A woman with hyperpigmentation caused by hormonal changes, seeking treatment and prevention

Get Rid of Dark Spots: Hyper pigmentation Causes, Treatments & Prevention

Discover the root causes of hyperpigmentation and how to prevent it. Learn about effective skincare solutions to achieve a brighter, more even complexion with specialist advice from Dr. Koo.

Hyperpigmentation is more than just ‘skin deep’. It’s a skin concern that can lead to a lack of confidence and reduced self-esteem. However, with the right knowledge and skincare regimen, it’s possible to ‘SAY GOODBYE’ to skin pigmentation, sunspots, or affectionately called age spots, or pigmented acne scars and achieve a brighter, more even complexion.


Hyperpigmentation is a common skin concern that affects many people, particularly on the face, around the mouth, under the eyes and on the neck. Hyperpigmentation presents as dark spots, or dullish-gray brown patches on the skin, causing what appears like dull, sallow skin with an uneven tone. Sound familiar? You’re not alone! As we have said, it’s a common skin concern and it can affect anyone, regardless of their skin type.


Skin hyperpigmentation can be categorized into three common types. These are:


This type of skin pigmentation concern is most common amongst women as pregnancy is the main cause. That is why melasma is also known as ‘the mask of pregnancy’. Melasma presents as brown and gray-brown patches on the skin and is common in the cheek area. But, it can also manifest anywhere on the face and even the neck.


Age spots are also known as sunspots, liver spots or solar lentigines. This type of hyperpigmentation is caused by sun exposure. They present as dark spots on the face, neck, and hands, making the skin look dull with an uneven color. However if you have areas of your skin regularly exposed to the sun, its likely you’ll develop them there too.


This type of skin pigmentation is a result of skin injury, trauma or inflammation. The most relatable cause here would be acne breakouts. Post-inflammatory hyperpigmentation appears as discolored patches face, especially on the cheeks, or any previous areas of acne breakouts. These can range from dark brown to cafe-au-lait color.

Before and after of a woman using Dr Koo Pigment Refiner and to treat Melasma hyperpigmentation


What causes hyperpigmentation is an increase in a pigment called melanin. It’s a naturally occurring pigment, so it is produced by our skin all the time. Melanin gives our skin its natural coloration for our genetics. Variations in the levels of melanin is what gives your skin its color and undertone, and this is genetically determined. However, hyperpigmentation, dark spots or an uneven skin tone can be a result of your lifestyle and environment. There are several factors that might cause a significant increase in melanin. As the melanin transfers from the basal layer of your skin to the surface it forms the dark spots and patches we have come to know, but not love!


  1. Natural skin aging
  2. Changes in hormone levels, especially during pregnancy and any hormonal fluctuation such as peri-menopause and menopause
  3. Damage from sun exposure (this is why hyperpigmentation is so common on the face, neck and hands)
  4. Damage from environmental toxins and pollutants
  5. Skin injury and inflammation (allergic reactions, blemishes, harsh chemicals)
  6. Health conditions, such as Addison’s Disease
  7. Medication treatments, such as Chemotherapy drugs or even antibiotics can trigger hyperpigmentation


You can prevent or at least reduce the risk of hyperpigmentation by adjusting your skincare regimen to include protective measures. Let’s run through some tips and tricks on how to prevent hyperpigmentation and the development of dark spots on your face.


Add an SPF into your daily skincare routine. Dr. Koo recommends an SPF of at least 30. Your really don’t need a factor of more than 30-40, but certainly nothing less than 30. Don't worry, you’ll still get some sun color, the sunscreen will slow and prevent deep permanent damage. For the ultimate protection, apply your SPF multiple times a day, especially if venturing outside. It can take only 15-20 minutes of sun exposure to cause damage to your skin. The key to successful sun protection is repeated application AND consistent daily use even if it is overcast. There are some great products on the market now, such as lightweight SPF sprays that you can conveniently apply on top of your make up. If you don't have sunscreen to hand, grab a hat or umbrella to protect your skin. Any skin product helping to build your skin barrier, such as vitamin serums, hyaluronic acids, and moisturizers will help lessen sun damage. Physical sunscreens are the gold standard for repelling the sun if you can stand the slightly thicker consistency. 


