Prescription treatment for hyperpigmentation (dark spots)

The main cause of hyperpigmentation according to Dr. Howell is an overproduction of melanin, the pigment responsible for skin color. This can be triggered by factors such as sun exposure, hormonal changes (like during pregnancy or from oral contraceptives), inflammation from acne or injuries, and certain medications that increase skin sensitivity to sunlight.

Dr. Howell says that vitamin C helps with hyperpigmentation by inhibiting the enzyme tyrosinase, which is involved in melanin production. Its antioxidant properties also protect the skin from free radical damage and promote a brighter, more even skin tone. He recommends the regular use of vitamin C serums in the morning followed by sunscreen with SPF 50 to reduce dark spots and improve overall skin radiance.

Dr. Howell says there are many creams and serums for hyperpigmentation. Some are available over the counter such as tranexamic acid, thiamidol or kojic acid and others are sold with a prescription such as hydroquinone, tretinoin, and azelaic acid. Products like Tri-Luma, which combine hydroquinone, tretinoin, and a corticosteroid, are particularly effective. These ingredients work together to lighten dark spots, promote cell turnover, and reduce inflammation.

Dr. Howell says there are several treatments that work effectively for hyperpigmentation, including hydroquinone, retinoids, vitamin C, and chemical peels. Consistent use of these treatments, along with diligent sun protection, can significantly reduce dark spots and improve skin tone. Professional treatments like laser therapy and microdermabrasion can also provide excellent results.

Dr. Howell says that tretinoin helps with hyperpigmentation to some extent by promoting cell turnover and increasing the shedding of pigmented skin cells. However, if you want to obtain more dramatic results you should use tretinoin and hydroquinone together.

Yes, tretinoin can fade dark spots by promoting faster cell turnover and helping to exfoliate the skin. This process gradually reduces the appearance of hyperpigmentation and leads to a more even skin tone. Regular use of tretinoin, combined with sun protection, can improve dark spots over time.

Hydroquinone typically takes 4-6 weeks to show noticeable improvements in hyperpigmentation, with more significant results visible after 2-3 months of consistent use. Continued application and strict sun protection are essential for achieving the best results and preventing new pigmentation from forming. Unlike tretinoin, hydroquinone should not be used indefinitely and the exact duration of treatment is something that can be discussed during your consultation.

According to Dr. Howell, hydroquinone can significantly lighten or remove pigmentation, but it may not be permanent. Continued sun exposure or other triggers can lead to new hyperpigmentation. Maintenance treatment and constant use of sunscreen are necessary to sustain the results and prevent recurrence of dark spots.

According to Dr. Howell, hyperpigmentation can come back after discontinuing hydroquinone if underlying triggers like sun exposure or hormonal changes are not managed. To prevent this from happening you need to continuously use sunscreen with SPF 50 and maintenance treatments to prevent recurrence and maintain results.