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Hyperpigmentation is a condition causing blotchy darkening of the skin, and can occur in isolated patches, or more spread out over the skin. Pigment cells are components of the skin separate from the more common Keratinocytes or normal skin cells in the epidermis. Pigment cells, when stimulated, produce packets of melanin (brown skin pigment) which are released into the skin cell layers and give darker color to the skin. These cells may be stimulated above their normal melanin release by sun exposure (tanning); pregnancy (hormonal); inflammation of the skin (post inflammatory hyperpigmentation; PIH) and even after laser stimulation.

It is often said that Hyperpigmentation is more “managed” than “cured”. This is because the Melanocytes or pigment cells are a genetic component of the skin and will always be present. The mainstays of management are: 1. Addressing the cause of the stimulation; 2. Bleaching or decolorizing the released melanin; and 3. Destroying pigment using laser energy. To be sure, the first two options are the safest and most comfortable.

Obviously, sun exposure is one of the most controllable factors. Patients prone to hyperpigmentation must avoid direct exposure, wear hats and other occlusive clothing and always wear a sun block of SPF 15 or better. My overall favorite types of block are the elegantly formulated mineral blocks containing micronized zinc and titanium dioxides. We offer these as our Scott Wells MD Clear Shade or Sheer Shade products.

Reducing pigment that exists already in the skin is best done using a combination of in office peels combined with a regimen of Retinol and Arbutase which we custom blend for our patients. The retinol helps even out pigment cells while the Arbutase is converted in the skin to a powerful bleaching agent. Patients may stay on this “resurfacing cream” for extended periods safely. Other excellent ingredients to assist in lightening hyperpigmentation are Kojic acid present in our Scott Wells MD Illuminate and Azelaic acid in Scott Wells MD Weekly Glow Pads.

Lastly, under certain circumstances, laser energy may be used successfully to treat hyperpigmentation. This is slightly more risky, however, since the laser itself can stimulate pigment cells not effectively destroyed by the treatment. Make sure your doctor is very experienced!

Treatments for hyperpigmentation cost between $250-$450 for light peels, up to $1500/session for spot lasering, and $5000 for comprehensive facial laser resurfacing.

Suggested products by Scott Wells, MD:

Clear Shade $80.00

Sheer Shade $80.00

Illuminate $100.00

Weekly Glow Pads $85.00

Scott Wells MD is a Board Certified Plastic Surgeon in practice on New York’s Park Avenue for over 20 years. In addition to his surgical Practice Dr. Wells is the Medical Director of the Park Avenue Plastic Surgery Center Medispa and the creator of SCOTT WELLS MD skincare, which is available online at SCOTTWELLSMD.COM.


Originally published: 08/11/16

Scott Wells, MD

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