Light Spots & Hypopigmentation | 9 Ways to Fix Them

Beautiful, smiling dark skinned woman, hands in her hair | Light Spots & Hypopigmentation | 9 Ways to Fix Them | Masterpiece Skin Restoration

What Causes Light Spots?

Not long ago,  I had a reader call about treating light spots on her face. She got them after a laser treatment. When your skin loses color like hers did, it's called hypopigmentation. It often happens after laser treatments that target one specific color - called a chromophore. Lasers that work this way are very good at removing dark spots, tattoos or hair; but in some cases they work too well. The dark spot, hair, or tattoo is removed, but so is all of the pigment in the treated area. Only a light spot remains.

The people most frequently affected have dark skin and have had multiple treatments. Usually their color loss is temporary, but for some it is permanent. This also happens in people who have skin resurfacing treatments where the entire top layer of skin is removed.

So now you know that hypopigmentation is a light spot in skin caused by low amounts of melanin. (Melanin is what gives skin its color.) But there are other causes of color loss besides lasers.

Diseases (like Vitiligo, Seborrheic dermatitis, or Tinea versicolor) can cause light spots. And skin injuries (like infections, pimples, blisters, or scrapes), burns, or any kind of trauma can also cause hypopigmentation. When an injury causes inflammation and damage leading to color loss, it is called post-inflammatory hypopigmentation, or PIH.

So what can you do about light spots and hypopigmentation?

Treating hypopigmentation is tricky. If you get light spots that don't go away, be sure to see a dermatologist. The best treatment option will depend on what's causing your hypopigmentation, the amount of light skin you have, and the result you want to achieve.

There are many treatments for hyperpigmentation. There aren't nearly so many for hypopigmentation.

4.  If you have light spots caused by a skin disorder like vitiligo, (shown above right) the treatment usually includes prescription medications. Vitiligo is an autoimmune disorder that causes white patches of skin. People with vitiligo get hypopigmentation because their white blood cells attack and kill the cells which give their skin color. When these melanocytes are destroyed, they don't come back. So people with light spots over more than half of their body may want their dark spots lightened to match the rest of their body. In cases like this doctors use skin lighteners like hydroquinone or Tri-Luma. Some people with vitiligo also get improvement with a drug called Psoralen combined with light therapy.

5.  IPL, excimer lasers, and the Fraxel Restore laser are all recommended for treating hypopigmentation by the doctors on RealSelf.com.

  • IPL stands for intense pulsed light. You may also have heard it called a photofacial, BBL (broadband light), or photorejuvenation. It treats sun damage, dark spots and rosacea. This kind of light treatment targets brown and red chromophores. For people with greater than half of their skin affected by hypopigmentation, using IPL to treat the melanin in unaffected skin can create a more even skin tone.
  • The 308-nm excimer laser was studied in the treatment of white stretch marks and scars that had lost melanin. Patients were treated every 2 weeks for a maximum of 10 treatments. Each patient achieved a 100% correction to the eye and a 75% increase by colorimetric measurement (The amount of light absorbed as it travels through a sample.) BUT maintenance treatments were required every 1 - 4 months to retain the color. This study was published in the Archives of Dermatology Journal in 2004.
  • Another study published in Dermatologic Surgery in 2007, was done on hypopigmented scars on the faces of 7 patients. A 1550-nm Fraxel laser was used to treat all 7 patients. 6 out of 7 got a 51 - 75% improvement in color after 2 - 4 treatments spaced every 4 weeks. The last patient measured at a 26 - 50% improvement. Fractional resurfacing also evens skin tone with a mixture of hypo and hyperpigmentation.
Pretty medium skin tone woman, smiling, hands on hips | Light Spots & Hypopigmentation | 9 Ways to Fix Them | Masterpiece Skin Restoration

6.  Micro-Needling works to reduce scars and hypopigmentation. This method uses needles to pierce the skin without removing tissue. Your body reacts to these micro-injuries by forming new collagen and elastin. Our bodies won’t replace the scar tissue completely, especially if the scar is deep; but they will replace the parts that are injured by micro-needling. This creates a mixture of scar tissue and normal tissue and results in a smoother, better looking, softer scar. Indented scars fill and raised scars flatten. Needling a hypo-pigmented scar will also cause your pigment producing cells to move from the surrounding skin into the scar, improving its color. Learn more on our Scars and Stretch Marks page.

