Do you ever find yourself staring at yourself in the mirror, wondering how certain parts of your body are darker than others? In times where flawless skin is often seen as the definition of beauty, hyperpigmentation can be an unwelcome visitor.
While typically harmless, the darkened patches or spots it causes can appear anywhere on the body and cause low self-esteem for some.
Inocentia Makola from Pretoria speaks about having hyperpigmentation for a very long time and mentions how finding the right products to treat it has been a downhill battle.
“I’ve had hyperpigmentation for a long time now, and I have no idea what caused it. I have it between the thighs, armpits, neck, and face. I can’t seem to wear shorts and vests because of the darkness.”
Inocentia Makola
Impact on self-esteem
“I’ve tried many skin products; they work for a few weeks, then my skin starts peeling off. I’ve noticed that heat makes it worse; it gets worse with seasonal change. I just hope I find a solution to it before it affects my confidence fully,” she says.
Also having struggled with hyperpigmentation for a long time, Akhona Quvane from Johannesburg mentions not using sun protection and having eczema as the cause. Additionally, she says not knowing and understanding my skin type was one of the reasons she ended up using products that were not suitable for her skin.
“I had hyperpigmentation on my neck, chest, and around my mouth area. As a teen, it affected my self-esteem. People would also assume that I’m not scrubbing enough when I bathe or that I have a condition. Back then, I did not know about hyperpigmentation and its causes.
“Being light-skinned with dark areas was not easy to hide in real life. One of the reasons I started using concealers. In pictures, I could just use filters and edits,” she says.
She found ways to deal with her problem.
“I couldn’t afford to consult a dermatologist, but I watched videos on social media and YouTube from dermatologists who offered free advice. I also got to search for and read about my skin type and suitable products to use. In 2022, I decided to save and buy sunscreen and noticed a huge difference after two weeks of consistently applying it every day with a two-finger method and an aqueous cream I got at a local clinic.
Learn to use the right products
“Over time, I managed to afford serums. I started with vitamin C and hyaluronic acid. I bought them to maintain my even skin tone, plus it is compulsory to use sunscreen when applying them. However, I stopped using Vitamin C for now because it made me look lighter than I already am,” explains Quvane.
“Now that I know I have normal and sensitive skin, I am making sure to not use products that will cause irritation and post-inflammatory hyperpigmentation. It is very important to use products that are suitable for your skin type.
“Consult a dermatologist when you can, or go to a local clinic. Do your research to understand skin care products and their ingredients, and be patient with yourself,” Quvane says.
Based in Bloemfontein, Dr Lehlohonolo Makhakhe who is a skin specialist, chief formulator at Epicutis Skincare Range, and a CEO of the South African Institute of Dermatology, defines hyperpigmentation as a clinical term that refers to the darkening of the skin that may or may not be palpable, can be local or widespread, and often involves specific parts of the body.
“Skin hyperpigmentation is often used by clinicians to aid in making clinical diagnoses. Skin darkening can be in relation to pain, itch, or both. Hyperpigmentation of the skin can also be asymptomatic and be a consequence of a previously active skin condition that is fading out,” he says.
“It is also important to note that the term hyperpigmentation refers to an individual’s skin type, and so the darker areas must be noted in relation to the general skin tone of a specific person.
“Common causes include acne, chronic dermatitis, insect bites, melasma, and drugs, to name but a few.”
Dr Lehlohonolo Makhakhe
Speaking about the treatment available for hyperpigmentation, Dr. Makhakhe explains that it depends on the identified cause. He says treatment is largely based on the diagnosis, the degree of involvement (local or extensive), the degree of pigment change (mild or severe pigment changes), how clinically active the condition is at the time of treatment, and the availability and access to skin-related care.
“Treatment for hyperpigmentation then ranges from a range of topical creams to laser therapy, skin peeling procedures, and many other modalities, depending largely on the cause, clinical presentation, and distribution.”
Dr. Makhakhe advises that any skin pigment changes should be assessed formally by a qualified healthcare worker. He mentions that some skin changes, such as a rare and aggressive form of skin cancer called melanoma, present as focal skin pigmentation that is asymptomatic yet time-sensitive.
“Melasma is common and benign, yet it is worsened by chronic and continuous sun exposure. Early review by a clinician is of paramount importance and can lead to disease-halting treatment and the prevention of further spread of the pigment changes.
“Pigment changes can be recalcitrant to different modalities of treatment and lead to the affected individual being self-cautious and even affected psychologically,” he says.
“It is always advisable to get medical advice from a qualified health practitioner to assist with a specific diagnosis after a clinical examination. Should there be home remedies, then the clinician can further advise accordingly.”
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