All Things Pigment: Part 1

By Warren B. Seiler III MD

Summer has come and gone, which means our patients have been coming in with a lot of questions about pigmentation. From what causes it to which treatments work best, we’ve heard a lot lately and wanted to answer your questions directly. There’s a lot to unpack on this topic, so we’re doing a two-part blog series — the first covering a bit of background on what exactly pigmentation (and more specifically hyperpigmentation) is and what causes it. Stay tuned for our follow-up blog on the best treatments and products available at Seiler Skin!

What is pigmentation/hyperpigmentation?

We all have different levels of pigment (color) in our skin no matter if your complexion is fair, dark or anywhere in between. Hyperpigmentation is a broad category of concerns and conditions defined by discolored skin, typically with affected areas being darker than your overall skin. Some of the more common forms of hyperpigmentation include sun damage (lentigines), melasma (commonly called hormone/pregnancy mask), and skin discoloration from multiple types of trauma to the skin including burns, scars, incisions, acne and even friction/rubbing.

What causes hyperpigmentation?

Hyperpigmentation is typically injury induced and is the skin’s reaction to some form of external or internal harm. People typically think of sun exposure, burns and acne as the leading causes of hyperpigmentation, but it can also occur due to other common reasons such as hormonal imbalances, especially during pregnancy. It’s important to recognize there’s no one cause and therefore no singular treatment for all hyperpigmentation, which is why a personalized consultation to assess your skin concerns is crucial.

I always wear sunscreen — why do I still experience hyperpigmentation?

Once again, hyperpigmentation can be caused by many factors aside from just sun exposure. The most common mistakes I see with patients when it comes to sunscreen use, however, involves both the ingredients in the product and how often someone reapplies.

Over-the-counter (OTC) sunscreens simply don’t cut it and lack the ingredients needed to protect your skin fully and sometimes even contain unnecessary, harmful chemicals. All sunscreens should be medical-grade and contain zinc to block both UVA and UVB rays. These products also help block out infrared light which commonly causes heat-induced hyperpigmentation. The skin absorbs infrared light that can penetrate into the layers of the dermis, causing damage that leads to discoloration. If you’re looking for a new medical-grade sunscreen or need to restock on your favorite brand, you can easily shop through our online store.

Another thing people commonly overlook is sunscreen application. You should be using sunscreen every single day, regardless of the season, weather or time of day. It’s also important to reapply more often than you think. Let’s say you get ready and put on sunscreen at 7:30 a.m., go on a run, shower and then meet a friend for brunch at 11:00 a.m. By the time you’re sitting down to eat, your sunscreen has already worn off. Reapply on a regular basis, especially when in direct sunlight, to really decrease your chances of hyperpigmentation.

Why am I experiencing hyperpigmentation even if I’ve avoided the sun for years?

Especially living in the South, we tend to think sun exposure has to be from laying out at the pool or spending the day on the lake. I commonly refer to sun exposure as “death by a thousand cuts,” aka the small bits of time we spend in the sun every day add up over time. If you were to walk your dog for 20 minutes a day, twice a day for an entire year, that adds up to more than 240 hours in the sun. You may not experience hyperpigmentation right away, but your skin slowly incurs sun damage over time that can manifest as discoloration years down the road.

Should I be concerned about hyperpigmentation? 

Some hyperpigmentation is a sign of possible skin abnormalities that go beyond just aesthetics. We recommend patients regularly visit a board-certified dermatologist to detect and prevent potential skin cancers, which can be dangerous if left untreated. You should also schedule an appointment if you notice discoloration that seems different from typical hyperpigmentation you may experience.

Next Series: All Things Pigment: Part 2


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