7.  If none of these work, some doctors will recommend skin grafting or blister graftingBlister grafting is a great option because there is no scarring. During this procedure, your doctor creates a blister on an part of your skin with normal color. Then he or she removes the top of the blister and reattaches it to the area without pigment.

8.  Another interesting option is being researched. It treats light spots and hypopigmentation using bimatoprost ophthalmic solution 0.03% (also know as Latisse and Lumigan) in combination with the Fraxel laser and topical retin-A. Bimatoprost increases pigment production, while the Fraxel and retin-A allow the bimatoprost to better penetrate the skin. There are a few studies, but more research is needed.

9.  Finally, if the hypopigmentation does not improve with medications or treatments, camouflaging with makeup, cosmetic tattooing or permanent makeup are good options.

  • Airbrush makeup is typically used to cover large or small areas with hypopigmentation or hyperpigmentation. Learn more in our articles, How Airbrush Makeup Covers Tattoos, Acne, Vitiligo, Etc., and Airbrush Tattoo Cover Up.
  • Tattoos can be used to cover light spots. The tattoo artist uses a pigment that matches the color of your surrounding skin to make the light spots barely noticeable. It's called cosmetic tattooing, permanent makeup, or paramedical tattooing. Check out Basma Hameed on YouTube. She is amazing!
  • Dermablend makeup was created by a dermatologist and his makeup artist wife to solve the complexion problems that skincare could not.

You'll probably need a couple of different types of treatments to minimize your hypopigmentation.

None of the methods work perfectly, so you'll need to work with your provider to find what will work best for you. Initially, you may have had dark spots removed, which in turn caused light spots. The next best step is to find a method that will blend the dark and light spots - as they're often a package deal. Sorry to tell you! And be sure to wear sunscreen to prevent more problems! Good luck!

Masterpiece Skin Restoration is your online resource for all things medical aesthetics, beauty, and wellness. We keep you up to date on leading edge technology and the services available to help you restore your natural beauty.

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References:

https://www.realself.com/Hypopigmentation/info

http://www.livestrong.com/article/109977-restore-pigment-white-spots-skin/

http://www.livestrong.com/article/287489-how-to-boost-melanin-production/

http://emedicine.medscape.com/article/1120837-overview#a5

http://practicaldermatology.com/2010/05/dermatology-qa-new-directions-in-the-treatment-of-hypopigmented-scars

http://www.mdedge.com/edermatologynews/article/18140/skin-color-postinflammatory-hypopigmentation-and-hypopigmented-scars

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533534/

https://www.researchgate.net/publication/51218038_Postinflammatory_hypopigmentation

http://www.mayoclinic.org/diseases-conditions/vitiligo/diagnosis-treatment/treatment/txc-20319051

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401843/

http://dermatologytimes.modernmedicine.com/dermatology-times/content/tags/dermatology/research-uncovers-new-innovative-treatments-conditions-pa

Correcting White Spots on the Face. Can It Be Done? by Dr. Brandith Irwin

Principles of Colorimetric Measurements on www.scribd.com

https://www.realself.com/guide/ipl-overview#.WXUt4oTyt0w

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126803/

Basma Hameed TEDx (Paramedical Micropigmentation):  https://www.youtube.com/watch?v=z3RXbbwJuHY

Disclaimer:

The Information provided on our website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some - like melanoma - can be deadly. If there is any doubt, please, please consult your physician. Thank you!