How to deal with hyperpigmentation

Treating post-acne spots and scars

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We’re here to tell you what we know, but don’t take it as medical advice. Talk to your medical provider about your specific health concerns.

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Haunted by the ghosts of breakouts past? Hyperpigmentation can happen for a number of reasons: acne, sun exposure, and pregnancy-related hormonal changes, to name a few. However they got there, the brown spots and other forms of discoloration commonly called hyperpigmentation can be frustratingly difficult to remove! But don’t worry—we’re here for you. There are things you can do to fade hyperpigmentation, some of which your Curology provider can help you with! So let’s get started on getting rid of those unwanted spots.

What is hyperpigmentation?

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

Illustration / diagram of skin with labels "Hyperpigmentation," "Melanocyte," "Melanin," "UVB," "UVA," and a key: "PIH, post-inflammatory hyperpigmentation" and "PIE, post-inflammatory erythema"

Post-acne spots, like skin, come in all sorts of colors. If you have a darker skin tone, you may be more susceptible to post-acne brown spots known as post-inflammatory hyperpigmentation (PIH in medical parlance). If you have a lighter skin tone, you may have pink and red spots — called post-inflammatory erythema, or PIE. Try pressing a clear glass to your spot. If it disappears or turns white under pressure, most likely you have PIE.

Causes of hyperpigmentation

Cause no. 1: acne

The biggest culprits of acne scars and hyperpigmentation (the fancy scientific term for those red or 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 aka acne brown spots or red spots is to 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. Scars change skin texture, not just color. Hyperpigmentation from acne can take 6 to 12 months to fade away—or sooner, if you wear sunscreen regularly! 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! We encourage you to seek out a board certified dermatologist near you if you’re dealing with acne scars.

Cause no. 2: sun exposure

Illustration of a woman's head and hand with brown spots on both, with text "Sun-exposed areas"

What do freckles and age spots (aka liver spots) have in common? They all like to show up in sun-exposed areas, such as your face and the back of your hands. What’s the difference between sun spots and age spots? In medical speak, these are also called either solar or actinic lentigines—sun spots vs. age spots. Freckles, on the other hand, are also called ephiledes. All of these 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). They can also just happen with age, but usually that’s also the result of sun exposure over the course of a lifetime.

Cause no. 3: pregnancy/hormonal imbalance

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

Cause no. 4: aging (i.e. age spots and liver spots)

Age spots can be caused by 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 an age spot, it’s better safe than sorry.

When to see a doctor about a spot

While most hyperpigmentation and 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 potentially 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!

See spot run: what to do about hyperpigmentation

To help fade dark spots, apply your Curology cream every night! If you go with an over-the-counter product, make sure it includes ingredients such as niacinamide, alpha hydroxy acids (AHA), or vitamin C. We also can treat hyperpigmentation such as melasma and post-inflammatory pigmentation with tranexamic acid. If you’re a Curology member, your provider can help you address issues like hyperpigmentation by adjusting the ingredients in your custom cream—we’re always here for you.

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