Hyperpigmentation is beginning to rival acne and wrinkles as a top reason people consult aestheticians. Although different types of hyperpigmentation may have different etiologies, the outcome is still a visible result of what happens when melanocytes – whether in normal numbers in the basal layer of the epidermis or those transferred to the dermis – repeatedly receive signs of distress or trauma, either to the skin or another system of the body. Instead of the melanin umbrella of pigment closing when the distress is over, the melanocytes continue to produce excessive melanin in an effort to protect the other cells and systems in the dermis; as a result, the umbrella remains open.
Causes of Hyperpigmentation
Different forms of hyperpigmentation, such as post-inflammatory hyperpigmentation, melasma, periorbital hyperpigmentation, and solar lentigines, do share some common triggers and potential root causes, which can be addressed with a strictly holistic and integrative approach. These causes include: high levels of toxicity in the body; micronutrient deficiency; processed and junk food diets that are high in sugar, artificial sweeteners, preservatives, fillers, and other food additives; and food sensitivities, intolerances, or undiagnosed allergies.
Hyperpigmentation can also be caused by underlying stealth infections or autoimmune disease; gut dysbiosis, including candida overgrowth; overexposure to both UVA and UVB rays, either from the sun or from indoor tanning beds; stress; skin trauma, such as constant picking or acne excoriee; regular use of exfoliants, such as alpha and beta hydroxy acids, strong enzymes, microdermabrasion, scrubs, and dermaplaning; laser treatments and improper usage of microneedling; consistent exposure to environmental toxicants; and consistent application of irritating or sensitizing topical ingredients.
A Wholeful Approach
A holistic topical approach alone, meaning one consisting purely of natural and organic products and non-invasive or alternative/complementary treatment modalities, will not be enough for lasting results. Suppressing melanin production or inhibiting tyrosinase with cosmeceutical ingredients is also not truly helpful for solving the problem – it merely makes the problem more pleasant for the client. However, it is not a long-term solution and suppressing one function often leads to the imbalance of another. Treating symptoms only with topical ingredients and treatments is a reactive, allopathic approach and does not support a whole, healthy person, especially when the root causes of the visible symptom lie in the person’s diet, lifestyle, or mindset.
A beneficial topical regimen, however, can be very helpful when complementing diet, lifestyle, and mindset shifts. When treating hyperpigmentation, it is important to be gentle with the skin; as tempting as it is to try to scrub, burn, needle, or zap away dark spots or uneven pigmentation, this kind of behavior can often do more harm than good. It is also helpful to reduce chemical exfoliation and completely avoid mechanical exfoliants, such as scrubs, dermafiles, and microdermabrasion; while gentle enzymes are generally beneficial, acids can be too irritating. Remind clients not to over-cleanse their skin as this practice can cause irritation and make their skin more susceptible to topical inflammation – they should use soothing oil, milk, or lotion cleansers rather than those that produce foam.
When treating hyperpigmentation, sun protection is essential. Look for sunscreens that contain soothing ingredients, such as zinc oxide, rather than potentially irritating, synthetic sunscreen ingredients. Clients should keep their skin hydrated and lubricated with both water-containing botanical preparations (herbal infusions and hydrosols) and natural carrier oils. Let them know that spot treatments on dark areas are fine, as long as the products are used as directed and not overused. Some ingredients they should look for in a topical regimen for hyperpigmentation include aloe vera gel, green tea, calendula, rose geranium, chamomile, bilberry, blueberry, paper mulberry, licorice root, turmeric, chickory root, gingko, green coffee, and niacinamide. Other ingredients include vitamin C in the forms of tetrahexyldecyl ascorbate, sodium ascorbic phosphate, and magnesium ascorbyl phosphate; pomegranate seed oil; sea buckthorn oil; red raspberry seed oil; cypress; frankincense; and sandalwood essential oils.
Hyperpigmentation and Diet
Although hyperpigmentation shows up on the surface of the skin and melanocytes reside within the layers of the skin, the health and functionality of those cells largely rely on the nutrients they receive from a person’s diet. Diets rich with fresh, whole foods containing high amounts of phytonutrients (plant-based vitamins and antioxidants), minerals, amino acids, proteins, and essential fatty acids are crucial for healthy cells, which are the key to beautiful, healthy skin.
Diets that consist of packaged, processed, convenience, and fast foods lack nutrient density and quality. They also contain high levels of manufactured, unhealthy fats; sodium; and sugar. They tend to be difficult to digest and acidic, both of which are factors that contribute to systemic inflammation. The nutrients that are printed on food product labels are often added to fortify these food-like substances and are not derived from whole foods. They are most often synthetically manufactured substances that are not bioavailable; therefore, they are not able to be properly absorbed by the body and utilized to build healthy cells and support the tissues, organs, or bodily systems.When the skin is malnourished at the cellular level, DNA mutations are more frequent and cells do not function as they should. Improperly functioning melanocytes due to DNA mutation plays a primary role in hyperpigmentation. Furthermore, pro-inflammatory diets, like those mentioned above, will continuously send distress signals to the cells in the body, triggering a constant inflammatory response, thus keeping the pigment umbrellas open. While skin care professionals cannot prescribe nutritional protocols to prevent or treat skin conditions like hyperpigmentation, there are many simple and general dietary improvements that, over time, can significantly reduce triggers and address root causes.
One dietary improvement includes eating lots of fresh, dark, leafy greens, such as romaine, kale, collards, broccoli, and dandelion greens. Clients can try these greens in salads, lightly steamed or sautéed, or blended into smoothies with fruit. Another change clients can make is to eat colorful fresh fruits and vegetables, like beets, sweet potatoes, peppers, tomatoes, eggplant, blueberries, strawberries, kiwi, and pineapple. With fresh foods, a good rule of thumb is to eat a variety of colors because natural pigments contain high amounts of antioxidants that help to neutralize free radical damage on the inside, which protects and nourishes the cells.
Clients should also try to reduce or eliminate processed sugars and simple carbohydrates, such as white rice, white flour, and white pasta. Complex carbohydrates, like whole or sprouted grains (brown rice, quinoa, millet, and buckwheat) may work for some clients. They can also support their gut health and their gut microbiome with homemade bone broth, which is rich in healthy fats, minerals, and gelatin (cooked collagen); and naturally fermented foods, like kimchi, raw sauerkraut, and kefir. Another helpful dietary change is the consumption of organic animal foods. Conventional meats and dairy products are made from animals that are frequently treated with hormones; adding these hormones to an already hormonally imbalanced body will not help a hormone-related skin condition. Clients can also reduce their alcohol and caffeine intake and keep an eye out for food triggers. Different people react to different things, so if a client’s pigmentation seems more prominent after eating certain foods, there is a good chance the client has a sensitivity.