Skin of Colour and Hyperpigmentation
Highlights treatment considerations for hyperpigmentation in skin of color, focusing on safe topical options, procedures, preventive care, & minimizing risks like post-inflammatory hyperpigmentation.
Understanding Hyperpigmentation in Skin of Colour
What is hyperpigmentation, and why does it affect people with skin of colour more commonly?
Hyperpigmentation refers to patches of skin that become darker than the surrounding skin due to excess melanin production. People with skin of color are more prone to hyperpigmentation because they have more active melanocytes (the cells that produce melanin), which can overreact to skin injury, inflammation, or sun exposure, leading to dark spots or patches.
What do you mean by skin of colour?
"Skin of colour" refers to individuals with Fitzpatrick skin types IV to VI, which includes people of African, Hispanic, Asian, Middle Eastern, and Indigenous descent. These skin types typically have more melanin, the pigment responsible for skin colour, making them more prone to conditions like hyperpigmentation. Skin of colour has distinct biological and clinical characteristics that affect how it responds to environmental factors, skin injuries, and treatments.
What Are Fitzpatrick Skin Types?
The Fitzpatrick Skin Type system is a classification that helps determine how different skin tones respond to UV light exposure. It was developed to assess the risk of sunburn and predict a person’s likelihood of developing conditions related to sun damage, such as hyperpigmentation.
Here are the six Fitzpatrick skin types:
Type I:
Very fair skin, often with freckles.
Always burns, never tans.
Common in people with light eyes and hair (e.g., Celtic ancestry).
Type II:
Fair skin.
Usually burns, tans minimally.
Common in people with light eyes and hair.
Type III:
Light to medium skin.
Sometimes burns, tans gradually and uniformly.
Common in people with European or mixed ancestry.
Type IV:
Olive or light brown skin.
Rarely burns, tans easily and deeply.
Common in people with Mediterranean, Middle Eastern, or Asian backgrounds.
Type V:
Dark brown skin.
Very rarely burns, tans easily and significantly.
Common in people with African, Indian, or Southeast Asian descent.
Type VI:
Deeply pigmented dark brown to black skin.
Never burns, tans very easily.
Common in people with African or Afro-Caribbean descent.
Fitzpatrick types IV-VI, which include people with darker skin tones, are at higher risk for hyperpigmentation because their melanocytes produce more melanin when exposed to UV rays or trauma. Understanding your skin type helps dermatologists recommend appropriate treatments and preventive measures for hyperpigmentation.
How Do I Know My Fitzpatrick Skin Type?
You can determine your Fitzpatrick skin type by considering how your skin reacts to sun exposure and what your natural skin tone looks like without a tan. Here’s a simple guide to help you figure it out:
What happens when you spend time in the sun without protection?
A: Always burns, never tans.
B: Usually burns, tans minimally.
C: Sometimes burns, tans gradually.
D: Rarely burns, tans easily.
E: Almost never burns, tans very easily.
F: Never burns, always tans deeply.
What is your natural skin tone (without sun exposure or tanning)?
A: Very pale or fair skin.
B: Light skin, may have freckles.
C: Light to medium skin.
D: Olive or light brown skin.
E: Dark brown skin.
F: Deep brown to black skin.
Matching Your Answers:
If you mostly answered A, you are likely Fitzpatrick Type I.
If you answered B, you may be Type II.
If you answered C, you may be Type III.
If you answered D, you may be Type IV.
If you answered E, you are likely Type V.
If you answered F, you are likely Type VI.
Your Fitzpatrick type is based on how your skin naturally reacts to the sun and your baseline skin color. A dermatologist can also help assess your skin type more accurately.
How does melanin play a role in hyperpigmentation in darker skin tones?
Melanin is the pigment responsible for skin color. In darker skin tones, melanocytes are more active, and any damage, such as inflammation or UV exposure, triggers an increased production of melanin. This can lead to uneven pigmentation or dark spots, as the excess melanin builds up in certain areas of the skin, making hyperpigmentation more noticeable and persistent.
