"Teen Vogue" is celebrating its annual Acne Awards this week with a series of stories on all things acne. From knowing when to pop a pimple to understanding why some people get breakouts and others don’t, we’ve got you covered. Read all of the stories here.
Having hyperpigmentation means constantly trying not to touch the acne, cuts, or pimples on your face and hoping they don’t leave dark marks.
I was reminded of this during my most recent attempt to wax my lip.
One night, out of a pang of anxiety, I decided it would be a good idea. I hadn’t gotten by eyebrows threaded in over a month because I liked the way they were naturally growing out. But this also meant I wasn’t getting my normal, painful lip threading. I relived moments I’d spent in the chair, my head back, tears rolling as I felt the pain of the thread run across my lip. I did not miss it, but something needed to be done. So I drove around the corner to CVS, picked up a box of small waxing strips, and planned to do it myself.
This left me with two small scratches, almost twinlike, at the top of my lip. I looked at myself in my bathroom mirror and said, “You knew better.” I didn’t pick at it, and I convinced myself they were small scratches that would “go away” in a few days. The scratches did disappear within four days, but they left scars I was sure would not appear since I hadn’t picked. Right? Wrong.
I DM’d Ashley White, an aesthetician licensed in Illinois and New York who specializes in hyperpigmentation, and asked her if even small cuts would leave scars on my skin. “Trauma such as cuts, acne, or friction will trigger the process known as melanogenesis that is responsible for hyperpigmentation,” she told me.
She had me at *melanogenesis*, a word I don’t commonly hear when talking about hyperpigmentation, but is apparently responsible for it. This is when I knew it was time for me to figure out, like, really figure out everything I could about hyperpigmentation; what causes it, and most importantly, how to prevent and treat it — especially for people of color and those who suffer from acne. Both are more prone to hyperpigmentation.
People with darker skin can run a higher risk of developing dark spots and uneven skin tone because they’re more sensitive to factors that can cause or further develop hyperpigmentation, such as sun exposure. The more a dark spot is exposed to the sun, the darker it becomes in comparison with lighter skin surrounding it. Without proper prevention practices in place, the struggle to get rid of it becomes tougher.
Acne is one of the main culprits of hyperpigmentation because the infected area is inflamed, which can eventually lead to scarring. Picking and squeezing don’t help.
I spoke with dermatologist Eliot Battle, who works with the cosmetic industry on how to safely and effectively use products, aesthetic treatments, lasers, and plastic surgery on patients of color.
Dr. Battle’s first piece of advice to me is the same that he gave to his 15-year-old daughter: “The best approach to the skin is to not overtreat it but, literally, a hand’s off approach — applying less product and applying it less frequently is more effective than standing in the mirror with a minute-to-minute application.”
Minute-to-minute application… drag me!
That said, there are simple steps that, over time, can help dark spots, or hyperpigmentation, go away, and can lead you to the glow up you deserve.
In the name of blemish-free skin, let’s uncomplicate this process:
What Is Hyperpigmentation Exactly?
Hyperpigmentation is a common condition where dark spots form on your skin.The darkened spots can be the result of the overproduction of melanin, the brown pigment responsible for our normal skin color. Although we all have different levels of melanin in our skin, the process that creates melanin is melanogenesis, and it happens to all of us. Melanin gives hair and eyes their color as well.
The time it takes to get rid of these dark spots varies from person to person. “It typically takes months to see results,” Dr. Battle says. “You’ll also need to keep up with regular treatments or hyperpigmentation may return.”
How you should go about treating a dark spot can depend on the kind of mark left from scarring, superficial or deep. A dark spot is superficial if it’s less than three to four months old, and deep if older than that, existing on the second layer of the skin (the dermis). “For deeper, older marks, prescription creams or clinical treatments may be a better choice,” says Dr. Battle.
One misconception about hyperpigmentation is that the harder you scrub, or more potent the product, the quicker it will fade. But the opposite can be true. ”The fact is, being too aggressive will just further irritate the spot,” says Dr. Battle, “leading to it getting even darker and taking longer to go away.”.
As you get older, hyperpigmentation becomes harder to treat because natural exfoliation is slowing down.
What can cause hyperpigmentation?
The list of factors that can lead to hyperpigmentation is endless because any irritation can cause it. Acne, cuts, scrapes, waxing, and rashes are just a few. Dr. Battle says the main culprit of hyperpigmentation is sun exposure, because it can cause irritation to the skin (such as sunburn) or darken an already present mark. This is why SPF is so important, but we’ll get into that later.
According to Dr. Battle, “an acne lesion is slightly swollen because it is inflamed and infected, leading to a series of events that lead to hyperpigmentation.”
Any squeezing or picking of acne can cause further trauma to the skin, and therefore, dark spots, which is why we need to learn to keep our hands off our faces.
Is There Any Way We Can Prevent It?
Dr. Battle notes that “even with the best prevention, that doesn’t mean dark spots will never form.” However, it’s still what you want to do to help keep hyperpigmentation at bay. The most crucial part of prevention is a consistent routine. “Keep the skin clean, bacteria-free, well-hydrated, slathered with sunscreen, and appropriately take care of any scrape, cut, irritation, or acne bump.”
