A holistic, multi-pronged approach to hyperpigmentation:
ONE – TYPE
Realize not all hyperpigmentation is created equal. There are 3 main common types of pigmentation. Melasma (caused by hormonal changes, birth control) is the most stubborn and it can take up to 7 years to resolve. UV induced pigmentation (sun spots, liver spots, etc.) is the next stubborn and is particularly sensitive to being re-darkened by exposure to sunlight. Last is post-inflammatory hyperpigmentation, which is redness or darkness created with cutaneous wounding, like acne. SSRIs (medicines for anxiety and depression) can unfortunately worsen PIH.
TWO – SUNSCREEN
Sunscreen becomes absolutely vital. Wear it daily EVEN IF you work/live in a dark cave, wear hats, etc. And it is important to reapply it often – it is not enough to put it on just once in the morning. Mineral sunscreen is safer than chemical sunscreen (chemical sunscreens can actually oxidize and betray your skin by causing the aging damage you think you are preventing by using it).
A good option is to apply a regular sunblock in the morning at home, and carry a powder sunblock stick with you for grease-free, light touch-ups throughout the day. If you are worried about sunblock aggravating acne, a good option is to use a mix-in like our moss Halo Powder which turns your favorite tried and true non-acneic facial oil into a sunblock.
THREE – INTERNAL HEAT
Internal heat, a concept in Traditional Chinese Medicine and Ayurveda can also aggravate/invigorate melanin production. Avoid exercise that leaves you hot and sweaty, hot saunas, hot tubs, drinking alcohol and eating spicy food. Take cooling herbs and consume cooling foods. Consider rolling with a jade roller that has been chilled in the fridge. This has a few benefits – it reduces heat in the skin and it stimulates lymph flow.
FOUR – LYMPH
Speaking of stimulating lymph, stagnation in the skin, another holistic medicine concept, is linked to stubborn pigmentation issues. Stimulating lymph fluid helps to release stagnation. A great way to get your lymph fluid draining is to perform a daily facial massage. One tool that is great for this is gua sha. Remember to keep a light to medium touch and move slowly – lymph is a thick viscous fluid and you will get better results with slow massage.
FIVE – DEPIGMENTATION SERUM
There are many skincare ingredients and products that can help lighten skin. Look for a serum that contains a combination of ingredients shown to support depigmentation mechanisms in the skin. Vitamin C (featured in moss’s Illumina), licorice root or other lightening botanicals like hops or bearberry are very commonly used for hyperpigmentation.
There are also stronger yet synthetic ingredients such as peptides that have depigmenting properties and acids like tranexamic acid. If you are very serious about depigmenting, ingredients like hydroquinone, corticosteroids, and kojic acid are very commonly used and have the highest efficacy, but have safety concerns and side effects associated with them.
That being said, for more stubborn pigmentation like melasma, dermatologist prescribed creams like Tri-Luma (a combo of steroids, hydroquinone and retinol) may be what you decide to go with and that’s ok.
SIX – PATIENCE
Keep in mind, even the best dermatologist formulated creams that sell for hundreds of dollars have been trialed over a course of 12 weeks (3 months) and even after 12 weeks, only a percentage of users saw results and NO users saw complete depigmentation.
Working to reduce hyperpigmentation requires faithful and consistent application of both a depigmenting serum and also sunblock. It takes at least one month to begin to see results but more commonly, results only start to show after 8-12 weeks. So the first 8 weeks is a leap of faith. For those that like to see immediate results, a laser might be a better option.
SEVEN – LASER
A good “non-chemical” option is a BBL (broadband light) laser. This type of treatment isn’t cheap, but is used successfully to diminish age spots and other pigmentation, as well as work to even skin tone and reduce wrinkles. There is a little down time post laser and it does hurt a little but not unbearably.
With BBL, getting a few treatments is common, so work that into the budget instead of assuming one will take care of all your pigmentation in one fell swoop. Be aware there is down time and for a week or two after lasering, the skin is red with possible peeling.
EIGHT – DERMAPLANING
If hard-hitting steroids and acids aren’t your thing, try dermaplaning in the areas of hyperpigmentation. In short, dermaplaning is using a scalpel to shave/scrape the surface of the skin, removing both peach fuzz and dead skin. You can book dermaplaning at most estheticians or if you’re feeling capable, get dermaplaning blades on Amazon. This can help slough away the hyperpigmentation and encourage cell regeneration.
It is not for you if you have any sort of active skin condition, including active acne. It’s also something that’s really easy to overdo, so keep your dermaplaning sessions at least 3-4 weeks apart. Lastly, it’s important to note that while dermaplaning helps with hyperpigmentation, overdoing it, or using it on a skin type it isn’t suited for can actually cause or worsen hyperpigmentation.
NINE – EXFOLIATION
Speaking of dermaplaning, plain old chemical exfoliation is very commonly touted as a depigmenting option. Usually, it is suggested to use glycolic acid as it, of all the acids, penetrates deepest into the layers of skin. However, any type of exfoliation (with the exception of abrasive mechanical) works, as long as you don’t overdo it.
Overdoing exfoliation can actually aggravate hyperpigmentation, worsening it instead of making it better, as it makes the skin MORE susceptible to UV rays (which are to be avoided as much as possible during your depigmentation journey) AND also introduces heat into the skin (see point number 3) which can stimulate melanogenesis.
TEN – CELLULAR TURNOVER
You can also encourage cellular turnover WITHOUT exfoliating per se. The difference here is that you are stimulating the skin to shed old cells itself vs. removing those cells FOR the skin, as with exfoliation. There are certain ingredients, like peptides, or botanicals that work to encourage cellular regeneration. Botanical examples include carrot seed, helichrysum, moth bean, and bakuchiol.
ELEVEN – SUPPLEMENT
Lastly, consider supplementing with “vegan collagen,” as the supplement BioSil is known. It is a combination of choline and silicon and purports to increase production of the beauty proteins in the body, ie collagen, keratin and elastin. Users report better results with Biosil than with collagen supplements. Supporting skin health from the inside out can help regulate and optimize all of the skin’s functions and can support and speed up everything you are doing topically.
TWELVE – DOCUMENT
Document how your skin is changing. Pick a specific area or mark on the skin (I picked a liver spot near my eye and a PIH acne scar on my chin) and photograph those areas in a brightly lit space that you have consistent access to. Take pictures with the same angle, and roughly at the same time of day only once a week (doing it every day is too often and will drive you crazy). Use these specific markings (not the whole face generally) to track depigmentation.
At week 4, compare pics from week 1 and week 4. Do the same at week 8, and at week 12, comparing with your week 1 pics. If you have different types of pigmentation (ie, melasma, PIH, and UV-induced) pick one marking/area from each type.
THIRTEEN – ACCOUNTABILITY
To keep you on track during the 3 months, consider an accountability buddy like a friend or an esthetician. Check in with them, share pics, remind each other to keep applying sunscreen and depigmentation serum, even when the basic repetitiveness of the routine is killing you. Book brightening facials together once or twice during the 3 months you are waiting to see results to help keep your morale up.