Of all the obstacles that stand in the way of flawless skin, such as acne, redness and deep wrinkles, arguably the biggest one is uneven skin tone, or discoloration. This can include everything from sun spots to acne scars and the “mask of pregnancy.” We’ll take a look at what causes uneven skin tone, how to prevent it- and how to improve it.
What is Uneven Skin Tone?
Uneven skin tone generally refers to hyperpigmentation, which is a darkening of the skin. Hyperpigmentation usually shows up as spots and patches. It is a normal part of the aging process and is caused by overproduction of melanin, a pigment that gives color to skin and hair.
Dark spots are sometimes called “age spots” or “liver spots” but their technical name is a “solar lentigines.” Sun spots can appear anywhere on the face, but are usually found in areas where the sun hits the most, such as along the hairline and over the bridge of the nose. Dark spots are often seen on the chest and back of the hands, as well as the shoulders.
Dark spots are one of the visible signs of “photoaging.” As the Skin Cancer Foundation notes, “Responsible for 90 percent of visible changes to the skin, photoaging is a direct result of cumulative sun damage you’ve been exposed to throughout your life.”
Are Sun Spots and Uneven Skin Tone Something to Worry About?
A true sun spot is light or dark brown, and is flat. They are not dangerous but it is important to know the difference between a sun spot and something that could potentially be more serious. According to the American Cancer Society, “Not all skin cancers look the same. In fact, skin cancers can show up in many shapes and sizes.” Spots that grow, change or expand could be something more dangerous, and any concerns should be checked with a medical professional.
What Causes Uneven Skin Tone?
Dark spots and hyperpigmentation are caused by a multitude of factors, ranging from sun exposure to hormones but it all comes down to melanin production. As the Mayo Clinic explains, “Age spots are caused by overactive pigment cells. Ultraviolet (UV) light accelerates the production of melanin. On the areas of skin that have had years of frequent and prolonged sun exposure, age spots appear when melanin becomes ‘clumped’ or is produced in high concentrations.”
The main causes include:
The Sun: Sun spots crop up from exposure to the sun. While they don’t appear overnight, they are caused by cumulative sun exposure. UV rays from the sun trigger the body to produce melanin, which is how the body protects itself.
Hormones: Some pregnant women develop a dark patch on their face, which is called the “mask of pregnancy,” or melasma. It can also occur in women taking contraceptives.
Medication: Certain drugs can cause pigmentation of the skin. According to the NCBI (National Center for Biotechnology Information), about 20% of pigmentation cases are thought to be caused by drugs. Drugs associated with pigmentation include cytotoxic agents, analgesics, anticoagulants, antimicrobials, antiretrovirals, metals and antiarrhythmic ones.
Tanning Beds: Tanning beds also contribute to sun spots (and more) as they expose the skin to UV light, which damages the skin.
Pollution: Some studies suggest that pollution may also contribute to dark spots on the face. As Professor Jean Krutmann, director at the Leibniz Research Institute for Environmental Medicine in Germany told The Guardian in 2016, “UV [damage from the sun] was really the topic in skin protection for the last 20-30 years. Now I think air pollution has the potential to keep us busy for the next few decades…But what we can say is that, at least for the pigment spots on the cheeks, it seems air pollution is the major driver.”
Post-Inflammatory Hyperpigmentation: Scars from acne or an injury can also show up as flat,
dark spots, which is something to consider when you are tempted to pick at a pimple.
How To Prevent Uneven Skintone
While some dark spots are a natural part of the aging process, there are a few things you can do to help keep them at bay, such as applying sunscreen daily, and covering up. Sun exposure is the leading cause of hyperpigmentation, which is why it is essential to wear a broad spectrum SPF every single day, no matter the season or the weather forecast. Look for physical sun blockers such as zinc and titanium dioxide. Give your face and eyes another level of protection from the sun by covering up with a wide brimmed hat and sunglasses.
How to Get Even Skintone
There are multiple remedies for helping to fade the look of dark spots and get even skintone, but keep in mind that patience and persistence are key. It can take around 30 days to start to see results from lightening and brightening products, and sometimes it can take months. The products need to be used continuously in order to maintain results – and skin must be kept protected by the sun. According to Harvard Health, “But remember that after any treatment for age spots, you must unfailingly use sunblock. If you don’t, just 10 minutes of sun on a spring day can cause them to become dark again, reversing the months of effort it took to lighten them.”
