Interview with Christina Maria Hayn
Hyperpigmentation caused by acne:
what it is, how it appears and how to get rid of it
About Christina Maria Hayn
Christina studied Medicine in Germany until 2017. She then worked in the Department of Dermatology at the University of Magdeburg as a resident doctor with a focus on skin cancer. Since 2020 she works in a dermatological practice. Treating common skin diseases like Acne is her daily business and passion since then.
Sencyr: Hi Christina, quite often we receive inquiries from clients about how to deal with hyperpigmentation as a result of acne. What exactly is hyperpigmentation and in which cases can it occur?
Christina: Hyperpigmentation is a medical term used to describe dark skin spots that result from an increased melanin production. This can be caused by many things from acne lesions and sun damage to hormone fluctuations. Hyperpigmentation in acne patients occurs as a response to inflammation or insults on the top layer of the skin and is called Post inflammatory Hyperpigmentation (PIH). If the spots are more red, it can as well be Post inflammatory Erythema (PIE) due to widening or growth of small capillaries.
Sencyr: So when I notice red or brown spots on my skin, I can assume that I am dealing with hyperpigmentation?
Christina: Probably yes, but eventually it might not be from acne.
Sencyr: So besides acne, hyperpigmentation can also be caused by other factors as well?
Christina: Exactly. Besides acne there are numerous conditions that can lead to hyperpigmentation but have different causes. Another very common condition is melasma which has mainly hormonal and genetic roots. Hyperpigmentation can also occur from irritation, medication, fungus and many more. Sun exposure aggravates most types. It’s important to know the cause to get targeted treatment.
Sencyr: What about acne scars? Is there any specific difference between acne scars and acne related hyperpigmentation?
Christina: Acne scars are also the result of inflammation of acne lesions, but mainly occur in people with moderate to severe acne. The skin tries to repair the tissue defect by forming new collagen. Too much or too little of the repair tissue can lead to elevations or dents in the skin. This is different from PIE and PIH. In their final state scars are usually lighter than their surroundings (Depigmentation), but can also be hyperpigmented especially in people with a darker skin tone. Acne scars are even harder to treat than PIH and PIE so it’s best to prevent by treating acne early.
Sencyr: Can hyperpigmentation spread over the whole skin, if I don’t treat it correctly?
Christina: Not if acne is the cause. The hyperpigmentation occurs only in the affected areas.
Sencyr: Are there any treatments to remove hyperpigmentation?
Christina: Yes. But first let me say that daily sun protection is the most important thing to do when dealing with hyperpigmentation. Also try not to pick your acne and avoid irritation for example due to a harsh scrub. It can cause both scarring and hyperpigmentation. Hyperpigmentation might fade on its own but it often takes months to years. In office treatments, mainly laser therapy, is the most effective. But it is also possible to try treatment at home.
Sencyr: Is there an anti-pigmentation cream that I can use?
Christina: Yes, but patience and consistency is key as it often takes weeks to months to see a benefit. Ingredients that you can incorporate in your skin care routine are for example Retinoids, Vitamin C, Azelaic acid and Niacinamide as well as prescription Hydroquinone. It’s best to pick one or two ingredients or to alternate to avoid irritation. Personally I use a Vitamin C Serum in the morning after cleansing and a Retinol Cream in the evening.
If you're dealing with hyperpigmentation, know that you aren't alone and always feel free to speak to your dermatologist anytime!