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Patchy discolouration on the body is a common concern; here doctors explain how to prevent and treat hyperpigmentation for a more even skin tone
Hyperpigmentation – dark patches on the skin due to an excessive production of the natural pigment, melanin – is mostly talked about in relation to the face, but discolouration is very common on the body, too.
Medical and cosmetic doctor Dr Ewoma Ukeleghe, who is Superdrug’s skincare ambassador, tells us that “pigmentation issues – mostly presenting as dark patches on the underarms, pubic area and inner thighs, knees and elbows – is one of the top body skin concerns”. While patchy skin darkening is completely harmless, some people might want to prevent or treat it for a more even skin tone.
On the body, hyperpigmentation is generally triggered by one of three things: sun damage, hormonal changes, and inflammation (from friction or post-inflammatory scarring).
“There’s a combination of causes,” Dr Ukeleghe confirms. “Friction exasperates it” – think body parts that constantly rub against each other, or against tight clothing, which can cause chaffing resulting in inflammation and subsequently darkening. “But for women of reproductive age, due to hormonal fluctuations it is very common for certain areas of the skin to spontaneously darken. If it’s due to spurts in hormones, for example in pregnancy, or when starting contraceptive treatments, it can self-regulate when hormonal changes settle down – but sometimes it doesn’t resolve.”
While many of us are diligent with applying facial SPF, it’s common to neglect the body, but protecting the skin from harmful UVA and UVB light with a full spectrum sunscreen is important for both the skin’s health and appearance. The bottom line: “If you’re exposing your skin to sunlight, always use SPF,” says Dr Ukeleghe.
When it comes to managing hyperpigmentation, this is particularly important – regardless of the cause of your discolouration. In her book Skin Revolution, doctor and cosmetic formulator specifically for skin of colour, Dr Vanita Rattan says to “block further UV stimulation by using broad-spectrum SPF50”.
Given that hyperpigmentation can often present in areas subjected to hair removal (such as the underarms and public area), due to friction and ingrown hair scarring, Dr Ukeleghe says to address this cause.
“If you’re inclined, explore options of laser hair removal,” she advises. “While the intent is to remove hair, I find that consequentially it improves the skin texture, and allows the skin to brighten over time.”
If you shave, the most important thing is to “make sure that you’re using a sharp razor,” she says. “Not doing so is a common problem.” For any sensitive area of skin, she recommends the Gillette Venus For Pubic Hair & Skin Women's collection. “The razor is specifically designed so that you don’t pull and snag the skin. It can be used with the innovative 2-in-1 Cleanser and Shaving Gel – it adheres to the skin while you shave, giving you a smoother shave.
“There’s also a Daily Soothing Serum in the range which can be used post-shave to provide soothing moisture, helping reduce itching due to dry skin,” she says. It contains lactic acid which helps reduce build-up of dead skin cells, ergo preventing ingrown hairs. “In addition, the gentle Skin-Smoothing Exfoliant can be used in between hair removal days to smooth your skin.” It gently polishes away sebum, dirt and oils from the skin’s surface that can also lead to trapped hairs.
Darkening of areas like the knees, and inner thighs can mostly be attributed to friction causing inflammation, which results in pigmentation.
Here, “The first thing to do is to stop the root cause: friction,” explains Dr Rattan. “Nothing else will help if this is not addressed. So, [if your inner thighs rub together] wear trousers or cycling shorts underneath your skirt or dust your skin with talcum powder where your thighs meet.” If you spend time on your knees daily – when exercising, praying, or doing housework, for example – you also need to block the trigger by not kneeling for long periods.
As with SPF, many of us address our facial skincare needs with active ingredients, but rarely apply them to the body. However, body care products are increasingly incorporating targeted actives into formulas – such as the Venus Daily Soothing Serum, mentioned above, which harnesses lactic acid.
“I’d also recommend glycolic acid,” another alpha hydroxy acid which help to exfoliate and remove dead skin cells, says Dr Ukeleghe. So, is the TikTok trend for using glycolic acid on the underarms really effective? “It actually does wonders to improve hyperpigmentation," she says, "but also it helps with perspiration too, from a cleansing point of view by unclogging some build-up.”
She says to try Superdrug’s Naturally Radiant Glycolic Tonic, but as with any active skincare proceed with caution: “Patch test, and don’t use it in same sitting as shaving that area of skin,” she says, also advising against applying antiperspirant or deodorant right after. “I recommend following up with hydrating but lightweight moisturiser like the Me+ Hyaluronic Acid Body Gel Cream. You only need a pea size amount for both underarms; don’t over-moisturise that area as it will make you sweat more.”
You could apply the same approach to the pubic region too, she adds, “but only focus on the mons pubis – the triangle shape that covers the pubic bone – and don’t descend lower into the labia area.”
Remember: “Exfoliants are known for increasing the skin’s sensitivity to the sun, so it’s really important you counteract that with using sunscreen,” Dr Ukeleghe reiterates. “In an ideal world, I like to focus on body care in colder months, so you don’t have to worry about burning your skin because you’ve been exfoliating,” she says. During warmer weather try sticking to the active skincare use at night.
Dr Ukeleghe and Dr Rattan also both recommend niacinamide for improving pigmentation, as well as body breakouts and acne. “Niacinamide reduces the rate of melanosome packets travelling to surrounding cells,” Dr Rattan explains, adding that it causes “no irritation”. Try the Me+ Niacinamide Body Gel Cream or Dr Sam's Flawless Body Therapy which combines niacinamide with lactic acid and bakuchiol (a retinol alternative).
When home skincare and gentle exfoliation isn’t successful, or you want something a bit more powerful, you could seek personal, professional advice. Aesthetic doctor Dr David Jack says, “Most good skin clinics and dermatologists will have a wealth of experience in treating pigmentation issues. Whoever you decide to see should take a full medical history and assess your skin using a variety of methods before making a detailed bespoke plan for your treatments.”
Treatment options may include prescription skincare and/or treatments such as professional-strength peels, IPL, microneedling and mesotherapy.
But before considering any home or in-clinic options, heed Dr Rattan’s warning that if you are too harsh when treating skin darkening, you will worsen hyperpigmentation. “Always choose the non-irritating option or you run the risk of making the pigmentation darker and more resistant.” And remember, hyperpigmentation on the body is totally normal.