Houston Hyperpigmentation Treatment

WHAT CAUSES HYPERPIGMENTATION?

Several contributing factors lead to hyperpigmentation:

Sun Damage & UV Light

UV light and UV radiation stimulate melanin production, leading to freckles, sunspots, and uneven skin texture. Repeated sun damage is the leading cause of hyperpigmentation.

Hormonal Changes

Hormonal fluctuations during pregnancy, menopause, or from birth control use can trigger melasma – a type of hyperpigmentation that appears as symmetrical brown patches on the face. It is particularly common in pregnant women.

Post-Inflammatory Hyperpigmentation (PIH)

After an injury or both acne breakouts, darkened patches may form as part of the healing process.

Genetics and Skin Type

Some people are genetically more prone to pigmentation disorders, especially those with darker skin tones.

Medications and Medical Conditions

Certain medications, including chemotherapy drugs and antibiotics, as well as health issues like Addison’s disease, may cause extra melanin to develop in treated areas.

TYPES OF HYPERPIGMENTATION

• Melasma – Characterized by symmetrical dark patches, typically on the cheeks, forehead, upper lip, or chin. Often linked to hormonal changes and sun exposure.

• Sunspots (Solar Lentigines) – Flat, darkened patches that appear with age and prolonged UV exposure, commonly on sun-exposed areas.

• Post-Inflammatory Hyperpigmentation (PIH) – Dark spots that develop following acne breakouts, injuries, or inflammation of the skin.
  
• Freckles – Small brown spots often inherited genetically and worsened with sun exposure.

WHAT IS HYPERPIGMENTATION TREATMENT?

To reduce hyperpigmentation, our dermatologists use a range of therapies designed to fade dark spots, encourage skin cell turnover, and reveal healthier skin beneath. Professional care can improve tone, refine large pores, and create smoother skin texture.

How is Hyperpigmentation Treatment Done?

At Nikko Dermatology, hyperpigmentation treatment is always tailored to each patient’s condition, severity, and goals.

Compounded Hydroquinone Cream

This prescription-strength topical treatment contains active ingredients that regulate melanin production. It is considered an effective treatment for melasma, dark marks, age spots, and uneven tone.

Complexion Peel (formerly Cosmelan Peel)

This professional peel uses chemical peels with alpha hydroxy acids like glycolic acid and lactic acid to exfoliate, accelerate skin cell turnover, and penetrate deep into damaged layers. It reduces discoloration, improves skin cells, and helps in revealing brighter skin.

Laser and Light Therapy

For stubborn pigmentation, our dermatologists may recommend advanced laser treatments or light therapy using controlled visible light. These options break down clusters of pigment caused by excessive sun exposure or UV light while protecting the surrounding skin.

Supportive Skin Care

To maintain results, medical-grade skin care products with kojic acid, azelaic acid, or hyaluronic acid may be recommended. Choosing fragrance-free formulas and always remembering to apply sunscreen and practice daily sun protection are essential for long-term success.

Some patients may require multiple sessions of treatment to achieve their desired results, especially for deeper pigmentation issues.

What is Basal Cell Carcinoma Removal?

The goal of treatment is to remove cancerous cells completely while preserving cosmetic appearance.

Techniques for Basal Cell Carcinoma Removal

1. Surgical Excision

Surgical excision is one of the most common and reliable treatments for basal cell carcinoma. During this procedure, the dermatologist numbs the area, then removes the cancerous lesion along with a margin of surrounding healthy tissue. This margin ensures that no microscopic cancer cells are left behind. The tissue is then sent to a pathology lab to confirm complete removal. Surgical excision has a very high cure rate, especially for small to medium lesions, and is often performed on the trunk, arms, or legs, where there is more skin flexibility for sutures. While the procedure may leave a fine scar, it typically heals well and is a strong option for long-term cancer control.

2. Mohs Micrographic Surgery
Mohs surgery is considered the gold standard for treating high-risk basal cell carcinomas, especially in areas where preserving as much healthy tissue as possible is crucial, such as the face, ears, or eyelids. The process involves removing the tumor layer by layer and examining each layer immediately under a microscope. This continues until no cancer cells are detected. The advantage of Mohs surgery is its precision; it allows maximum removal of cancer while sparing the most healthy tissue, making it ideal for cosmetically sensitive areas. Mohs surgery also boasts the highest cure rate of all treatments, often up to 99%, making it especially valuable for recurrent or aggressive basal cell carcinomas.

3. Curettage and Electrodessication (C&E)
Curettage and electrodessication is a technique used for smaller, superficial basal cell carcinomas. In this procedure, the tumor is scraped away with a curette, and then the remaining area is cauterized with an electric needle to destroy any residual cancer cells.
C&E can be performed in a dermatologist’s office without the need for stitches. It is cost-effective and efficient, but it does have slightly lower cure rates than excision or Mohs surgery. It is also not recommended for aggressive tumors or cancers located in high-risk areas like the nose or eyelids. Patients should expect a round, pale scar at the site, but for small, low-risk tumors, this remains an excellent option.

4. Topical and Light-Based Therapies
Non-surgical therapies are sometimes recommended for very superficial basal cell carcinomas, particularly when patients want to avoid cutting or scarring. Topical treatments include prescription creams like imiquimod, which stimulates the body’s immune system to attack cancer cells, and 5-fluorouracil, a chemotherapy cream that destroys abnormal skin cells. Another option is photodynamic therapy (PDT), in which a special light-sensitive medication is applied to the skin and then activated by a medical light source, targeting and destroying the cancer cells. These treatments are especially useful for multiple small cancers or those located on cosmetically sensitive areas such as the face. However, they are not recommended for deeper or more aggressive basal cell carcinomas, and close follow-up is necessary to ensure the cancer does not return.

POTENTIAL COMPLICATIONS

While professional treatments are generally safe, some risks may include:

• Temporary redness, peeling, or irritation.
• Increased sun sensitivity in treated areas.
• Rare cases of scarring or uneven pigmentation if not performed properly.

Patients are always advised to apply sunscreen after treatment to protect the results.

AT-HOME REMEDIES VS. PROFESSIONAL CARE

Many at-home products contain fragrance-free formulas and active ingredients like azelaic acid or kojic acid. While these can help with mild discoloration, they are often not strong enough for deep pigmentation.

Professional treatment ensures safety, the ability to penetrate deep layers of skin, and longer-lasting results.

Takeaway

• Hyperpigmentation treatment at Nikko Dermatology is customized to target melasma, sun damage, and postinflammatory hyperpigmentation.
• Core options include compounded hydroquinone cream and the Complexion Peel, with support from light therapy and medical-grade skin care.
• Treatments address discoloration while also improving skin texture, reducing large pores, and supporting healthy skin cells.
• To maintain results, patients should apply sunscreen daily and avoid too much sun exposure.