What are the common types of hyperpigmentation seen in people with skin of colour?
Common types of hyperpigmentation in people with skin of color include:
Melasma: Dark, irregular patches, often triggered by hormonal changes or sun exposure.
Post-Inflammatory Hyperpigmentation (PIH): Dark spots or patches that develop after skin inflammation or injury, such as acne or eczema.
Lentigines (sun spots): Caused by sun exposure and seen as small, dark patches
How can I tell if I have melasma or post-inflammatory hyperpigmentation (PIH)?
Melasma usually appears as symmetrical, larger patches on sun-exposed areas like the forehead, cheeks, and upper lip, and is often related to hormonal changes or sun exposure. PIH, on the other hand, results from skin trauma (e.g., acne, cuts, burns) and appears as dark spots that develop at the site of skin injury or inflammation. Unlike melasma, PIH can occur anywhere on the body and is directly linked to prior damage.
Are there any genetic factors that make hyperpigmentation more likely in certain ethnicities?
Yes, genetic factors play a role in hyperpigmentation. People of African, Hispanic, Asian, and Middle Eastern descent often have Fitzpatrick skin types IV-VI, which have higher melanin levels and are more prone to hyperpigmentation. Conditions like melasma and PIH can also run in families, meaning individuals with a family history of these conditions are more likely to experience them. Ethnicity and genetic predisposition are important factors to consider when developing a treatment plan for hyperpigmentation.
Triggers and Risk Factors for Hyperpigmentation
What triggers hyperpigmentation in skin of colour?
Several factors can trigger hyperpigmentation in people with skin of color, including:
Sun exposure: UV radiation stimulates melanin production, leading to dark patches.
Skin inflammation or trauma: Acne, eczema, and injuries can cause post-inflammatory hyperpigmentation (PIH).
Hormonal changes: Pregnancy, birth control, or hormone therapy can lead to conditions like melasma.
Certain medications: Some drugs, such as antibiotics or chemotherapy, can increase pigmentation.
Can acne cause long-lasting hyperpigmentation in darker skin?
Yes, acne can cause long-lasting hyperpigmentation, especially in darker skin. After a pimple heals, the inflammation can leave behind dark spots known as post-inflammatory hyperpigmentation (PIH). These spots can persist for months or even years if not treated, and sun exposure can make them darker and more noticeable.
How does hormonal imbalance contribute to hyperpigmentation in women of colour?
Hormonal imbalances can lead to melasma, a type of hyperpigmentation that appears as dark patches on the face. Women of color are particularly prone to melasma, which is often triggered by fluctuations in estrogen and progesterone during pregnancy, while taking birth control pills, or with hormone replacement therapy. Hormonal changes can stimulate melanocytes, causing an overproduction of melanin and uneven pigmentation.
Is pregnancy a risk factor for melasma in women of colour?
Yes, pregnancy is a common trigger for melasma, often called the "mask of pregnancy." This occurs due to the increased hormone levels (especially estrogen and progesterone) during pregnancy, which can stimulate melanin production. Melasma usually appears as dark patches on the face and is more prevalent in women with darker skin tones.
Can hyperpigmentation develop from minor skin injuries like cuts or bug bites?
Yes, even minor skin injuries like cuts, bug bites, or scrapes can lead to post-inflammatory hyperpigmentation (PIH) in people with skin of color. When the skin is injured, inflammation can cause melanocytes to overproduce melanin, leaving dark spots at the site of injury. These spots can take time to fade, especially without proper treatment.
How does sun exposure worsen hyperpigmentation, especially in skin of colour?
Sun exposure worsens hyperpigmentation by triggering melanin production. In people with skin of color, this response is heightened due to more active melanocytes. UV rays from the sun not only darken existing hyperpigmented areas but can also lead to new dark spots. Consistent use of broad-spectrum sunscreen is critical to prevent worsening of hyperpigmentation.
