Haunted by the ghosts of breakouts past? Hyperpigmentation can happen for a number of reasons: acne breakouts, sun exposure, and pregnancy-related hormonal changes, to name a few. 

These dark marks and other forms of discoloration can be frustratingly difficult to remove! But don’t worry—there are answers. There are things you can do to help fade hyperpigmentation, some of which your Curology provider can help you with! 

What is hyperpigmentation?

Your skin naturally produces a pigment called melanin, which gives it its color.¹ Dark spots are typically places where too much pigment is present (which is why they’re also called hyperpigmentation).² Common causes of post-breakout dark spots include skin inflammation (like acne!), prolonging inflammation by picking at the skin (hands off!),³ and sun exposure⁴ (wear broad-spectrum sunscreen with at least SPF 30).

Post-acne spots, like skin, come in all sorts of colors. If you have a melanin-rich skin tone, you may be more susceptible to post-acne brown spots known as post-inflammatory hyperpigmentation (PIH in medical parlance). If your skin tone lacks melanin, you may be more likely to have pink and red spots — called post-inflammatory erythema, or PIE.⁵ Let's break it down!

Types of hyperpigmentation, at a glance

Sun spots

Sun spots (including freckles) are caused by sun damage.⁶ Most sun spots can be prevented by practicing sun protection. Sometimes, they can be an indication of skin cancer, so see a doctor right away if your spot develops into something more serious. 

Melasma

Melasma is a chronic condition caused by a variety of factors including genetics, hormones, and exposure to sun and heat. People with melasma experience brown patches in symmetrical patterns on the face.⁷ Melasma is notoriously difficult to treat, but there are options available!   

Post-inflammatory hyperpigmentation 

Post-inflammatory hyperpigmentation (sometimes mistaken for acne scars) is left behind as inflammatory events (like blemishes or burns) heal.⁸ Unlike scars, PIH will fade over time on their own. You can speed healing by using skincare products with ingredients that treat dark spots—more on those in a second! 

Causes of hyperpigmentation, explained

Pimples

One of the biggest culprits of acne scars and post-inflammatory hyperpigmentation (the fancy scientific term for those brown spots) are picking at zits (don’t do it!) and not wearing sunscreen (wear it every day—you’ll thank yourself later). The best way to avoid post-inflammatory hyperpigmentation aka acne brown spots is to help prevent them from forming in the first place.

Acne scars vs. hyperpigmentation 

Post-acne scars often get bundled up with dark spots, but they’re a different beast. Unlike acne scars, hyperpigmentation from acne can fade in 6 to 12 months⁹—potentially sooner, especially if you wear sunscreen regularly! 

Scars from acne, unfortunately, don’t often go away. Scars change skin texture, not just color. Types of acne scars include:¹⁰

• Rolling scars: wide and shallow scars, usually around 4-5 mm.

• Boxcar scars: U-shaped, crater-like, wide depressions that may be shallow or deep, with sharp edges.

• Ice pick scars: narrow ( < 2mm) deep depressions with steep edges, tapering to an even narrower base.

Unfortunately, acne scars can be permanent. Topical treatments won’t really help with scarring beyond fading hyperpigmentation on/around the scars. Some treatments you can get in person at a cosmetic dermatologist’s office can help improve scarring, though! If scars from acne lesions are bothering you, we encourage you to seek out a board certified dermatologist near you.

Sun exposure

What do freckles and age spots (aka liver spots) have in common? They are both considered “sun spots” and like to show up in sun-exposed areas, such as your face and the back of your hands. What’s one of the differences between freckles and age spots? In medical speak, age spots are also called either solar or senile lentigines.¹¹ Freckles, on the other hand, are called ephelides.¹² Freckles tend to fade in the winter but age spots usually persist all year round.¹³ Both types of dark spots can result from being in the sun too much without sunscreen—so if you’d like to avoid spots, don’t forget to wear sunscreen (and reapply). Age spots tend to happen as we get older as the result of sun exposure over the course of a lifetime.

Hormones

Skin changes during pregnancy don’t stop at the “pregnancy glow.” Some expecting mothers experience hyperpigmentation on their face—it’s typically melasma (aka chloasma) sometimes called the “pregnancy mask.” Hyperpigmentation due to melasma may include dark splotches on your cheeks and forehead, and on your chin.¹⁴

Aging

Age spots result from sun exposure over the course of your life, and they’re very common (if not a little annoying at times!). Make sure to get any new spots checked—even if you think it’s a “just” a spot, it’s better safe than sorry.

How to treat hyperpigmentation

Just like acne, hyperpigmentation can have multiple, intersecting causes. So it makes sense to use treatments with multi-tasking mechanisms that treat and help prevent dark marks. 

Alpha Hydroxy Acids

Did you know you can do exfoliating chemical peels at home? Ingredients like glycolic acid and lactic acid help reduce hyperpigmentation.¹⁵ They also help stimulate collagen production and while clearing away dead skin cells.¹⁶ 

Retinoids

Retinoids are vitamin A derivatives that can help increase cell turnover. Retinol and certain forms of adapalene (aka Differin) are popular retinoids that you can get over the counter. Tretinoin is a prescription-strength retinoid, considered the gold standard in anti-aging and acne treatment. After diligent sun protection, it's one of the best ingredients to repair certain forms of skin damage like dark spots.¹⁷,¹⁸,¹⁹

Azelaic acid 

Azelaic acid has a brightening effect that targets and fades dark spots while having little effect on normal skin.²⁰  That makes it a treatment of choice for those seeking a dark spot treatment.  

