Hyperpigmentation GQ Article

As men in 2024, we are constantly influenced and surrounded by hype culture. Words that have become quite popular in culture, words like hype beast, a person devoted to acquiring fashionable items especially clothes or shoes.

Hypercars, the top tier supercar that beats all the elements of other supercars, the most superior and high performance cars on the market. Only 1% of cars are hypercars. Simply put, these are the most sort after of all sports cars. The ones that turn the most heads.

Similarly, in order to bring male skincare and skincare routines to the forefront, if we are going to bring the hype to skincare, we need to address and discuss one of the unwanted hype or hyper elements namely hyperpigmentation.

What is hyperpigmentation?

Uneven skin pigmentation or hyperpigmentation is a common dermatological complaint. Frequently referred to as age spots, dark spots or sun spots, these are frequently found in the sun exposed areas of the face, neck and arms. They present as darkened patches that are often harmless, give the skin an uneven appearance or pigmentation. Simply put, it is skin that is darker in certain areas.

Melanin gives our skin and hair its colour. Melanin is our natural protective agent against the damaging rays of the sun. There are many factors that can cause our melanocytes to produce more melanin but the most common causes are: excessive unprotected sun exposure, age and skin injury known as post inflammatory hyperpigmentation or PIH.

The pathophysiology or mechanism of hyperpigmentation is an over production of melanin. When exposed to sunlight, UV B rays penetrate the epidermis and stimulate the activity of tyrosinase, the key enzyme involved in melanin production. This process is known as melanogenisis, and occurs within the melanocyte. Following melanin production, the pigment is transferred to nearby keratinocytes and eventually reaches the skins surface. This results in the colouring of the outer layer of the skin. As the skin renews itself, these melanin filled cells are then shed and the tan acquired by sun exposure disappears. In some cases certain melanocytes continue to produce excessive amounts of melanin without regulation and this leads to the uneven spread of pigment or what we know as hyperpigmentation.

Can this condition affect all skin tones or colours?

Yes it can, however the darker skin tones, or scientifically described as higher Fitz Patrick skin types, are more adversely affected. The darker your skin, the higher your risk of hyperpigmentation. Why? Darker skin has more melanocytes, therefore more melanin, therefore the higher the risk of over production.

The Main Cause

There are many causes of hyperpigmentation, but by far the most common cause is sun exposure. The sun is what triggers the melanocyte to produce melanin. Melanin is your body’s defence mechanism against the sun, a naturally occurring photo protector against harmful UV rays. But excessive, unprotected sun exposure often disrupts this protective mechanism and leads to hyperpigmentation.

This is why, in my opinion, the most important weapon you have against hyperpigmentation is photo protection. Wear a hat, seek shade, wear protective clothing and choose a sunscreen that protects you against harmful UV A and UV B rays. If you forget everything else, this is the most important preventative measure. And sunscreen should be the most important part of your daily skincare routine.
In general, men are less diligent and consistent with skin care routines. They often describe them as too complex and too expensive. But if you are going to chose one product to prevent hyperpigmentation then sunscreen would be it.

Other Causes include:

Post inflammatory hyperpigmentation

This is where the skin barrier gets damaged as a result of an injury. There is an inflammatory response, which leads to wound healing. The melanocytes are triggered and the wound heals darker then the rest of the skin in that area. Injuries to the skin barrier include cuts, burns or even damage to the skin barrier from chronic skin conditions such as atopic dermatitis, eczema and acne.

After sun burn and sun exposure, the 2 common chronic skin conditions, namely eczema and acne are some of the leading causes of post inflammatory hyperpigmentation.

Post inflammatory hyperpigmentation (PIH) due to acne is one of the leading reasons for patients to consult a dermatologist. PIH is more frequent and more severe if you have darker skin.

This is why the early, effective management and maintenance of these 2 conditions is so important when it comes to preventing hyperpigmentation. The use of a moisturiser that limits trans epidermal water loss, keeps the skin hydrated and restores the skin barrier is so important. Maintain the skin barrier, prevent flare ups and this will keep hyperpigmentation at bay.

And whatever you do, don’t pop or squeeze your pimples. This causes trauma to your skin and it could lead to PIH (post inflammatory hyperpigmentation)

Age

Dark spots or hyperpigmentation is more common after the age of 40. As we age, our bodies produce less and less melanocytes. So why do we get hyperpigmentation if we have less melonoctyes. Well these remaining cells become larger and more focused, and if triggered have a lower threshold for excessive melanin production.

Hormonal changes

This is more relevant and prevalent in females. And although GQ is a predominately male audience, for completeness and education it is important that we talk about this.
This is known as melasma or chloasma and is as a result of female sex hormones, oestrogen and progesterone, triggering the overproduction of melanin when the melanocytes are exposed to the sun.

Delicate areas

In the gentle areas such as the axilla, in between the groin, the bikini are common places where mechanical friction can happen and this can lead to hyperpigmentation.

Some of the myths surrounding hyperpigmentation.

That it only occurs in females, and only occurs during pregnancy.

That men cannot suffer with hyperpigmentation. Men spend large amounts of time in the sun. And unlike females (as a broad generalisation) don’t use photo protection and sunscreen. So in fact put themselves more at risk.

That skin bleaching will cure hyperpigmentation. Generally speaking, doctors are not fans of skin bleaching at all.

That nothing can be done, once you have it you have it, when in actual fact there are treatment options available

The most important take home message regarding hyperpigmentation

The sun is the most important trigger in the hyperpigmentation pathway. So avoiding and protecting yourself from the sun is the most valuable piece of advice that I can give you. The cornerstone in any skin care routine, not just for hyperpigmentation prevention, but for everything should be daily sunscreen sunscreen sunscreen.

Added to the sun avoidance protocols of seeking shade, wearing a hat, avoiding the sun during its peak midday times.

What are some of the treatment protocols for treating hyperpigmentation.

Although hyperpigmentation causes no physical harm, it can definitely have an impact on your mental health. It can make you more self aware, lower your self confidence and could eventually lead to social withdrawal and isolation.

There are products that can be incorporated into your skin care routine that will help reduce these hyperpigmentation areas and improve your quality of life. Products that target the melanin production pathway, controls inflammation and promotes epidermal cell renewal are recommended.

Bioderma have a Pigmentbio range, which includes a cleanser, moisturiser and serum. This Pigmentbio range addresses all of the above mechanisms and helps reduce hyperpigmentation, with the patented LumiReveal technology.

Added to this never forget daily sunscreen, because prevention is always better than cure.

Other treatment modalities include:

Chemical peels, which helps exfoliate the skin (removal of dead skin cells) and helps stimulate the growth of new skin cells, or skin renewal.

Laser therapy, works in a similar fashion, it is just more focused and directed on the specific area where there is hyperpigmnation.

Please note, that everyones skin is unique and everyones skin care journey is different. Therefore no treatment regime is a one size fits all. For an accurate diagnosis individualised treatment plan please consult your doctor.