"I tend to really moisten my skin with a vitamin serum, apply sunscreen, then my makeup, and even spray a hyaluronic acid mist over my makeup for a dewy look that enhances my sunscreen protection."


Essential products like Dr. Koo’s Anti-oxidant Vitamin Serum doesn’t just nourish your skin. It contains five vital vitamins (C, D, E, F and K) for antioxidant protection, brightening and skin barrier repair. You won’t regret adding a topical vitamin-rich serum into your skincare regimen. These are the nutrients your skin cells require for collagen synthesis and repairing the ceramide layer to make our skin plump, brighter, and less wrinkly!

Dr. Koo's Antioxidant Vitamin Serum, used to help strengthen and brighten the skin barrier, preventing hyperpigmentation


If you’ve already noticed dark spots on your face, especially on your cheeks, around your mouth, under your eyes or on your neck, you may want to look into hyperpigmentation treatment options. Now there are a number of procedures available from spas, dermatologists, and plastic surgeons that can help get rid of hyperpigmentation, such as microdermabrasion, chemical peels and laserS. However, the cost of these procedures can add up along with the downtime. Managing skin pigmentation effectively and for the long term comes down to using the right products and using them CONSISTENTLY. Did we say that loud enough?! By investing in the right products to brighten your skin everyday, you can lengthen the time between alternative skin hyperpigmentation procedures, not to mention other interventions such as BOTOX, DYSPORT, and hyaluronic fillers to improve the overall look of your skin.


Dr. Koo Private Practice Skincare offers a range of skincare products for hyperpigmentation. This range consists of three levels of pigment refiners, specially formulated to target and help get rid of dark spots, restoring the skin's natural radiance. The level depends on the degree of pigmentation on your face.

Dr. Koo's range of Pigment Refiners, effective treatment for hyperpigmentation


The Level 1 Pigment Refiner helps you maintain an even undertone and prevents future age spots from developing. It’s been designed for all skin types, and contains key ingredients like Arbutin, Liposomal Green Coffee Extract, Bearberry Plant Extract, Niacinamide, Tetrahexyldecyl Ascorbate and Caffeine.

By inhibiting melanin collection in the skin, you can reduce the formation of dark spots and promote a bright, even complexion.

Discover the Level 1 Pigment Refiner - Sustaining


If you have moderate pigment spots or dark patches on your face, Dr. Koo's Level 2 Pigment Refiner offers targeted treatment. Similar to the Level 1 Pigment Refiner, the product is formulated with Arbutin, Niacinamide, Tetrahexyldecyl Ascorbate and Green Coffee. However, it also includes a ‘super hero’ ingredient, Kojic Acid. This face acid is a popular choice when it comes to treating skin pigmentation. This product helps lighten dark spots, returns bright undertones, and illuminates the skin.

Discover the Level 2 Pigment Refiner - Activating


If you have moderate to advanced discoloration, Dr. Koo's Level 3 Pigment Refiner provides intensive repair.. With ingredients like Niacinamide, Tetrahexyldecyl Ascorbate, Vitamin E, a patented Tetrapeptide, and Hexylresorcinol, this specialized formula restores skin brightness and reverses dark age spots.

Discover the Level 3 Pigment Refiner - Repairing

Before and after of a woman using Dr Koo Pigment Refiner LEvel 3 and Retinol to treat hyperpigmentation


Let's run through some of the powerhouse ingredients that help get rid of hyperpigmentation.


Tetrahexyldecyl ascorbate is a stable form of Vitamin C and is known for its superior absorption rate, which is 50 times better than traditional Vitamin C (L-ascorbic acid). It penetrates deeper into the skin, brightening tone and lessening skin pigmentation.

Tetrahexyldecyl ascorbate helps reduce hyperpigmentation by inhibiting an enzyme called tyrosinase, the enzyme responsible for melanin production. Multiple clinical studies have shown that it improves skin evenness, reduces dark spots, and gives a more radiant complexion.

