Hyperpigmentation causes patches of skin to become darker than the surrounding skin. It occurs when the skin produces excess melanin, the pigment that gives skin its color. It can affect any skin type and is more likely during pregnancy, with older age, or after an injury.
Hyperpigmentation is very common on skin of color, as darker skin tones already have a higher melanin content. Burns, bruises, acne, rashes, or other trauma to the skin can cause it to produce more melanin and lead to dark spots.
Types of hyperpigmentation include:
Some medications and certain health conditions can also lead to hyperpigmentation.
In this article, find out about different causes of hyperpigmentation and the treatments available. We discuss these below.
Hyperpigmentation is a common skin condition affecting people of all skin types.
Below is a table of the most common types of hyperpigmentation and their symptoms:
|Type||Symptoms||Where on the body?||Who can it affect?|
|age spots, also called liver spots or solar lentigines||brown, tan, or black spots that appear on the skin with sun overexposure||commonly on the face and hands or on sun-exposed areas of the body||usually older adults or those with extended sun exposure|
|melasma, also called chloasma or “the mask of pregnancy”||large patches of darkened skin||often on the forehead, face, and stomach||usually women, people who are pregnant or taking birth control pills, and those with medium to darker skin|
|post-inflammatory hyperpigmentation||spots or patches of darkened skin that appear after an inflammatory skin condition, such as acne or eczema||anywhere on the body||people who have had inflammation or an injury to the skin|
Sun spots are more common in areas with frequent sun exposure, including the face, arms, and legs.
Post-inflammatory hyperpigmentation can occur after skin inflammation resulting from an injury, cuts, burns, acne, or lupus. It can occur anywhere on the body, but sun exposure can make it more pronounced.
Having extra pigment in some areas of skin is usually harmless but can sometimes indicate another medical condition, such as Addison’s disease.
Hyperpigmentation is often harmless and may require no treatment at all. However, some people may prefer to remove it. For those who do, various treatment methods and home remedies may help.
Many people use topical treatments to treat hyperpigmentation. Topical treatments will include ingredients that can lighten the skin, such as:
- azelaic acid
- cysteamine cream
- vitamin C
- kojic acid
- retinoids, such as tretinoin
- glycolic acid peels
- N-acetyl glucosamine
Creams containing steroids and hydroquinone can take 3–6 months to affect the skin color.
Some skin-lightening creams, such as steroids and hydroquinone cream, have been
- skin rashes and irritation
- steroid-induced acne, leading to scarring and recurrence of hyperpigmentation
- thin skin
- reddening of the skin
- skin sores
- xeroderma, or extreme dryness
- an allergic reaction or contact dermatitis
- blue and purple pigmentation after long-term use, known as exogenous ochronosis — though this is rare
People should speak with a doctor before using skin-lightening products, as they may cause adverse effects. Always purchase products from a reputable source and follow the instructions on the pack.
These products should not be used to lighten complexion.
Some cosmetic procedures can also lighten areas of skin to reduce the appearance of hyperpigmentation.
Cosmetic procedures for hyperpigmentation include:
- laser therapy
- intense pulsed light
- chemical peels
People considering whether to undergo one of these procedures should discuss the process and possible side effects with a skin care specialist or dermatologist.
They can possibly worsen hyperpigmentation by injuring the outer layer of the skin.
It may also be possible to lighten areas of hyperpigmentation using natural remedies. However, there are no large-scale studies in humans to confirm that any of these remedies are effective.
If a person wishes to try a new treatment or natural remedy, they should always try the product on a small patch of skin first and stop using it if it irritates the skin.
Aloesin, a compound present in aloe vera, may lighten hyperpigmentation. Aloesin works by inhibiting the production of melanin in the skin.
People can apply aloe vera gel from the plant directly to the skin daily. However, no research has directly linked aloe vera to reduced areas of hyperpigmentation, so scientists do not yet know the effectiveness of this technique.
Licorice extracts may lighten hyperpigmentation.
People can use creams containing glabridin on areas of hyperpigmentation.
Green tea extracts may improve hyperpigmentation. Researchers have long studied green tea for its potential antioxidant and anti-inflammatory properties.
