Your pimple healed (hurrah!). But wait, now there’s this dark patch in its place. This is actually hyperpigmentation from acne.
If you have hyperpigmentation from acne (medically known as post-inflammatory hyperpigmentation from acne), this is an all too familiar story. While sometimes this discoloration is only temporary, other times, it’s near-permanent.
Though some people don’t love the look of their dark spots, they’re totally harmless and very common. Much like birth marks, freckles, and skin color, this is just another part of the skin you’re in.
But, if these dark patches bug you, we totally get it. Here’s why you might have hyperpigmentation from acne and how to treat it.
Hyperpigmentation from acne is a dark spot left behind on the skin after a zit goes away. The spot might appear tan, brown, or dark brown in color.
Acne can cause or exacerbate hyperpigmentation in people who are especially prone to it. While anyone can have hyperpigmentation, it happens more often in people who have more melanin. Those more likely to develop hyperpigmentation from acne include:
- African Americans
- Native Americans
- Pacific Islanders
- people of Middle Eastern descent
Hyperpigmentation happens when skin cells overproduce melanin, which is the substance that gives skin its color.
Melanin overproduction often occurs after the skin has been inflamed, which is why acne really sets off hyperpigmentation. Basically, popping a zit could trigger an inflammatory and immune response that signals your bod to produce more melanin. This means more inflammation and more pigmentation.
After the hyperpigmentation occurs, spending time in the sun may darken the spots even more (sunscreen up!).
In rarer cases, the hyperpigmentation occurs deeper in the skin and might look blue-gray. This hyperpigmentation is often permanent.
Docs still don’t know why some hyperpigmentation is more intense than others, and there’s little scientific research out there to know for sure.
If you want to get rid of your hyperpigmentation from acne, treating it as soon as it onsets can accelerate the natural fading process. Without treatment, some hyperpigmented areas may heal on their own, but it could take up to 6 to 12 months.
Keep in mind that if your spots are blue or purple, they’re likely deeper in the skin and will be more difficult to treat. Because of the nature of pigment, treatments typically involve lightening the skin.
Word of warning: Always do a patch test on your wrist to see how your skin reacts, before putting anything on your face! And, consider chatting with your dermatologist about what’s right for your skin type, some options will require a derm anyways.
1. Vitamin C
Vitamin C seems to be the treatment for every other skin prob out there, and hyperpigmentation is no exception. Essentially a skin care superhero, the hardcore antioxidant brightens and evens out skin tone and reduces the appearance of scarring by boosting collagen production.
A 2019 scientific report of several studies concluded that vitamin C at levels from 3 to 10 percent offer a safe method with a “fast onset of action” for the long-term management of hyperpigmentation.
For best results, apply it once a day after cleansing and before moisturizing.
2. Azelaic acid
If Vitamin C is the queen of fighting hyperpigmentation, azelaic acid is the queen of tackling inflammation. Since inflammation precedes those pesky dark splotches, azelaic acid is the perfect ingredient to ease bumps and redness before discoloration happens.
You can purchase over-the-counter (OTC) azelaic acid products of potencies up to about 10 percent. If you have serious acne-related inflammation, talk to a dermatologist about a prescription for a stronger dose.
You can use it twice a day, morning and night.
3. Mandelic acid
Mandelic acid is made from almonds, which even makes it sound healthy and nurturing for your skin. And it is! A type of alpha-hydroxy acid (AHA), the exfoliant is often used as a chemical peel to even out skin tone, diminish wrinkles, and treat inflammatory acne.
In a 2020 study of those with acne, regular mandelic acid peels of 45 percent proved effective in treating inflammatory acne in particular.
Alongside glycolic acid, salicylic acid, and phytic acid peels, a 2019 study also found that 10 percent mandelic acid peels were very effective in treating acne and hyperpigmentation.
For best results, use an OTC mandelic acid formula of at least 10 percent 2 to 3 times a week. Using it any more frequently may irritate the skin and isn’t recommended. You can also get a stronger mandelic acid chemical peel from your local esthetician.
4. Kojic acid
Kojic acid comes from a type of fungus (which sounds ew, but it actually occurs naturally when foods like sake, soy sauce, and rice wine ferment).
It works like a natural bleach and whitens, which can aid in fading dark spots on the skin, too. It’s often used for age spots but can definitely tackle acne-related hyperpigmentation.
It works by inhibiting the production of tyrosine, an amino acid that produces melanin. You can buy it over the counter in concentrations of 1 percent or less.
If you try a cream-based kojic acid formula, plan to use it once daily. You can also use a kojic acid face mask, but these are only meant to be used now and then. To avoid irritation and maximize results, use a kojic acid mask about once a week.
The chemical bleaching agent also happens to be one of the harshest options out there. Sensitive skin? You might want to look elsewhere. But if you have severe discoloration and hardy skin, a hydroquinone product might be just the thing.
You can buy hydroquinone OTC at concentrations of 2 to 4 percent, but if you want something stronger, talk to your dermatologist about a prescription. Significant hyperpigmentation is more likely to improve with hydroquinone concentrations above 4 percent.
