Dermal versus epidermal hyperpigmentation: How deep does the melanin go?

Successful skin lightening will depend on first understanding two things:

• the reason or cause for the excess pigmentation (hyperpigmentation)
• the depth of the excess pigmentation (melanin)

Where is the excess pigmentation located? How deep is the excess melanin?

The skin is made up of layers, split by the epidermis and the dermis. The epidermis is the top layer while the dermis sits deeper underneath. Excess melanin caused by hyperpigmentation can be found within either layers.

While the location, or more specifically, the depth of the excess melanin would depend on the the cause, it can sometimes be difficult to tie the two together. However, the below can be looked at as a general guide.

Depth of excess melanin in the skin

* Types of pigmentation with ‘Yes’ in both columns simply indicate that melanin depths would vary case-by-case.

But what does this mean? It means the choice of skin lightening treatments is critical to successful skin lightening

As expected, cases of hyperpigmentation found in the top layer only (known as epidermal melanin) are much easier to treat. Epidermal hyperpigmentation are also responsive to over-the-counter skin lightening creams and lotions like those containing kojic acid or hydroquinone, while dermal (deep) cases do not respond to these treatments at all. Dermal or deep hyperpigmentation requires more invasive skin lightening treatments or changes made from within, if changes are to be seen.

To understand this further, compare the distribution and placement of the excess melanin-containing melanosomes between normal skin against both epidermal and dermal hyperpigmentation. Melanin-containing melanosomes are indicated by the dots.

Illustration of (deeper) dermal hyperpigmentation versus epidermal hyperpigmentation. The distribution of melanin is indicated by the gray and black dots.

This also explains why some skin lightening treatments work well for some and not at all for others

The pursuit of lightening excess skin hyperpigmentation can prove to be frustrating as many will inevitably find that what works for someone else will not necessarily work for them. This leads to disappointment and confusion, and many will chase one skin lightening cream after another in the hope of finding one that works. If this sounds familiar, it is likely that the reason for your stubborn hyperpigmentation is that it is simply buried deeper within your dermis, where skin lightening creams and lotions cannot penetrate.

While this can be disheartening at first, it is the first step to your journey in finding out which skin lightening treatments may actually make a difference.