What exactly is hyperpigmentation, and how and why does it occur?
The pigment producing cells or melanocytes of the skin are not evenly distributed but are present in everyone in the skin. They get excited to grow and produce pigment or melanin, when exposed to ultraviolet radiation (the sun), heat, inflammation and with hormonal changes. The melanocytes are there to actually protect the skin from such damage, so they get bigger, this can be seen visually on the skin as darker areas of skin.
2. Are there any common myths or misconceptions about hyperpigmentation that you’ve encountered as a dermatologist?
The biggest myth or misconception in all skin types when treating hyperpigmentation, is that once treated, it will not come back. Treatment of hyperpigmentation is typically ongoing, as those melanocytes are there under the skin, and can always get excited and get bigger again. It is a very important concept to explain to patients, as it can be quite disheartening to get the desired results and then have the pigmentation come back, due to not wearing sunscreen etc.
3. What can you do to try and prevent it? The most important prevention of hyperpigmentation is to use a good physical sunblock of SPF>30. These products, bounce UV radiation off the skin and prevent the melanocytes from getting bigger. Using sun protective clothing/hats and behaviors is also preventative. If one is prone to hyperpigmentation and getting a procedure done that will likely cause hyperpigmentation, such as a chemical peel or surgery, then using a pigment lessening agent to the area pre and post procedure in combination with sunblock can prevent hyperpigmentation from occuring.
4. How do you treat hyperpigmentation? Pigmentation has been treated for decades with ingredients that shrink the melanocytes, and prevent them from making melanin. This is most commonly done by inhibiting a tyrosinase pathway. Hydroquinone is the most common ingredient in the world that has been used in the world to do this. I can be used in a range of concentrations from over the counter to prescription strengths. It is very effective, however can lead to complications when used over a long period of time , one of which is irreversible hyperpigmentation. This ingredient has been banned in most European countries and states in the US.
There are safer ingredients on the market that can achieve the same results as hydroquinone, without the side effects, such as kojic acid, licorice, azelaic acid, L-ascorbic acid, arbutin, and tranexamic acid. They can when in combination or alone, help decrease hyperpigmentation, especially if combined with retinol or bakuchiol.
5. What ingredients should people dealing with hyperpigmentation look for in their skincare products? see above.
Products with an SPF >30 should be used in the am at all times.
6. Can you explain the process of how you came to develop the ingredient llluminotex? Being a POC dermatologist in Memphis TN, I very quickly became a skin of color expert in the community. Hyperpigmentation is a common skin issue in POC. The biggest issue with hydroquinone, which was the only rx I had to treat this, is the safety, and hyperpigmentation by nature is a chronic treatment - usually for life. The need to develop a safer and efficacious non-hydroquinone serum became apparent to me very early in my practice, and that is when I set up my lab to develop and patent Illumniotex. lluminotex™ is as
I.IIlluminotex™ key ingredients
Vitamin C
Kojic Acid
Niacinamide
Sodium Hyaluronate
Licorice Extract
Tocopherol
Retinol
Illuminotex™ offers a gentle and hydroquinone-free skin-brightening alternative to target stubborn skin pigmentation problems.
The key here was to blend the ingredients in the right concentration and vehicle so as to give the same results in as prescription strength hydroquinone, without the side effects. This ingredient is also in the Visha Skincare Mommy Brightener, but the salcylic acid has been replaced with more azeleic acid, so as to make the product safe to use in pregnancy and nursing.
7. Are there any products or ingredients that people dealing with hyperpigmentation should avoid?
Overly inflammatory or irritating products should be avoided if you are treating hyperpigmentation. Ingredients such as benzoyl peroxide, high concentration Retin A, or high concentration acid peels can make the skin red, and that in turn can result in increased hyperpigmentation.
8. Are there any skincare routines or treatments--other than using the correct products--that work especially well for people who deal with hyperpigmentation?
When monitored closely under a board-certified dermatologist, most in office procedures such as chemical peels, microneedling and lasers can be done safely in those with hyperpigmentation, there just needs to be strict pre and post treatment care with lightening agents. Series of light chemical peels performed and monitored closely by your dermatologist, in my experience seem to augment treatment with topicals. Oral treatment with tranexamic acid is also an option in extreme cases.