Why do hyperpigmentation spots appear?

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Have you noticed pigmentation spots, also called hyperpigmentation, on your skin?

Hyperpigmentation is when some areas of the skin become darker than the surrounding skin. It can be caused by an overproduction of melanin, the pigment that gives skin its colour. Spots can appear on any part of the body, but especially on areas often exposed to the sun, such as the face, arms and shoulders. The most common types of hyperpigmentation include sun spots, age spots and melasma (Nieuweboer-Krobotova, 2013).

In short

• Brown spots come from a local excess of melanin.
• The sun is the leading cause, ahead of hormones, age and inflammation.
• The best prevention remains sun protection, every day.

What causes pigmentation spots

Genetic predisposition: some people are genetically predisposed to hyperpigmentation, meaning they are more likely to develop brown spots on the skin due to hereditary factors. This tendency can affect how quickly and intensely pigmentation spots appear.

Sun exposure: prolonged exposure to the sun's UV rays prompts the skin to produce more melanin as a defence mechanism, which can lead to sun spots or solar lentigines. It's one of the most common causes of hyperpigmentation, especially on areas often exposed to the sun. To understand what the sun also does to collagen, read The sun destroys your collagen, and here's how to fix it.

Hormonal changes: hormonal changes, such as those during pregnancy, menopause or when taking the contraceptive pill, can cause melasma, a type of hyperpigmentation that usually appears on the face. The sun makes it significantly worse (Passeron and Picardo, 2018). See also Menopause and skin: what changes, and how to care for it.

Skin inflammation: conditions such as acne, eczema or skin injuries can cause hyperpigmentation, with spots appearing where the skin has healed from inflammation. This is due to a local increase in melanin production in response to inflammation.

Ageing: as we age, the skin's natural ability to regenerate and renew itself declines, which can lead to age spots, especially on areas exposed to the sun for a long time. These spots are more common in older people and reflect years of accumulated sun.

Medication: some medicines, including certain antibiotics, anti-inflammatories and drugs used to treat psychiatric disorders, can increase the skin's sensitivity to the sun, which can cause hyperpigmentation. This is called a phototoxic reaction, which can cause permanent or temporary changes in skin pigmentation. If in doubt, ask your pharmacist.

Skin injuries: physical injuries to the skin, such as cuts, scrapes or burns, can cause hyperpigmentation, with darker pigment appearing where the skin heals. This is the body's natural response, involving increased melanin production in the affected area.

Preventing spots: sun protection first

As the sun is behind most spots, prevention starts with it: a broad-spectrum (UVA and UVB) sunscreen on your face every day, even in winter and on cloudy days, a hat in full sun, and no exposure during the hottest hours. Existing spots also darken in the sun: this is the best way to avoid making them worse.

Home care

To fade spots, topical treatments often contain ingredients such as aloe vera or turmeric. Vitamin C serum is one of the most studied: applied to the skin, antioxidant vitamin C slows melanin production and helps even out skin tone (Telang, 2013). These treatments work gradually, over several weeks.

One precaution: avoid lemon juice on your skin. When later exposed to the sun, it can actually cause brown spots (Sasseville, 2009).

As part of prevention, don't overlook a healthy lifestyle, including a balanced diet rich in antioxidants, enough hydration, regular physical activity and good-quality sleep, as all these factors contribute to overall skin health. It's also important to avoid smoking and drinking too much alcohol, as these can worsen skin condition and speed up the ageing process. To find out more about what keeps skin firm, read Collagen for skin: what the science says.

When should you see a dermatologist?

Most brown spots are harmless. Still, show a doctor or dermatologist any spot that changes in size, shape or colour, has irregular edges, bleeds or appears suddenly. They can also suggest stronger treatments (prescription creams, peels, laser) if the spots bother you.

Frequently asked questions

What is hyperpigmentation?

Areas of skin that are darker than the rest, due to an excess of melanin. The most common forms are sun spots, age spots and melasma.

Do hyperpigmentation spots go away on their own?

Those that follow a spot or injury often fade within a few months. Sun spots and melasma, however, usually persist without treatment and darken in the sun.

Is melasma linked to pregnancy?

Often, yes: it's also called the “mask of pregnancy”. It can also appear with the contraceptive pill or with no obvious hormonal cause. The sun makes it worse.

Which sunscreen should you choose to prevent spots?

A broad-spectrum (UVA and UVB), high-factor protection, applied to your face every morning and reapplied when exposed.

Further reading

• The sun destroys your collagen, and here's how to fix it
• Collagen for skin: what the science says
• Menopause and skin: what changes, and how to care for it

Sources

• Nieuweboer-Krobotova L. (2013). Hyperpigmentation: types, diagnostics and targeted treatment options. Journal of the European Academy of Dermatology and Venereology, 27 (Suppl. 1), 2-4.
• Passeron T., Picardo M. (2018). Melasma, a photoaging disorder. Pigment Cell & Melanoma Research, 31(4), 461-465.
• Telang P.S. (2013). Vitamin C in dermatology. Indian Dermatology Online Journal, 4(2), 143-146.
• Sasseville D. (2009). Clinical patterns of phytodermatitis. Dermatologic Clinics, 27(3), 299-308.