Why is My Face Darkening on the Forehead and Cheeks?

1. Definition of Facial Hyperpigmentation

   Hyperpigmentation is the presence of darkened areas of skin that may occur in small patches and even larger areas. It may also affect the entire body but it is commonly seen affecting the forehead and cheeks. Facial hyperpigmentation is a condition that is characterized by dark patches or areas of the skin of the face, which may occur due to the overproduction of a pigment that gives color to the skin. This pigment is known as melanin.

   There are various factors that can cause skin hyperpigmentation or darkening of the face on forehead and cheeks:

   • Sun exposure
   • Hormonal changes
   • Aging
   • Inflammation
   • Skin injuries
   • Medications

   Some of the common facial hyperpigmentation include melasma, post-inflammatory hyperpigmentation, and age spots.

2. Importance of Addressing Facial Darkening

   Facial darkening can affect a person’s self-esteem and can affect quality of life. It, therefore, is important to address it. The other reasons why addressing facial darkening is important include:

   • It can take a person’s confidence and self-image to a backseat
   • It may be due to an underlying condition that may require treatment.
   • Prolonged sun exposure can lead to serious health conditions including cancer.

3. Brief Overview of Common Causes of Facial Hyperpigmentation

   There are numerous causes of facial hyperpigmentation. A few common causes include:

   • Sun Exposure: As the skin gets exposed to the ultraviolet rays of the sun there is an increase in the production of melanin in the skin which may result in hyperpigmentation or face darkening on forehead or cheeks.
   • Hormonal Changes: Fluctuation of hormones that mostly occurs during pregnancy and menopause can lead to hyperpigmentation, especially on the face.
   • Medications: Certain medications such as antibiotics and hormone treatments can cause hyperpigmentation.
   • Skin Irritation: Irritation occurs in the skin due to certain chemicals, environmental irritants, exfoliants, and acne treatments. This may cause the overproduction of melanin.⁽¹⁾
   • Post-Inflammatory Hyperpigmentation: It occurs due to the overproduction of melanin in response to inflammation, injury, eczema, or a wound.

1. Explanation of How UV Rays Cause Hyperpigmentation

   UV rays from the sun are the common cause of hyperpigmentation. It can lead to the darkening of the face on forehead and skin by the overproduction of melanin. Exposure of the skin triggers the production of reactive oxygen species, that damage the melanocytes, the melanin-producing cells in the skin. In response to damage, the melanocytes produce more melanin in an effort to protect against further damage caused by UV radiation. This excess production of melanin can lead to hyperpigmentation.⁽⁵⁾

2. Importance of Wearing Sun Protection

   Wearing sun protection can be helpful in maintaining healthy skin and preventing skin-related problems like face darkening on the forehead and cheeks. It can be helpful to the skin in the following ways:

   • It prevents the risk occurrence of skin cancer, which can occur due to exposure of the skin to UV radiation from the sun.
   • Sun protection reduces the risk of the early development of signs of aging which include wrinkles, fine lines, and age spots. It can help keep the skin looking healthy and youthful and reduce the risk of pigmentation.
   • It prevents sunburn that can result due to exposure to UV radiation which can increase pigmentation and the risk of cancer. Sunburn causes long-lasting damage to the skin.
   • Sunscreen should be generously applied all over the body. One should reapply it after every 2 hours and more in case of swimming or when sweating.

1. Description of Melasma

   Melasma is a condition that is characterized by brown patches or freckle spots on the skin. It has a common occurrence mostly in people with fair skin and females in the menopausal stage. It is usually harmless.

   It occurs due to the overproduction of cells that give color to the skin. They are mostly seen occurring on the face, usually on the cheek, forehead, nose, or on upper lip.

2. How Hormonal Change Cause Melasma?

   How hormonal changes cause melasma is not known but it is thought to be related to the hormone estrogen, which stimulates the production of melanin and increases the sensitivity of the skin to sunlight. During pregnancy, the level of estrogen and progesterone increase This leads to the development of melasma. Hormonal changes are also associated with taking birth control pills or hormone replacement therapy. Hormonal changes may not be sufficient to cause melasma, other factors including genetics and sun exposure may also play a role. It is therefore essential to protect the skin from the sun and consult a dermatologist for any changes on the skin or if you notice face darkening on the forehead and cheeks.

3. Treatment Options for Melasma

   Treating melasma can be difficult but there are several options that can play a role in reducing the appearance of dark patches on the skin. The various treatment options include:

   • Chemical Peels: The procedure of chemical peels involves applying a chemical solution to the skin. The chemicals lead to the peeling of the outer layer of the skin. This can be helpful in reducing the appearance of melasma.
   • Microdermabrasion: This involves using a special device to exfoliate the outer layer of the skin. The procedure can help in reducing the appearance of melasma.
   • Laser Therapy: There are certain types of lasers that target melanin in the skin and break it down, thereby reducing the appearance of melasma.
   • Topical Bleaching Agents: Various skin-lightening agents can be applied to the affected area of the skin. They work by reducing the melanin on the skin. The bleaching agents include ingredients such as hydroquinone, kojic acid, and azelaic acid.⁽²⁾

1. Medications That Can Cause Skin or Face Darkening

   There are several medications that can cause skin hyperpigmentation. Some of the common medications causing skin pigmentation or skin darkening include:⁽³⁾

   • Chemotherapy drugs including bleomycin and thioridazine
   • Antimalarial medications such as chloroquine and hydroxychloroquine
   • Hormonal medications including contraceptive pills and hormone replacement therapy
   • Non-steroidal anti-inflammatory medications
   • Antipsychotic medications including chlorpromazine and thioridazine

   Withdrawal is usually the option for the hyperpigmentation produced by medication. If skin or face darkening on the forehead or cheeks is noticed after taking medication, a healthcare professional should be consulted.

