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As people age, dark spots or patches on the skin become more common. The sun, hormones, and certain illnesses and medications can stimulate the skin cells to produce more melanin, resulting in hyperpigmentation. Melanin is the substance that gives color to the skin, and produces a tan in response to exposure to ultraviolet rays. Overproduction of melanin can result in freckles or larger "age spots."
Melasma is a dark skin discoloration that appears on sun-exposed areas of the face. Young women with darker skin tones are at greatest risk. Melasma is often associated with the hormones estrogen and progesterone, and is especially common in women who are taking birth control pills and pregnant women (known as the "mask of pregnancy"). Creams containing various combinations of tretinoin, kojic acid, azelaic acid, hydroquinone and a corticosteroid have been shown to improve the appearance of melasma.
Skin discoloration can also be a symptom of an underlying medical condition such as Addison's disease, or the result of interaction between UV light and certain medications. Skin sometimes darkens after an injury, such as a cut or burn.
Although dark spots may not be attractive, hyperpigmentation is usually harmless. You can help to prevent hyperpigmentation by limiting sun exposure, wearing protective clothing, and using a broad spectrum, water-resistant sunscreen with a minimum SPF of 15.
If the discoloration bothers you, ask your dermatologist about using a skin lightener, chemical peel, microdermabrasion or laser therapy to treat the darkened spot.
Our compounding pharmacist can work together with your dermatologist to customize combinations of topical medications and sequential treatments for hyperpigmentation. We always welcome your questions.
Cutis. 2008 Nov;82(5):372-8.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001839/
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