Hyperpigmentation FAQs with Cherie Callahan, Professional Esthetician

In this special guest post written by esthetician, skincare consultant, and former Skin Games champion—Cherie Callahan—she answers common questions about hyperpigmentation issues and how red light therapy can help.

I’m Cherie Callahan, and I have been treating hyperpigmentation as a professional esthetician for over 15 years. Although it’s common, the patches of darker skin that develop from hyperpigmentation aren’t very well understood, and I hear a lot of the same questions over and over. So let’s go over the basics!

Here are answers to some of the most frequently asked questions about skin hyperpigmentation:

What is Hyperpigmentation?

If patches or spots of your skin appear a bit darker than others, there’s a good chance it’s hyperpigmentation. Pigmentation is a genetic cell mutation caused by hormonal changes or some sort of injury (e.g., sun damage, acne, over-aggressive chemical peels, lasers, and/or microdermabrasion treatments).

Darker areas of hyperpigmentation are actually excess deposits of melanin, which is normal pigment on overload. It’s very common, and those darker spots are pretty harmless, but many people have cosmetic concerns about how they look, which is why they come to people like me for professional help.

What Causes Hyperpigmentation and Who Commonly Experiences it?

There are 3 main types of hyperpigmentation, and they all have different causes, so let’s break it down:

Age Spots: These are the common spots of brown, black, or tan skin that older people often develop over time on their hands, face, and head, especially. Age spots are typically caused by excess sun exposure over a person’s lifetime, and lighter-skinned people tend to be more affected.

Melasma: These are the larger patches of darkened skin that often appear on women’s faces and stomachs during pregnancy because of hormonal changes. However, it’s not only pregnant women who experience melasma. It can affect anyone, but is more common in women, and people with darker skin.

Inflammation: I treat a lot of inflammatory hyperpigmentation, which is caused by the autoimmune reactions people have due to certain skin conditions like acne and eczema. It can also be caused by skin injury. These hyperpigmentation markings most often appear on the face and neck.

Hyperpigmentation may look different depending on the tone of your skin, but it’s a universal experience that affects people of all skin colors and origins.

How is Hyperpigmentation Treated?

The tone of your skin matters in terms of which treatments will work best. Generally speaking, fair skin responds well to most hyperpigmentation procedures. Medium skin tones may find chemical peels and microdermabrasion therapy very helpful, but the use of pigment inhibitors both before the treatments begin (at least 2 weeks), and throughout the course of the treatment protocol is very important. Darker skin might benefit from Glycolic acid, Kojic acid, microdermabrasion (low setting), lower-strength chemical peels (ones blended with water rather than alcohol), and laser treatments, but only at lower intensities and over several sessions.

When treating hyperpigmentation, it’s very important to remember that it can lead to hypopigmentation (white spots), which cannot be fixed. So this is why treating darker, pigmented skin should be a much slower and cautious process.

Treating hyperpigmentation should be done on an individual basis, but typically, you want to keep 3 basic principles in mind:

• Keep melanocytes (melanin-forming cells) from producing more pigment by suppressing/inhibiting them (ie. “putting them to sleep”). Vitamin C (at 20% concentration) is a very nice antioxidant, which is an incredibly important quality in fighting dark spots. Vitamin C helps to inhibit the enzyme tyrosinase, which helps to prevent melanin production. It significantly lightens pigmentation, but simply brightens normal skin. So vitamin C is a MUST-HAVE before any pigmentation treatments should be started.
  
  
• Although it sounds counterintuitive, you need to re-injure the affected area of the skin in order to flush the pigment to the surface so it can be effectively treated.
  
  
• Use red light therapy for its healing properties (e.g., improve circulation, stimulate fibroblasts, etc). Some people also use topical creams for the same purpose, while others use home remedies like aloe vera, green tea, and licorice. These are pretty hit or miss in my experience. I have the most success treating hyperpigmentation with red light therapy, ideally with a full-body system, like the Joovv I have in my office.

What is Light Therapy & How Does it Help with Hyperpigmentation?

Red light therapy, also known as photobiomodulation, uses healing natural light to help your body produce more energy and regenerate your skin. My full-body Joovv system is a very effective natural skin treatment that I use for clients with acne, inflammation, burns & scars, and yes, hyperpigmentation. Many other estheticians do as well.

When used consistently, and part of a holistic treatment protocol, I’ve found Joovv is effective at reducing the appearance of hyperpigmentation patches and, for many of my clients, helping them heal and return to their normal pigment levels.

Healthy wavelengths of light help your skin cells heal and rejuvenate, as I’ve seen with numerous clients. Researchers have also conducted numerous trials showing this. Red light therapy is also well-known as a powerful natural inflammation relief tool, and that makes a huge difference for the inflammatory kind of hyperpigmentation!

Why I Choose Red Light Versus Near Infrared Light When Treating Hyperpigmentation

I’m always in favor of using published, scientific evidence to inform my approach to skin treatment. And it’s no different when it comes to hyperpigmentation. In this study, researchers used wavelengths of red and near infrared light to positively impact hyperpigmentation. And this study demonstrated that wavelengths in the near infrared spectrum alone, 830 nm and 850 nm, helped inhibit the production of tyrosinase, which led to decreased melanin synthesis.

But in other clinical studies, near infrared light has also helped patients suffering from vitiligo by stimulating melanocytes, which may be why some people have reported hyperpigmentation upon initial use.

When you look at the clinical literature in its entirety, the reality is that there isn't a clear clinical consensus amongst photomedicine researchers when it comes to using near infrared light for hyperpigmentation. So, that’s why I stick to red wavelengths of light in the mid-600 nm range. They’re completely safe, are very rejuvenating in nature, and do not stimulate the production of pigment.

How Long Does it Take to See Results When it Comes to Light Therapy and Hyperpigmentation?

I have personally seen results in my client’s skin after only a few weekly treatments. And researchers have found similar results. It’s important to use light therapy on a consistent basis for the best results, and with any hyperpigmentation, you’ll get much better results if you treat it carefully. No picking or touching!

I can’t stress this enough, the use of red light therapy is a MUST in any combination of pigmentation treatments for the healing and collagen/elastin benefits.

I hope this helps you understand hyperpigmentation and how to best treat it!