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Skin Lightening (AKA: Skin Brightening, Skin Bleaching, Evening Out Skin Pigmentation):
Hyperpigmentation is a
common, usually harmless condition in which patches of skin become
darker in color than the normal surrounding skin. This darkening occurs
when an excess of melanin, the brown pigment that produces normal skin
color, forms deposits in the skin. Hyperpigmentation can affect the
skin color of people of any race.
Age
or "liver" spots are a common form of hyperpigmentation. They occur due
to sun damage, and are referred to by doctors as solar lentigines.
These small, darkened patches are usually found on the hands and face
or other areas frequently exposed to the sun.
Melasma or chloasma
spots are similar in appearance to age spots but are larger areas of
darkened skin that appear most often as a result of hormonal changes.
Pregnancy, for example, can trigger overproduction of melanin that
causes the "mask of pregnancy" on the face and darkened skin on the
abdomen and other areas. Women who take birth control pills may also
develop hyperpigmentation because their bodies undergo similar kind of
hormonal changes that occur during pregnancy. If one is really bothered
by the pigment, the birth control pills should be stopped.
Changes
in skin color can result from outside causes. For example, skin
diseases such as acne may leave dark spots after the condition clears, known as post-inflammatory hyperpigmentation (PIH).
Other causes of dark spots are injuries to the skin, including some
surgeries. Freckles are small brown spots that can appear anywhere on
the body, but are most common on the face and arms. Freckles are an
inherited characteristic.
Freckles, age spots, and other
darkened skin patches can become darker or more pronounced when skin is
exposed to the sun. This happens because melanin absorbs the energy of
the sun's harmful ultraviolet rays in order to protect he skin from
overexposure. The usual result of this process is skin tanning, which
tends to darken areas that are already hyperpigmented. Wearing a
sunscreen is a must. The sunscreen must be "broad spectrum" (i.e. it
blocks both UVA and UVB). A single day of excess sun can undo months of
treatment.
Most prescription
creams used to lighten the skin contain hydroquinone. Bleaches lighten
and fade darkened skin patches by slowing the production of melanin so
those dark spots gradually fade to match normal skin coloration.
Prescription bleaches contain twice the amount of hydroquinone (4%), the
active ingredient, as over-the-counter skin bleaches (2%). In more severe
cases prescription creams with tretinoin (vitamin A) and a cortisone cream (containing hydrocortison) may be
used. These may be somewhat irritating to sensitive skin and will take
3-6 months to produce improvement.
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