Plan to use your hydroquinone product once to twice daily or as instructed. If you experience redness and irritation, stop use immediately and talk to your doc.
While they’re usually used to prevent and treat signs of aging, they can also treat acne and hyperpigmentation. Retinoids work by penetrating deep into the skin to even out skin tone and texture. As a result, dark splotches may diminish over time.
One 2016 study found that a 4 percent hydroquinone and 1 percent retinol treatment improved photodamage and melasma (both types of hyperpigmentation) significantly in participants after 24 weeks.
While this research doesn’t speak to retinol’s effectiveness on its own, it might be the perfect complementary ingredient to your treatment.
You can purchase OTC retinol products of concentrations of up to 2 percent. If you want something stronger, you’ll need to head to the derm.
To start, plan to use your retinol product about once or twice a week at night. Gradually work your way up to every other day if your skin doesn’t show signs of irritation. Prescription-strength retinol can be quite irritating and sometimes takes an adjustment period.
If you’ve looked into treatments for fine lines and wrinkles before, niacinamide might already be on your radar. Made from niacin (aka vitamin B3), it’s typically found in products for mature skin since it boosts water retention and makes the skin look more plump.
While it’s not the go-to option for hyperpigmentation, it can be a nice addition to your current skin care regimen. It won’t pack as big of punch as something like Vitamin C for your dark spots, though, so keep that in mind.
Most niacinamide products come in formulations of 10 percent or less. For best results, apply it twice a day. You should see firmer, smoother and more even skin tone in about 1 month.
8. Glycolic acid
Glycolic acid, the most popular and strongest type of AHA, is derived from sugar cane and seems to do it all. It exfoliates the skin, diminishes fine lines, thickens skin, and helps prevent acne and fades dark spots.
It’s often found in OTC and professional chemical peels. It’s also frequently used in tandem with microdermabrasion or microneedling to max out results. But it can also be found in face washes, moisturizers and serums of all kinds.
Glycolic acid products typically come in formulas of about 8 to 30 percent. The 10 percent stuff you can apply daily, but the 30 percent concentrations should only be used once or twice a week to avoid irritation.
9. Professional chemical peels
A chemical peel uses high concentrations of acids to remove the surface layer of the skin. While there are dozens of varieties out there, those with glycolic acid, mandelic acid, and lactic acid work best for hyperpigmentation.
Although there are plenty of OTC peels on the market, it’s best to avoid them (and don’t even think about DIY). A professional peel from your dermatologist or esthetician is the best option. Without proper precautions, the acids can cause further inflammation and more hyperpigmentation.
10. Laser resurfacing
Laser skin resurfacing is an intensive treatment provided by a dermatologist or esthetician. The treatment involves a laser that sends out pulses of high-energy light, which is then absorbed by moist parts of the skin.
This moisture then turns into vapor. Like magic (but really through science!), this vapor dissolves thin layers of the skin, bit by bit.
Microdermabrasion is a type of exfoliation treatment provided by a dermatologist or esthetician.
It involves using an abrasive tool to basically sand your skin down slightly, revealing the smooth, even skin underneath. If that sounds scary, don’t fear: it’s actually relatively gentle.
It’s often used to treat light scarring, discoloration, sun damage, and acne-related hyperpigmentation. If you’re interested in microdermabrasion, talk to your dermatologist.
You might not have heard much about N-acetylglucosamine (NAG). First of all, it doesn’t exactly roll off the tongue. Secondly, it’s a relatively new player to the skin care game.
Topical N-acetylglucosamine works by inhibiting melanin production and protecting skin cells from free radicals. In a 2014 study, researchers found that NAG-containing formulations reduced the appearance of hyperpigmentation.
You won’t find N-acetylglucosamine in many products on the market just yet, but there should be at least one option at most beauty retailers. It’s often an added ingredient in Niacinamide serums, so keep your eye out.
You can use it about 1 to 2 times a day.
Treating your dark spots is nice, but you also want to keep them from coming back. That’s why before treating hyperpigmentation, dermatologists recommend determining and treating its underlying cause.
Here are a few more key tips for preventing hyperpigmentation before it starts:
- Acne treatment. If acne is to blame, keeping zits at bay is one way to prevent its onset. Treatments with ingredients like benzoyl peroxide, salicylic acid, retinols/retinoids, and AHAs are best to fight back against acne.
- SPF use. Since the sun’s rays can significantly worsen hyperpigmentation, it’s important to always stay protected. And yes — this means even in the winter. If the harsh chemicals in some sunscreens aren’t your jam (or worse: make you break out), consider trying a mineral sunscreen, which is ideal for sensitive skin.
Since everyone’s skin is different, treating hyperpigmentation from acne often requires a highly individualized approach.
Since skin tone plays a major role in the intensity and type of hyperpigmentation, people with fair, medium, and dark skin often demand distinct treatments. When you add skin types and sensitivities to the mix, there’s a lot to consider.
If you’re not sure where to begin, schedule a chat with a dermatologist.
They can help you address the underlying cause and design a treatment to treat your dark spots as gently and effectively as possible.