The cause of hyperpigmentation depends on the type. The most common causes are:
The body produces more melanin to protect the skin from prolonged exposure to the sun. This can cause dark spots or patches on the skin called age spots or sun spots.
Areas of skin can darken after people have had inflammation of the skin. This can include acne, eczema, lupus, or an injury to the skin. People with darker skin are more likely to develop post-inflammatory hyperpigmentation.
Darker patches of skin can form when people experience hormonal changes. This type of hyperpigmentation is common during pregnancy.
Reactions to drug use
Certain medications, such as antimalarial drugs and tricyclic antidepressants, can cause hyperpigmentation. In these cases, patches of skin may turn gray.
Chemicals in topical treatments can also sometimes cause hyperpigmentation.
More serious causes of hyperpigmentation include Addison’s disease and hemochromatosis.
Addison’s disease affects the adrenal glands. It can cause hyperpigmentation in certain areas of the body, including the:
- folds of the skin
- elbows and knees
- inside of the cheek
Hemochromatosis is an inherited condition that causes the body to contain too much iron. It can cause hyperpigmentation, making the skin appear darker or tanned. Hyperpigmentation can occur when iron levels are
Melasma usually covers a larger area than other types of hyperpigmentation, and it usually appears on the face.
Melasma more often affects females than males. It is more common in individuals with light-brown to darker skin tones and may run in families.
Doctors are unsure about what causes melasma, but a change in hormones can trigger it, for example, during pregnancy or when using birth control pills. People sometimes call it the mask of pregnancy, but it can also occur on the abdomen.
Melasma typically disappears when pregnancy ends or the person stops taking birth control pills.
If it does not fade, a doctor may recommend:
- avoiding sun exposure
- using a topical cream that contains zinc oxide, titanium dioxide, or iron oxide
- using another medication for other types of hyperpigmentation, such as hydroquinone
- using camouflage makeup until melasma fades
- having a procedure such as a chemical peel, microneedling, or laser or light treatment
For procedures such as laser treatment, it is essential to see a board certified dermatologist.
A doctor can identify the type and cause of hyperpigmentation.
They will likely do so by:
- examining the skin, possibly with a special light called a Wood’s light
- asking about medical history
- asking about sun exposure and other lifestyle events or habits
- in some cases, taking a biopsy, or a small sample of skin, to help rule out skin cancer
They will then help make a treatment plan to suit the individual.
It is not always possible to prevent hyperpigmentation or stop it from becoming more prominent, but there are some ways to reduce the risk. You can do so by:
- protecting the skin from the sun by using a sunscreen of SPF 30 or higher and wearing clothes that protect the skin
- avoiding picking at the skin after an injury or when there are spots, scabs, or acne
- seeking professional advice before using creams to lighten dark patches, as this can cause reactions
- avoiding skin-lightening products to lighten the overall complexion
What are the types of hyperpigmentation?
The three main types include age spots, melasma, and post-inflammatory trauma. Post-inflammatory trauma can result from an injury, sun exposure, or a skin condition, such as acne.
What triggers hyperpigmentation?
Triggers include sun exposure, hormonal changes, and trauma to the skin, for example, due to acne or an injury. Picking at scabs and spots may make it worse. Some face creams can irritate the skin, leading to further hyperpigmentation.
How do you get rid of hyperpigmentation?
A person should protect their skin from the sun by using sunscreen and clothing that covers the body and shades the face. Various topical creams can help. If they do not, procedures such as laser treatment may help. A person should seek medical advice before using any creams.
Hyperpigmentation is a common skin condition that can occur for many reasons. Types of hyperpigmentation include age spots, melasma, and post-inflammatory hyperpigmentation.
Hyperpigmentation is often harmless, but people may choose to remove or reduce it. Options include avoiding sun exposure and using removal techniques such as cosmetic treatments, creams, and home remedies.
If a person notices other symptoms alongside hyperpigmentation, they should seek advice from a doctor.
If a person wants to treat hyperpigmentation for cosmetic reasons, a dermatologist can advise on the best treatment methods.