The Mayo Clinic’s suggestions for tackling dark spots include bleaching creams, laser, cryotherapy, microdermabrasion and chemical peels. Here’s a closer look at various remedies.
Concealer. One of the simplest ways to temporarily minimize the look of a dark spot or hyperpigmenation is to apply a concealer. Be sure to find a product that matches your skin tone.
Exfoliation. Whisking away dead, dull surface skin cells helps prep the face to receive products and can also help to improve the look of discolored skin. Skip the chunky physical scrubs as they can be too harsh for the skin. Look for a gentle scrub made from rice powder, or try one made from an alpha hydroxy acid which gently dissolve dead skin cells.
Retinol. Products containing vitamin A derived retinol can also help fade the look of hyperpigmented spots. It works by accelerating skin cell turnover to reveal fresher looking skin. Retinol can be irritating to the skin, so start slowly and use just a pea sized amount on the entire face before building up to more frequent use.
Vitamin C. This antioxidant helps to brighten the look of the skin, which means it can help make dark patches less noticeable. One of the best ways to deliver it to the skin is with a vitamin C serum, as it is are lightweight, readily absorbed and can be layered under moisturizer.
Microdermabrasion. A dermatologist or aesthetician can perform a deeper exfoliation with microdermabrasion, which is a manual exfoliation using a fine spray of crystals to blast off a layer of skin.
Dark Spot Corrector. These spot-treatment products help to gradually fade the look of dark spots and tend to be packaged as serums. Some of the most common ingredients in dark spot correctors include retinols, hydroquinone, glycolic acid and vitamin C, along with the more exotic peony extract and wild rose.
Laser. Lasers work by targeting discoloration with concentrated light. Another way to think about it is that it removes deep layers of the skin. According to the AAD, “Procedures, which include laser therapy and chemical peels, tend to work faster. Procedures also cost more and have a higher risk of causing side effects.”
Hydroquinone. Hydroquinone is essentially a skin bleaching ingredient. It works by blocking the melanin-producing enzyme tyrosinase, and is available in both over the counter and prescription products. A 2014 article by Seemal R. Desai, MD, Hyperpigmentation Therapy: A Review” published in The Journal of Clinical and Aesthetic Dermatology, said “Hydroquinone remains a workhorse of melasma and hyperpigmentation management and is often considered the topical “gold standard”.
However, hydroquinone is a controversial ingredient that has been banned in some countries due to concerns that it may be a carcinogen. Possible side effects include increased pigmentation and darkening of the skin, which can be permanent. Anyone using prescription strength hydroquinone is closely monitored by a doctor.
Chemical Peel. Another form of exfoliation is a chemical peel, which can be done at home using a wash off mask that usually contains AHAs such as glycolic, lactic, and citric acids to help remove dead skin. A deeper peel can be done by a doctor or aesthetician, and they work by removing layers of skin.
Cryotherapy. Performed by a doctor, this procedure involves freezing dark spots with liquid nitrogen, which look lighter as they heal. Every procedure carries risk, and some possible side effects include over lightening of the skin and permanent white scars, according to the American Society for Dermatologic Surgery (ASDS).
Are There Any Other Options?
There are some naturally derived ingredients which also help fade the appearance of dark spots. They also work by inhibiting the enzyme tyrosinase, which is necessary for the production of melanin. Kojic acid is derived from different types of fungi, and other skin lighteners include licorice root, mulberry extract and green tea. Ellagic acid, a compound that can be found in some vegetables, nuts and fruits, also works to lighten the look of dark spots.
For those that want to take a DIY approach to their sun spots, some people swear by dabbing lemon juice on their discolored areas. The vitamin C and citric acid may help fade the spot but could be irritating on the face. Other DIY favorites include apple cider vinegar, an acid, and buttermilk and yogurt, which contain exfoliating lactic acid.
No matter what product you choose, read the label carefully. The American Academy of Dermatology cautions against using any skin lightening products that contain mercury as “it could be damaging your kidneys without you knowing it. Mercury can also injure your nerves, leading to permanent numbness or tingling in your hands, feet, or around your mouth.” According to the World Health Organization (WHO), a product contains mercury if you see one of more of these ingredients: calomel, cinnabaris, hydrargyrioxydum rubrum and quicksilver.
Sources: Skin Cancer Foundation, American Cancer Society, Mayo Clinic, National Center for Biotechnology Information, The Guardian, Harvard Health, The American Academy of Dermatology, American Society for Dermatologic Surgery (ASDS), World Health Organization.