Additionally, Tetrahexyldecyl ascorbate is a potent antioxidant, protecting the skin from free radicals that contribute to uneven pigmentation. It also stimulates collagen production, improving skin texture and tone.

One of the best features of Tetrahexyldecyl ascorbate is that it has very little to no irritation side effects even when used with other active ingredients like in retinol skincare products. Any potential irritation is considered mild even for very sensitive skin which can’t be said about traditional Vitamin C.

Overall, the unique properties of Tetrahexyldecyl ascorbate make it an effective ingredient for addressing various types of skin discoloration and achieving a more even, luminous complexion.

The main downside is the higher cost of this vitamin C derivative. However, the benefits it provides are considered worth the higher price point. That is ONE of the reasons why Dr Koo Private Practice Skincare is expensive. It contains better ingredients and the right concentrations to achieve the change YOU want.


Niacinamide is the active form of Vitamin B3 and a multi-tasking ingredient that can effectively brighten skin and lessen hyperpigmentation.

It helps control the amount of melanin in your skin by inhibiting the transfer of pigment-containing cells (melanosomes) from melanocytes to keratinocytes. This means fewer dark spots and hyperpigmentation.

In addition, Niacinamide stimulates the production of collagen, reducing the appearance of pigmentation spots caused by sun exposure (photoaging). It also helps regulate the activity of the tyrosinase enzyme brightening the complexion.

It helps strengthen the skin barrier, protecting your skin from environmental stressors such as free radicals and pollution. 

Its anti-inflammatory properties help reduce and soothe redness and damage associated with post-inflammatory hyperpigmentation like acne, trauma from peels or lasers, or rashes from any cause.

In summary, Niacinamide inhibits melanin transfer, stimulates collagen, regulates melanin production, improves skin barrier function, and reduces inflammation. 


Kojic acid is a naturally occurring chemical compound. Its produced by various types of fungi, as well as a byproduct of the fermentation of certain foods like soy sauce, rice wine, and Japanese sake. It is also another potent ingredient for reducing hyperpigmentation. 

Like Tetrahexyldecyl ascorbate, it inhibits the activity of the tyrosinase enzyme, reducing the appearance of dark spots, age spots, and other forms of hyperpigmentation.

Kojic acid also has anti-inflammatory effects, reducing the redness and inflammation associated with post-inflammatory hyperpigmentation.

Similarly to Niacinamide, it's a powerful antioxidant, helping protect the skin from the free radicals that contribute to uneven skin pigmentation.

With consistent use, you can reap the benefits of Kojic acid in just over 6 to 12 weeks.


Azaleic acid is an ingredient that helps reduce several hyperpigmentation types, such as acne-related discoloration, sun damage, and melasma.

It regulates the tyrosinase enzyme, crucial for melanin production, and has anti-inflammatory effects, reducing redness and inflammation.

Azelaic acid also acts as a mild exfoliant, helping to loosen and promote the shedding of dead skin cells. Removing the layer of discolored cells improves skin clarity and brightness.

Studies have shown that 20% azelaic acid can continuously improve hyperpigmentation over 24 weeks of use, outperforming lower concentrations and even 4% hydroquinone.


Skin hyperpigmentation doesn't have to be a source of frustration or insecurity. With the right understanding of its causes and effective treatment options, you can say goodbye to dark spots and hello to brighter, more even-toned skin. Love and embrace your complexion, enjoy the process and let your confidence shine through. Don’t get frustrated, it takes several modalities to combat hyperpigmentation. One product, one procedure, one time is NOT going to be effective.

This is a lifelong process and takes patience and consistency.

If you need help determining the coloration of your dark spots or you have any questions you can book in a virtual consultation with Dr. Koo or call the office for a consultation, 314-984-8331. During the consultation, she will assess your skin pigmentation, discuss your main concerns and recommend the right product regimen for you. If her product line doesn’t specifically address your concerns, she will actually create the RIGHT FORMULATION for your skin’s hyperpigmentation needs and send it to you!