Why Does Hyperpigmentation Affect Some People And Not Others?

Why Does Hyperpigmentation Affect Some People And Not Others?

Although hyperpigmentation is extremely common throughout the world, you can’t help but notice that they don’t affect everyone equally. So why is that the case? Let’s find out.

Blame It On The Genes

As with so much when it comes to health, there are some contributing factors to hyperpigmentation regarding our ethnicity and genetics that are out of our control.

The ‘Fitzpatrick Skin Classification’ system is used to describe the different shades of skin present in the population, with very pale skin labeled as ‘type I’ and very dark skin as ‘type VI’. Studies have shown that it is those with skin types in the middle, especially types III and IV that have the highest rates of dark patch development.

The theory is that people with skin type I have pigment cells that are just not very active, even when exposed to things like sunlight. Those with skin type VI, on the other hand, have cells that are already producing the maximum amount of pigment, so they are relatively ‘stable’ in response to extra triggers. This leaves those in the middle with light brown skin who have pigment-producing cells that are pretty active already, but are still capable of becoming extra active in response to the sun or hormonal changes.

In this way, the genes that we have that control our skin color can explain why some of us are more prone to dark patches than others. Let’s take melasma as an example. The role of genetics in melasma is supported by twin-to-twin comparison studies showing very similar rates of dark patches between siblings who share the same genes. Likewise, 40% of those with melasma have a family history of the condition in their direct relatives.

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Let’s Talk About Gender

Aside from ethnicity, your gender may be another reason why you are more at risk for dark patches on your skin. Conditions like melasma that can cause dark patches occur at different rates between men and women. Studies have shown a clear increased risk of melasma in females as compared to males, with estimated frequencies ranging from 9:1 to as high as 35:1.

Pregnancy, Contraceptive Pills, And Other Medications

It is well-known that conditions of skin hyperpigmentation can be triggered by pregnancy or by the use of an oral contraceptive in about 40-50% of female patients. Although melasma associated with pregnancy typically completely disappears (with treatment) within one year of delivery, some dark patches will persist in up to 30% of patients. This happens more often in those using oral contraceptive and in cases with more intense pigmentation. Recurrence is common in subsequent pregnancies and the chances of developing melasma for the first time during any given pregnancy increase with a history of multiple pregnancies.

Importantly, aside from contraceptive pills, there are other types of medications, including antibiotics and blood pressure medications (e.g. minocycline and amiodarone) that can cause reactions in the skin leading to darkening. For this reason, it is important to provide your dermatologist with a full list of all the medications you are taking, including over-the-counter supplements.

Post-Inflammatory Hyperpigmentation (PIH)

As the name suggests, this type of skin darkening occurs after some kind of inflammation to the skin. This is most commonly seen secondary to flares of conditions such as acne and eczema. It is crucial to try to establish what is causing this inflammation and seek treatment for this from a board-certified dermatologist.

No matter what types of products you use to get rid of darkening from PIH, without stopping the inflammation itself, it will be impossible to get meaningful results in terms of skin recovery.

Custom Hyperpigmentation Treatment With ClearifiRx

To conclude, some of the reasons why some people get dark patches on their skin and others don’t are genetics, gender, pregnancy, medications and underlying inflammatory skin disorders. Although these are the most common explanations for dark patches on the skin, there are other factors that can play a part.

For a full evaluation of the dark patches on your skin, and to get treatment that is optimized especially for you, talk to your ClearifiRx dermatologist using our app today. We will develop a treatment that is customized to your skin and your needs to help you clear you regain a clear complexion.

Learn more about our Skin Hyperpigmentation Treatment


Usama Syed

Usama Syed is currently a dermatology resident at the Icahn School of Medicine at Mount Sinai. He received his medical degree from Imperial College London, United Kingdom, and a first class honors bachelor of sciences from the Imperial College London Business School. Dr. Syed moved to the United States in 2016 to pursue his specialist training in dermatology. He completed a year long postdoctoral research fellowship at Mount Sinai Hospital where he focused on the use of mobile applications in healthcare. Dr. Syed is a scholarship recipient from Advancing Innovation in Dermatology (AID), and is currently enrolled in the 'Virtual Magic Wand' program led by Dr. Rox Anderson of Harvard. Dr. Syed has made significant contributions to the world of cosmetic dermatology, authoring book chapters on the subjects of injectable fillers and platelet-rich plasma for publishers such as Thieme and Springer.

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