Preventing Hyperpigmentation in Skin of Colour
How can I prevent hyperpigmentation from worsening?
To prevent hyperpigmentation from worsening, consider these strategies:
Daily use of sunscreen: Apply broad-spectrum sunscreen (SPF 30 or higher) to protect against UV and visible light.
Avoid skin trauma: Don’t pick or scratch acne or other skin irritations, as this can lead to post-inflammatory hyperpigmentation (PIH).
Use gentle skincare products: Avoid harsh exfoliants or irritants that can inflame the skin.
Seek early treatment: Treat skin conditions like acne or eczema early to avoid lasting dark spots.
Are there sunscreens specifically for people with darker skin tones?
Yes, there are sunscreens formulated for people with darker skin tones. These sunscreens:
Include tinted formulas that block visible light, which can worsen hyperpigmentation.
Are sheer and non-whitening, so they don’t leave a chalky residue. Look for sunscreens that contain zinc oxide, titanium dioxide, or iron oxide for effective protection.
Are there any lifestyle changes that can reduce the risk of hyperpigmentation?
Yes, certain lifestyle changes can help reduce the risk of hyperpigmentation:
Wear sun-protective clothing (hats, sunglasses) to limit sun exposure.
Avoid peak sun hours (10 a.m. to 4 p.m.) when UV radiation is strongest.
Manage skin conditions like acne or eczema early to reduce inflammation and minimize dark spots.
Stay hydrated and maintain a healthy skincare routine that includes gentle, non-irritating products.
Can I prevent post-inflammatory hyperpigmentation after acne flare-ups?
Yes, to prevent post-inflammatory hyperpigmentation (PIH) after acne flare-ups:
Treat acne early with products that reduce inflammation.
Use non-comedogenic sunscreen daily to prevent dark spots from sun exposure.
Avoid picking or popping pimples to reduce the risk of inflammation that leads to PIH.
Use skincare products that promote healing and reduce pigmentation, such as niacinamide or azelaic acid.
Treatments for Hyperpigmentation in Skin of Colour
What topical treatments are safe and effective for hyperpigmentation in skin of colour?
There are several safe and effective creams and lotions for treating hyperpigmentation in people with darker skin tones. These include:
Hydroquinone: A skin-lightening cream that reduces the production of melanin.
Retinoids: Creams that help your skin produce new cells faster, fading dark spots.
Azelaic acid: Reduces dark spots and calms irritated skin.
Kojic acid: A natural ingredient from mushrooms that helps lighten the skin.
Vitamin C: Brightens the skin and helps reduce the appearance of dark spots. Using sunscreen daily is essential when using these treatments to protect your skin and prevent further darkening.
Is hydroquinone safe to use for people with darker skin tones?
Yes, hydroquinone is safe for people with darker skin when used carefully. It's often considered the most effective option for lightening dark spots. However, it should be used for a limited time (about 3-6 months) and always under a doctor's advice to avoid any side effects. It’s crucial to pair hydroquinone with sunscreen to prevent new pigmentation from forming.
What are the benefits of using retinoids for treating hyperpigmentation?
Retinoids, like tretinoin, help your skin create new cells faster. This can:
Fade dark spots as the old, pigmented cells are replaced with new ones.
Improve skin texture, making your skin look smoother and more even. Retinoids also help prevent new dark spots from forming, but they can cause mild irritation at first, so it’s best to start slowly.
How effective are natural agents like kojic acid and vitamin C for skin of colour?
Both kojic acid and vitamin C are gentle and safe options for people with skin of colour:
Kojic acid: Slows down melanin production and can help lighten dark spots over time.
Vitamin C: An antioxidant that brightens the skin and helps protect it from further damage. It can make dark spots less noticeable while improving your overall skin tone. These ingredients are natural, so they work more gradually, but they’re a good option for those looking for a gentler approach.
What is the role of azelaic acid in treating hyperpigmentation in skin of colour?
