Hyperpigmentation

There are many different types of dark spots and each type requires a different treatment. The four most common types will be discussed. The first type is the spot that started at birth or in childhood. These are called “nevi”. The pigment in the nevi is very deep and typically requires laser treatments. The second type of dark spot is the “lentigo”. These spots usually appear on the face and arms and are the result of sun exposure. These spots can also be deep, so a combination of laser treatments, chemical peels, and topical medications is necessary. The third type is “melasma”. This type is also called “the mask of pregnancy” because it appears shortly after pregnancy as a result of hormonal changes and occurs on the face in a mask-like distribution on the cheeks. Finally, the fourth type is called a “seborrheic keratosis”. This type occurs with age and can occur more frequently in areas of sun exposure. The seborrheic keratoses can be flat or bumpy like a wart. These can be removed with special instruments that scrape and burn them off.

Dr. Lin has developed a customized program designed to help most people out with their dark spots. This program can lighten or remove dark spots and even out the skin texture.

Dr. Lin combines multiple treatment modalities, which include chemical peels, topical medications, and laser treatments. Dr. Lin uses beta-hydroxy acid as a peeling agent to begin the process. The peel removes the top layer of the skin and allows the whitening topical medication to penetrate deeply. The next step is the topical medication. These medications were developed by Dr. Lin as a total skin care regime to remove dark spots. Throughout the treatment course, the patient’s progress will be monitored and treatment will be tailored to the patient’s needs during the treatment course.

If dark spots are especially deep or thick, Dr. Lin may use a laser, liquid nitrogen, or special instruments to remove the spots. The laser works by targeting the dark pigment in the spot and destroying it. The liquid nitrogen works by freezing and destroying the cold sensitive pigment cells. The special instruments work by physically scraping off the surface of the dark spot and burning the base.

Dr. Lin also works with the Profractional and Matrix lasers, which have dramatically improved the treatment efficacy in certain skin types’ pigment disorders. The laser selectively treats certain portions of the skin, allowing the surrounding skin to heal around the treated skin areas. This reduces the risk of scarring, hyperpigmentation, and the length of downtime.

The foundation for a long-term treatment plan for hyperpigmentation is a good skin care regimen. A vitamin C cleanser and moisturizing sunscreen with broad-spectrum SPF coverage of 30 or higher is beneficial. A hydroquinone based bleaching cream to lighten the skin is the most effective method to rapidly lighten the dark spots. There is some controversy requiring the safety of using high dose hydroquinone, so we try to minimize the use. Adding chemical peels, microdermabrasion, intense pulsed light, and lasers can help improve the hyperpigmentation faster.