14 Aug 2025
The human eye perceives “smooth” skin as being more vital, healthy and youthful looking. While there is considerable focus in the media on reducing fines lines and wrinkles, smooth skin is not simply about texture. It is also blemish free. There is a reason why it is such a compliment to be told that you have skin like a porcelain doll. Unfortunately, brown spots are a common occurrence if you spend any time in the sun. Hyperpigmentation is the overall term for these unwanted spots and/or patches of darker skin. While the sun is a definite driver, there are other underlying causes for hyperpigmentation which is why it’s important to schedule an in-person consultation with a Board-Certified Dermatologist such as myself. Any treatment plan must be customized to your skin’s specific needs as well as your lifestyle, but here are my most common procedures for how to treat hyperpigmentation safely and effectively.
Understanding Hyperpigmentation
Before we dive into treatment options, it is important to understand that there are a number of underlying causes of hyperpigmentation including:
- Sunspots
- Liver or Age Spots
- Post-inflammatory Hyperpigmentation
- Melasma
Part of what makes this skin issue so pervasive is that it can occur at any age, and some of the drivers are out of your control. For example, melasma is often the result of hormone fluctuations which can occur during pregnancy while post- inflammatory hyperpigmentation may result after an acne or eczema outbreak. It’s pretty frustrating for patients. However, the number one thing that all of us can do to reduce the incidence of brown patches and/or keep them from recurring after a treatment is to apply a broad-spectrum mineral sunscreen of at least SPF 30 every day, rain or shine.
Medical Grade Skincare
After sunscreen, my first course of action for improving your hyperpigmentation is probably going to involve overhauling your skincare routine. My Boston area patients are always surprised by how much improvement can be achieved in terms of skin texture, and to certain extent tone, with an appropriate skincare routine with medical grade products. These are products for which you do not need a prescription, but that are only carried by a medical professional so their strength and efficacy is higher than what you can get over-the-counter (OTC) at your local drugstore. During our consultation, I will inquire into your lifestyle, including finances, so that we come up with a routine that you can afford and will actually use. I am not going to tell you that you need 15 different products. Instead, I am looking to match your skin’s needs with something that will improve your issues without irritating your skin or creating other problems. For hyperpigmentation specifically, I recommend medical grade skincare products that contain:
- Tranexamic Acid
- Retinoids
- Vitamin C
These three have all been proven in clinical studies and my own practice to reduce the appearance of hyperpigmentation. In patients with really stubborn melasma, I may prescribe topical prescription options.
Hydrafacial for Hyperpigmentation in Boston
Next in my hyperpigmentation treatment arsenal is a hydrafacial with an appropriate brightening booster. If you haven’t had one before, this is not your “spa” facial. It is a skin procedure that utilizes a vacuum-like suction to gently, but effectively, exfoliate your skin while driving active ingredients deeper into your dermis where they can be more effective. There are different boosters to address a wide range of skin concerns. For hyperpigmentation, I recommend one of the brightening boosters. Again, the correct one for you is going to depend on your anatomy and needs.
Chemical Peel to Improve Hyperpigmentation
The last of my most common treatment options for improving hyperpigmentation is a chemical peel. I like to use the IV Peel Precision Plus as I find it offers a nice balance between efficacy and recovery time. In general, any chemical peel is going to be a more robust procedure that will require downtime for healing. Your skin is going to start peeling around day 3. This typically subsides around day 7 although for some patients, it takes 10 days. You will be sent home with specific post peel instructions and the more closely you follow these, the faster you should recover.
And sunscreen is mandatory. It makes no sense to go through the trouble of peeling off the damaged skin only to expose your fresh, rejuvenated skin to new damage. A chemical peel is more of a commitment, but it also may produce the most “wow” result.
To find out more about medical grade skincare, Hydrafacial, chemical peel, or any other aesthetic treatment with Dr. Melissa Michelon at Boston Center for Plastic Surgery, contact us today or call (617) 450-0070 to schedule a consultation.
