn’t mean they can be prevented entirely. Keeping skin clean, well-moisturised and sun-protected goes a long way, as well as treating any damage like scratches, acne bumps and spots and cuts quickly and carefully.
How do you treat hyperpigmentation?
There are maaaany different ways to treat postinflammatory hyperpigmentation, especially if you’re going down the topical skincare route—I know because I’ve tried nearly every single one.
Your first port of call when treating, and just as importantly, trying to prevent and minimise hyperpigmentation is a good sunscreen. Daily sunscreen use helps protect the skin as it goes through its healing process and will help prevent a pigmented spot becoming darker. You basically want to protect the spot before, during and after the acne is active because sun exposure can exacerbate or ‘set’ the hyperpigmentation. And also… you should be wearing sunscreen every day anyway, geez.
Topical treatments are something Dr Tong commonly prescribes to treat hyperpigmentation, and you want to be looking for products that either inhibits tyrosinase (the enzyme responsible for the rate of melanin production) or ones that contain depigmenting or brightening ingredients.
Some common ones active ingredients to keep an eye out for are retinoids (Vitamin A), ascorbic acid (Vitamin C), niacinamide (Vitamin B3), azelaic acid, kojic acid, arbutin.
Dr Tong also explains that there are certain procedures, such as chemical peeling and laser therapy, that can also help treat hyperpigmentation, however people of colour need to tread carefully here.
How do you treat hyperpigmentation as a person of colour?
The last thing you want to do when dealing with hyperpigmentation is to create more issues while trying to fix it. While many of the topical skincare products and ingredients mentioned will be generally beneficial to everyone, people of colour should take particular care with certain in-office procedures, according to Dr Tong.
“There are certain laser devices I would caution on using on darker skin tones, for example, IPL (intense pulse light). I’d be very careful with any type of laser than injures the skin, such as ablative lasers. You can use them but you have to treat these patients very carefully and with the right settings.” If you were interested in going down this route, Dr Tong explains that he’d use a topical cream first that stabilises someone’s melanocytes, which then prevents them from producing the packets of melanin and depositing them into the skin. This is, of course, something to discuss in-depth with your skin specialist or dermatologist.
Lead image via Teen Vogue.