2. Side Effects of Medication-Induced Hyperpigmentation

   The side effects of medication-induced facial hyperpigmentation include the following:

   • The discoloration is the most common side effect of medication-induced facial hyperpigmentation. The discoloration appears to be patchy and uneven in appearance.
   • Some medications such as anti-inflammatories, retinoids, diuretics and anti-depressants increase the sensitivity of the skin to the sun and lead to sunburn and other types of skin damage.
   • Medication-induced facial hyperpigmentation can have an impact on an individual’s self-esteem and mental health. It can lead to embarrassment, shame, and anxiety.
   • There are a few medications such as retinoids, antibiotics and non-steroidal anti-inflammatories that can make the skin sensitive and lead to skin irritation, itching, and redness along with hyperpigmentation.
   • Medication-induced facial hyperpigmentation can be difficult to treat and may require more expensive treatment to reduce the appearance of pigmentation.

3. Precautions to Avoid Medication-Induced Hyperpigmentation

   • The best way to prevent medication-induced hyperpigmentation is to avoid using medications that can cause hyperpigmentation.
   • Using sun protection when moving out of the house can prevent the pigmentation from worsening if at all it happens. One can also use protective clothing including full sleeves shirts, hats, and full pants.
   • It is also very important to keep a check on the skin changes and consult a healthcare professional for any vague symptoms on the skin.
   • Following the instruction written on the medication leaflet is important. One should not consume more than the dosage mentioned on it.
   • Pigmentation takes time to fade away, it is, therefore important for a person to follow the treatment plan patiently.

1. Explanation of How Skin Irritation Can Cause Hyperpigmentation

   Skin irritation refers to any kind of discomfort on the skin which can be due to a variety of factors such as allergies, infection, and exposure to irritants. The irritation can lead to inflammation that can stimulate the production of melanin. Skin irritation damages the skin barrier and leads to an inflammatory response that may activate melanocytes to produce melanin.⁽⁵⁾ This can be a reason for dark patches on the skin.

   Some of the common causes of skin irritation include skin disorders including acne vulgaris, melasma, or lentigo. It is important to consult a dermatologist for any such skin condition as self-prescription can worsen skin darkening. Using harsh products can also be the cause of skin pigmentation.

2. Types of Skin Irritants

   The skin irritants may contain preservatives such as Methylchloroisothiazolinone and methylisothiazolinone and other surfactants that may cause skin irritation, dryness, and inflammation. How the reactant may affect a particular person may vary depending on the type of skin and the person’s state.

3. Prevention and Treatment of Skin Irritation-Induced Hyperpigmentation

   Prevention of skin irritation-induced hyperpigmentation includes avoiding using products that may contain harmful irritants. Reading the ingredient list plays a major role. Also, buying products that are dermatologically tested and suitable for the skin type is important.

   Treatment involves a variety of topical treatments, creams and ointments, chemical peels, and laser treatments.

1. What is Post-inflammatory hyperpigmentation (PIH)

   Post-inflammatory hyperpigmentation occurs due to injury or inflammation to the skin after acne, eczema, or cut. It occurs as the skin cells react to damage and irritation and make extra melanin. It may appear as a darkened spot on the skin due to the overproduction of melanin.⁽⁴⁾ The pigmentation may get darker after extended exposure to the sun.

2. Causes of Post-inflammatory hyperpigmentation (PIH)

   The various causes of PIH include:

   • Bug bites
   • Burns
   • Razor
   • Allergic reaction
   • Infection
   • Psoriasis

3. Treatment Options for Post-inflammatory hyperpigmentation (PIH)

   PIH is not a serious condition and may not even require medical treatment. However, it can be corrected cosmetically for some people. PIH usually fades over time and treatments are needed to speed up the process.

Hyperpigmentation is not a harmful condition and neither it is a sign of any serious health condition.

Facial darkening on the forehead or cheeks can be caused due to a variety of factors such as sun exposure, hormonal changes, inflammation, certain medications, and genetics. The darkened areas mostly fade away on their own or by using good sun protection. The treatment may depend on treating the underlying cause and include lifestyle changes, topical treatment, and professional treatments like chemical peels and laser therapy.

Consulting a healthcare provider or a dermatologist is important for an accurate diagnosis and a personalized treatment plan for face darkening on forehead and cheeks.

As the UV rays of the sun are harmful, wearing sunblock every morning is important to make sure to reapply it throughout the day as needed.