Beauty Questions? Ask Dr. Irwin
- Hyperpigmentation On Cheek Areas

Reader’s Question

Hi Dr Brandith,

I was wondering if you could provide some direction. I’m approaching my 40s but have hyperpigmentation on my cheeks which seem to be deepening even though I use an SPF50+ sunscreen daily. I’ve tried dermabrasions and IPL but nothing seems to help. I’m told that with an Asian background, it’s likely that I may not be able to remove or lighten the hyperpigmentation, even with laser (which in fact may worsen the condition). I’ve been told that my hyperpigmentation is due to genetic and hormonal reasons and form from the inner layer of my skin, rather than from the surface like freckles caused by sun exposure. Could you advice me on the options that I have available to help with this concern? Thank you.



Dr. Irwin’s Answer

Dear Kaz –  I’m glad you asked about this because many women are concerned about pigment. The first thing to do, and you may need a Dermatologist to help you, is to figure out an accurate diagnosis. In other words, is the pigment melasma (more hormonally driven), sun damage, stucco keratoses (small slightly raised tan bumps), freckles (lentigoes), etc. Or sometimes, it’s a combination of several of these. I’m wondering from your description if you might not have melasma (since you were told it was more hormonal) but I would never want to try to diagnose something over the internetl!

It’s important because the treatment options and the likelihood of success change with your diagnosis. A series of peels might be the perfect thing for mild sun damage in someone who is 30 but do absolutely nothing for stucco keratoses. Or that IPL, when done in the right time of year, can be perfect for lentigoes but can make someone with melasma worse or just not improve them at all. There is a good section on melasma on our website at

Dr. Irwin

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2 Comments on "Beauty Questions? Ask Dr. Irwin
- Hyperpigmentation On Cheek Areas"

  1. Revitol says:

    When it comes to taking care of your skin… don’t use highly fragranced harsh soaps because they are the worst things you can put on your face. These types of soaps are high in pH which sucks out the moisture in your skin and removes the acid mantle (thin acid film on skin which acts as a barrier to ward off infections and bacteria).

  2. Kaz says:

    Thanks for the advice and your article on melasma is very informative. I’ll have to take myself off to a dermatologist then to get an individual consultation to determine what are the best options available to my skin condition.

    Revitol, thanks for the reminder. It’s good that because of my sensitive skin I’ve stopped using anything fragranced or harsh. Good reminder to ensure that cleansing doesn’t equate with stripping the skin of moisture.

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