Azelaic acid is another great option for reducing hyperpigmentation. It:
Helps fade dark spots by slowing down the production of melanin.
Calms any inflammation or irritation in the skin, which can help prevent further pigmentation from forming. It’s safe for all skin types, including darker skin, and works well when used with other treatments.
How long do topical treatments usually take to show results on darker skin?
Topical treatments typically take 8 to 12 weeks to show noticeable improvement on darker skin. However, results can vary depending on the severity of the pigmentation and how consistently the treatments are used. Patience is important, and using sunscreen daily is essential to protect the skin and maximize the effects of the treatment.
Chemical Peels
Are chemical peels safe for people with skin of colour?
Yes, chemical peels are generally safe for people with skin of colour when performed by a qualified specialist. However, the type and depth of the peel matter greatly. Milder peels, such as those using alpha-hydroxy acids (AHAs) like glycolic or lactic acid, are safer options because they exfoliate gently and are less likely to cause irritation or worsen pigmentation.
Peels that are too strong can lead to post-inflammatory hyperpigmentation (PIH) or burns, which is why it’s essential to use the right type and depth for your skin tone.
What types of chemical peels are recommended for darker skin tones?
For people with darker skin tones, the safest chemical peels are mild to medium-depth peels. The most recommended types include:
Glycolic acid peels: A mild peel that brightens and exfoliates the skin gently.
Lactic acid peels: A hydrating peel, ideal for sensitive skin and safe for darker skin tones.
Salicylic acid peels: Especially beneficial for acne-prone skin, this peel also reduces pigmentation safely.
These peels help improve skin tone and texture while minimizing the risks associated with deeper, more aggressive peels.
Laser Treatments
What are the common types of lasers used to treat hyperpigmentation in people with skin of colour?
There are several types of lasers used to treat hyperpigmentation, but not all are safe for darker skin tones. The most commonly used and effective lasers for people with skin of colour include:
Non-ablative fractional lasers: These are the safest option for darker skin tones. They work by penetrating the deeper layers of the skin without damaging the surface, reducing the risk of scarring or post-inflammatory hyperpigmentation (PIH).
Ablative fractional lasers: These lasers are stronger and remove layers of skin to treat deep pigmentation and scarring. However, they come with a higher risk of complications like scarring or PIH in people with skin of colour, so they should be used with caution and only by experienced professionals.
Q-switched lasers: These lasers are commonly used to treat dark spots by breaking down pigment particles in the skin. They are particularly effective for conditions like melasma or for tattoo removal and are considered relatively safe for darker skin tones when used properly.
These lasers must be used carefully to minimize the risk of worsening pigmentation in people with darker skin, which is why it’s important to seek treatment from a dermatologist experienced with skin of colour.
How do non-ablative fractional lasers work?
Non-ablative fractional lasers work by delivering heat to the deeper layers of skin without harming the surface. This triggers a natural healing process, encouraging the skin to regenerate and reduce pigmentation. Since the surface remains intact, this type of laser is safer for people with darker skin tones.
What Are Ablative Lasers and How Do They Work?
Ablative lasers are a type of laser that works by removing the outer layers of the skin. They create controlled damage to the skin's surface, which stimulates the body's natural healing response and leads to the growth of new, healthy skin cells. This process helps reduce pigmentation, scars, and other imperfections. Ablative lasers are more intense than non-ablative lasers and include:
CO2 lasers: These lasers target water molecules in the skin, vaporizing the top layers to treat deep wrinkles, scars, and pigmentation.
Erbiumlasers: These are somewhat gentler than CO2 lasers but still work by removing surface layers of skin to improve texture and tone
While these lasers are effective for treating a variety of skin concerns, they can pose a higher risk for people with darker skin tones, as the removal of skin layers can lead to complications like post-inflammatory hyperpigmentation (PIH), scarring, or permanent colour changes. For this reason, ablative lasers should be used with caution in skin of colour and only under the supervision of an experienced dermatologist.