Dr. Battle uses his daughter’s skin-care routine as an example of how to prevent and treat hyperpigmentation, especially if you are dealing with acne. In the morning: a mild exfoliating cleanser combining glycolic acid (an alpha hydroxy acid) and salicylic acid (a beta hydroxy acid), an antibiotic gel to both prevent and treat her acne, and a moisturizing sunscreen; at night, she washes with a nonexfoliating gentle facial cleanser, a low-strength retinoid, and a moisturizer. If she has a dark spot, she treats it with hydroquinone.
Aesthetician Ashley White has three white-cast-free suggestions for sunscreen:
Black Girl Sunscreen SPF 30: “This moisturizing formula avoids the minerals zinc oxide and titanium dioxide that are known to leave a white cast on darker skin tones and still give you broad spectrum protection.”
Neutrogena Hydro Boost Sunscreen SPF 30: White refers to this as the “lazy-girl sunscreen.” Infused with hyaluronic acid, “it's so hydrating that I've been able to just cleanse, apply this SPF, and retain moisture all day long.” (Personally, I love this sunscreen so much, I use it on my entire body because it’s not greasy and absorbs quickly.)
Glossier Invisible Shield Daily Sunscreen SPF 35: Most of Glossier’s products are known for creating that dewy look, but White says their SPF is closer to a semi-matte finish: “I like wearing this under makeup for summer rooftop afternoons. It really grips my foundation and still looks fresh by sundown.”
My current favorite is Make P:rem Blue Ray Sun Gel SPF 50+. It functions as a great primer — giving skin a prepped, dewy feeling — so I’ll skip that step in my makeup routine and go straight to foundation.
Our winner for the 2019 Acne Awards: Coola Sun Silk Drops SPF 30, a full-spectrum organic sunscreen that protects, adds dewiness, and absorbs quickly.
How Do We Treat It?
As mentioned above, the best approach to keeping skin dark-spot free is prevention. You don’t have to wait to begin the work to get rid of a dark spot; spots can be treated immediately after forming. But, Dr. Battle notes, “If the dark spot is around a wound then the wound needs to be completely healed before treatments start, usually four to six weeks after the wound was created.”
At his practice, Dr. Battle says, “The acne in people who are prone to get dark spots, particularly patients with skin of color, are treated differently, to try to not have the inflamed acne bump evolve into a dark spot. We don't try and dry the lesion as much to give the acne bump a chance to evolve without causing a dark spot.”
Treatment can also depend on where the dark spot came from. If from sun damage, laser treatment is best because of how deeply it penetrates the skin. Acne can be treated with topical products before it becomes a deep hyperpigmentation spot.
Exfoliation: When it comes to exfoliation, you have two choices: mechanical or chemical. Remember when skin-care Twitter was up in arms because Kylie Jenner included a walnut scrub in her line of skin-care products? You can go this route if you want, but Dr. Battle cautions that one of the main reasons dark spots get darker is scrubbing that is too abrasive and frequent.
Chemical exfoliants work by dissolving dead-skin cells. White says this can include alpha hydroxy acids (AHAs), such as glycolic and lactic acids, salicylic acid or benzoyl peroxide, but it all depends on which is best for you.
Either way, it’s important to be gentle, and avoid using products that are too harsh for your skin type because you want to see quick results.
Hydroquinone: Hydroquinone is one of the most common (and effective) solutions in treating spot hyperpigmentation — but it’s also a skin-bleaching agent. “The over-the-counter version is 2%, and the 4% prescription strength is very mild, and can be used daily on the individual dark spot, but can also be used once in a while on the full face to help to brighten (not lighten) the complexion,” Dr. Battle says. High strength, anything between 5-12%, needs a physician's prescription. So the key phrase here is: spot treatment, applied directly to the dark mark.
Other Acids: Azeliac acid is sometimes used in conjunction with glycolic acid or retinoids, and helps speed up cell turnover and decrease inflammation. Kojic acid is considered a natural bleaching agent (it’s derived from a type of fungus). “It’s often used for dark spots and the brown-colored pigmentation from acne,” Dr. Battle explains. Both acids are often paired with other spot-treating agents, such as hydroquinone.
Niacinamide is a form of vitamin B3, and some studies suggest that in combination with other molecules, it can help fade hyperpigmentation. The Ordinary carries a Niacinamide 10% + Zinc 1% serum ($6), which was our Acne Awards 2019 winner for Best Serum, and Paula’s Choice has one that combines hydrating and soothing ingredients as well.
Topical retinoids and retinols are all the craze these days, with Sunday Riley and Drunk Elephant selling products containing retinol and retinoids because they can help to reduce the appearance of wrinkles. At their core, retinoids can help acne by shrinking oil glands and speeding up cell turnover, so it’s popular in helping to treat acne and decrease post-inflammatory hyperpigmentation. However, a retinoid that’s too strong for the skin can irritate and actually make hyperpigmentation worse. A dermatologist can help you determine the right strength for you.
Credits:
Photographer: Anairam
Stylist: Michelle Li
Make-up: Courtney Perkins
Hair: Lizzie Arneson
Manicurist: Dawn Sterling
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