What is hyperpigmentation?
Melanin is the pigment produced by specialised cells called melanocytes in response to UV radiation, hormones, inflammation, and skin trauma. Hyperpigmentation occurs when melanocytes are overstimulated — producing more melanin than normal in specific areas, leading to patches that are darker than the surrounding skin.
In South Africa, hyperpigmentation is extremely prevalent due to the combination of high UV intensity year-round and a population that is predominantly Fitzpatrick Type III–VI (medium to very dark skin tones). Darker skin tones have more active melanocytes, which respond more dramatically to UV, hormones, and inflammation — making hyperpigmentation both more common and more persistent.
The three main types of hyperpigmentation
Sun-induced hyperpigmentation (solar lentigines / sun spots) results from years of UV exposure. Spots are generally well-defined, flat, and brown. They appear on the cheeks, nose, forehead, décolleté, and hands. Treatment: vitamin C serum, glycolic acid, and Heliocare 360° SPF daily.
Melasma is hormonally driven (see the dedicated Melasma article), appearing as symmetrical, diffuse brown or grey-brown patches. It is worsened by UV and requires specific treatment including Heliocare 360° Pigment Solution and Cosmelan protocol for significant cases.
Post-inflammatory hyperpigmentation (PIH) occurs after any skin inflammation — acne, cuts, burns, or aggressive skincare. It presents as flat, dark marks at the site of previous injury, and is significantly more pronounced in Fitzpatrick Type IV–VI skin. Treatment: azelaic acid, niacinamide, and gentle brightening serums — avoid over-exfoliation.
Treatment principles for hyperpigmentation
Effective treatment requires three simultaneous actions: suppressing new melanin production, breaking down existing melanin, and providing robust UV protection to prevent reactivation. No single product achieves all three — an effective regime combines a tyrosinase inhibitor (niacinamide, azelaic acid, vitamin C), an exfoliant to shed pigmented cells (glycolic acid at an appropriate concentration), and daily Heliocare 360° SPF 50+.
Clinical treatments accelerate results: chemical peels remove pigmented surface layers more effectively than home exfoliants, and microneedling with active serums stimulates even pigmentation distribution in the new skin generated. Patience is required — hyperpigmentation responds slowly, and most regimes require consistent use for 8–12 weeks before significant improvement is visible.