How do I know if I’m a good candidate for laser treatment?
You might be a good candidate for laser treatment if:
You have stubborn hyperpigmentation, such as melasma or post-inflammatory hyperpigmentation (PIH), that hasn’t responded well to topical treatments.
Your dermatologist has evaluated your skin type (particularly if you have Fitzpatrick types IV-VI) and recommended a non-ablative fractional laser or Q-switched laser as a safe option.
You are prepared to follow the recommended pre- and post-treatment care, including using sunscreen daily and avoiding sun exposure
What should I expect during a laser treatment session?
During the session:
Your dermatologist may apply a numbing cream (such as lidocaine) to reduce discomfort.
The laser will be passed over the treatment area, targeting deeper layers of the skin or specific pigmentation.
You might feel a tingling or mild stinging sensation, similar to a rubber band snap, but discomfort is typically minimal.
After the procedure, there may be redness, mild swelling, or darkening of spots, which usually subsides in a few days to weeks.
How soon will I see results after laser treatment?
Results vary depending on the type of laser used and the severity of the pigmentation:
With non-ablative fractional lasers or Q-switched lasers, you may start to see improvements after 3-5 sessions, typically spaced 4-6 weeks apart. Gradual fading of dark spots is expected over time as the skin heals and regenerates
Dark spots might initially appear darker or scab over before they lighten, so it’s important to follow all aftercare instructions to promote healing.
What can I do to minimize the risk of post-inflammatory hyperpigmentation (PIH) after laser treatment?
To minimize the risk of PIH:
Use sunscreen daily: Broad-spectrum (SPF 30 or higher) sunscreen is critical to protect your skin from UV rays that can trigger melanin production.
Follow post-treatment care: Your dermatologist may recommend soothing creams, gentle cleansers, and moisturizers to calm the skin.
Avoid irritating products: Steer clear of harsh exfoliants, strong acids, or scrubbing the treated area during recovery, as this can worsen pigmentation.
Stay out of the sun: For at least a few weeks after treatment, avoid prolonged sun exposure to reduce the risk of pigmentation returning
Can I combine laser treatments with other pigmentation treatments, such as chemical peels or microneedling?
Yes, combining laser treatments with other pigmentation therapies like chemical peels or microneedling can enhance results, but the timing and approach must be carefully managed:
Laser treatments are often followed up with microneedling or peels to improve skin texture and pigmentation results.
Combining treatments should be done under a dermatologist's supervision to prevent irritation and avoid worsening hyperpigmentation, especially for people with skin of colour.
Typically, laser treatments are done first, followed by gentle peels or microneedling after the skin has fully healed
Are there any specific risks for laser treatments in people with darker skin?
Yes, people with darker skin tones are at higher risk for certain complications after laser treatments, including:
Post-inflammatory hyperpigmentation (PIH): This is the most common risk, where treated areas become darker due to inflammation.
Scarring or texture changes: Though rare, improper laser settings or post-care can cause scarring or changes in skin texture.
Hypopigmentation: Some lasers can cause a loss of pigment, leading to light patches on the skin, especially with ablative lasers.
To avoid these risks, it’s important to choose a dermatologist who is experienced in treating skin of colour and to opt for non-ablative fractional lasers or Q-switched lasers, which are safer for darker skin tones
Oral Medications for Hyperpigmentation in Skin of Colour
What oral medications are used for treating hyperpigmentation?
Several oral medications are commonly used to treat hyperpigmentation, especially in people with skin of colour. These include:
Tranexamic acid (TXA): The most commonly prescribed oral treatment for melasma. It works by inhibiting plasmin, which reduces melanin production, helping to fade dark spots.
Oral retinoids: Low-dose isotretinoin can be used to reduce pigmentation, especially in conditions like post-inflammatory hyperpigmentation (PIH).