Hydroquinone 

Hydroquinone is a topical ingredient that's used for treating dark spots. It gets its rep for its lightening effect, which can help improve melasma²¹ and other types of hyperpigmentation.²²

Kojic acid 

Kojic acid brightens skin by blocking unwanted melanin production. It inhibits tyrosinase, an enzyme that kicks melanocytes into gear.²³ 

Niacinamide

Niacinamide is an antioxidant that helps repair skin damage while also defending against it.²⁴ Like azelaic acid, niancinamide is generally a good option for treating dark spots²⁵ in all skin types. 

Vitamin C

Like niacinamide, vitamin C is an antioxidant that can improve dark spots while helping to prevent them from happening.²⁶ Use it with your SPF to boost sun protection!

Tranexamic acid 

Tranexamic acid can help with melasma and post-inflammatory hyperpigmentation. It blocks overactive melanocytes, which helps reduce brown spots.²⁷

Hyperpigmentation can often be treated with topical treatments that have the ingredients listed above. While some people think in-office procedures like microneedling and laser resurfacing can help, these are generally used in combination with topical ingredients (like the ones listed above!).²⁸  

When to see a doctor to treat acne spots

While many types of hyperpigmentation (such as post-acne spots) are harmless, don’t take it upon yourself to diagnose a dark spot. Precancerous spots as well as various skin cancers may at times look like ordinary sunspots. Melanoma, which is a dangerous skin cancer, may appear as a very dark spot. If you notice a new spot, or if there’s a change in an existing spot —such as irregular borders, multiple colors, increasing size— always have your primary care physician or dermatologist examine it in-person. We know it can be scary, but remember, doctors are here to help you! 

Building a skincare routine to treat dark spots 

When tackling a complex concern like managing unwanted dark spots, it's often best to keep it simple. We recommend a 3-step routine with a cleanser, moisturizer, and treatment (along with sun protection!). You should look for a skin treatment with ingredients that treat dark spots. 

Curology can take the guesswork out of it for you by sending a complete dermatologist-designed skincare routine straight to your door. Your subscription features a Custom Formula with a mix of active ingredients prescribed for you by one of our dermatology providers. Your first box Is free* (just pay $4.95 plus tax to cover shipping and handling) and comes with any of our recommended skincare products at no extra cost. 

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

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You can get a skincare routine to treat dark spots sent straight to your door now—free. Start your Curology free trial now.

P.S. We did the research so you don’t have to

1. Schlessinger, D. I., et al. Biochemistry, Melanin. In StatPearls. StatPearls Publishing. (2021).

2. Wang, R. F., et al. Disorders of Hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. Journal of the American Academy of Dermatology. (2022).

3. Silpa-Archa, N., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. Journal of the American Academy of Dermatology. (2017).

4. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part I. Journal of the American Academy of Dermatology. (2011).

5. Bae-Harboe, Y. S., & Graber, E. M. Easy as PIE (Postinflammatory Erythema). The Journal of clinical and aesthetic dermatology. (2013)

6.  Wang, R. F., et al. Disorders of Hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. Ibid. 

7. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part I. Ibid. 

8. Silpa-Archa, N., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. Ibid.

9. Robert A Schwartz, MD, MPH. Postinflammatory Hyperpigmentation Treatment & Management. Medscape. (2021).

10. Fabbrocini, G., et al. Acne scars: pathogenesis, classification and treatment. Dermatology research and practice. (2010).

11. Wang, R. F., et al. Disorders of Hyperpigmentation. Part I. Pathogenesis and clinical features of common pigmentary disorders. Ibid.

12. DermNetNZ. Ephelis. 

13.  DermNetNZ. Brown spots and freckles. 

14. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part I. Ibid. 

15. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part II. Journal of the American Academy of Dermatology. (2011).

16. Moghimipour E. Hydroxy Acids, the Most Widely Used Anti-aging Agents. Jundishapur journal of natural pharmaceutical products. (2012). 

17. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part II. Ibid.

18. Chaowattanapanit, S., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. Journal of the American Academy of Dermatology. (2017) 

19. Ortonne, J. P., et al. (2006). Treatment of solar lentigines. Journal of the American Academy of Dermatology. (2006)

20. Nazzaro-Porro M. Azelaic acid. Journal of the American Academy of Dermatology. (1987).

21. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part II. Ibid.   

22. Ortonne, J. P., et al. (2006). Treatment of solar lentigines. Ibid.

23. Chaowattanapanit, S., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. Ibid.

24. Levin, J., & Momin, S. B. How much do we really know about our favorite cosmeceutical ingredients?. The Journal of clinical and aesthetic dermatology. (2010).

25. Chaowattanapanit, S., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. Ibid.

26. Chaowattanapanit, S., et al. Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention. Ibid.

27. Sheth, V. M., & Pandya, A. G. Melasma: a comprehensive update: part II. Ibid.

28. Ko, D., et al. Disorders of Hyperpigmentation. Part II. Review of management and treatment options for hyperpigmentation. Journal of the American Academy of Dermatology. (2022).

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Written by

Curology Team

Medically reviewed by

Nicole Hangsterfer, PA-C