Antioxidants: Oral supplements like vitamin C and polypodium leucotomos are sometimes recommended to help reduce the effects of UV-induced pigmentation and to support overall skin health.
Tranexamic acid
What is tranexamic acid (TXA)?
Tranexamic acid (TXA) is a medication that helps to reduce or prevent bleeding. It works by helping the blood clot and stay clotted longer.
What is tranexamic acid normally used for?
TXA is usually used to treat or prevent heavy bleeding in situations such as:
Heavy menstrual periods
Surgeries (to help reduce bleeding during operations)
Childbirth (to manage excessive bleeding)
Injuries (to control bleeding after accidents)
It’s commonly used in hospitals or by doctors to help stop bleeding in these cases.
How is Tranexamic Acid (TXA) Effective for Melasma?
Tranexamic acid (TXA) was originally developed to help with blood clotting. It works by blocking the action of plasmin, a protein that dissolves blood clots. By stopping plasmin from breaking down clots, TXA helps reduce excessive bleeding.
So, how does this connect to melasma?
In addition to breaking down blood clots, plasmin is also involved in inflammation and UV damage. When plasmin is active, it triggers a cascade of processes in the skin, including the production of melanin, the pigment responsible for dark spots. In people with melasma, this overproduction of melanin leads to the development of dark patches.
By blocking plasmin, TXA interrupts the melanin production process, which reduces the darkening of the skin. This connection between plasmin, inflammation, and melanin explains why TXA, a medication originally used for blood clotting, can also be effective in treating melasma. It essentially reduces the triggers for melanin overproduction in the skin.
Is Tranexamic acid (TXA) safe at the dose used for melasma?
Yes, tranexamic acid (TXA) is generally considered safe for treating melasma when used at the recommended dose, which is typically 250 mg to 500 mg per day, divided into two doses. This is much lower than the dose used for its primary purpose (as a medication to control bleeding), which can be several grams per day. At these lower doses, the risk of side effects, including serious ones like blood clots, is significantly reduced.
How does the dose of Tranexamic Acid (TXA) for treating melasma compare to the dose used for preventing bleeding?
The dose of tranexamic acid (TXA) used to treat melasma is significantly lower than the dose used to prevent bleeding. For melasma, the typical dose is 250 mg to 500 mg per day, divided into two doses. In contrast, for conditions like heavy menstrual bleeding or post-surgical bleeding, the dose is often 1,000 mg to 3,000 mg per day, taken in higher and more frequent doses.
Another key difference is the duration of use:
For bleeding, TXA is used for short periods, usually a few days during a menstrual cycle or after a surgical procedure.
For melasma, TXA is used for a longer duration, typically for 2 to 3 months or even longer in some cases, depending on the treatment response. The extended use for melasma is why careful monitoring is essential, but the lower dose reduces the risk of side effects like blood clots
What is the standard dose and duration of Tranexamic Acid (TXA)?
The typical regimen for tranexamic acid (TXA) in melasma treatment involves taking 250 mg twice a day (total of 500 mg per day). The recommended duration is generally 8 to 12 weeks, though treatment may extend depending on the patient’s response and the dermatologist’s recommendations.
How effective os oral Tranexamic Acid (TXA)?
Tranexamic acid (TXA) has shown reductions in Melasma Area and Severity Index (MASI) scores by 30-50% over 12 weeks. Comparatively, studies on 4% hydroquinone and triple combination creams (which include hydroquinone, a retinoid, and a steroid) have demonstrated reductions in MASI scores by 50-70%. Triple creams are typically considered the gold standard for melasma treatment and often show faster and more pronounced results than TXA alone
Does taking Tranexamic Aid (TXA) for melasma increase the risk of blood clots?
Several studies have looked at whether tranexamic acid (TXA) increases the risk of blood clots (VTE). At the low doses used for melasma (250-500 mg/day), the risk of blood clots is very low. Research shows that TXA is not a strong cause of blood clots, even at higher doses. Instead, the risk is more related to individual factors, like a history of clotting disorders or other health conditions. People without risk factors face very low chances of clots from TXA use.
Are the studies on Tranexamic Aid (TXA)'s safety for melasma based on long-term use?
Most studies on Tranexamic Aid (TXA) focus on short-term use for controlling bleeding, like during surgery or for heavy periods. These studies usually lasted only a few days or weeks. In contrast, melasma treatments often require TXA for 12 weeks or longer, and the research on its safety over such extended use is limited. While short-term studies show a low risk of blood clots (VTE), longer-term data is less available.
This means while the risk is considered low because of the dose, the duration of the treatment adds risk that we haven't been able to quantify.
What is the risk of blood clots for people taking Tranexamic Aid (TXA) compared to those not taking it?
For individuals taking TXA at low doses for melasma, the risk of developing blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism (PE), is very low if they do not have other risk factors. In contrast, those not taking TXA have a baseline risk of blood clots, which increases with age, inactivity, or certain medical conditions. When comparing the two groups:
For healthy individuals without risk factors for blood clots, the additional risk from taking TXA at melasma doses is minimal.
For individuals with risk factors (see below), TXA should be used with caution or avoided
What are reasons I shouldn't take Tranexamic Acid (TXA)?
You shouldn't take TXA if you have risk factors for venous thromboembolism (VTE), which includes:
History of blood clots or family history of VTE.
Obesity.
Hormonal therapy, including birth control pills and hormone replacement therapy (HRT).
Prolonged immobility (e.g., after surgery or long flights).
Cancer or undergoing cancer treatments.
Certain genetic conditions, like Factor V Leiden mutation, which increase clotting risk.
Individuals with these risk factors should consult their doctor before starting TXA for melasma. For healthy individuals without these risk factors, the risk of blood clots from low-dose TXA is considered very low.
What is the typical duration of use for Tranexamic Acid (TXA) in melasma treatment?
Most studies recommend using tranexamic acid (TXA) for melasma over a period of 8 to 12 weeks. In some cases, treatment may continue for longer, depending on how well the skin responds. This extended use helps reduce melanin production and lighten pigmentation. However, TXA should always be used under medical supervision, as the long-term safety data, especially regarding risks like blood clots, is still limited for prolonged use.
Do TeleTest physicians currently prescribe oral Tranexamic Aid (TXA) ?
TeleTest physicians do not currently prescribe oral Tranexamic Aid (TXA).
Oral Vitamin C
Is there evidence that oral vitamin C can help reduce hyperpigmentation?
There is no strong evidence supporting the use of oral vitamin C specifically for reducing hyperpigmentation. Most of the studies focus on topical vitamin C, which has been shown to effectively brighten the skin and reduce dark spots by inhibiting melanin production. Topical vitamin C works directly on the skin, delivering the antioxidant to the areas affected by pigmentation.
While oral vitamin C is beneficial for overall skin health due to its antioxidant properties and role in collagen production, it has not been proven to directly reduce hyperpigmentation. Its primary benefit is helping the skin recover from sun damage and supporting general skin vitality, which may indirectly help in managing pigmentation.
What doses were studies completed for oral vitamin C?
Studies on oral vitamin C for skin health, including hyperpigmentation, have varied in dosage:
Most clinical studies have used doses ranging from 500 mg to 1000 mg per day.
Vitamin C is often used in combination with other antioxidants (e.g., vitamin E) or as part of broader skin health supplements, which makes it difficult to assess the effectiveness of vitamin C alone in treating hyperpigmentation
What is the upper tolerable limit for oral vitamin C?
The upper tolerable limit (UL) for oral vitamin C in Canada is 2000 mg per day for adults. Exceeding this limit may lead to side effects like gastrointestinal discomfort, including diarrhea and stomach cramps. While vitamin C is water-soluble and excess amounts are usually excreted by the body, consistently taking more than the recommended upper limit could pose health risks, especially in individuals with certain conditions such as kidney stones
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