Hyperpigmentation is common in dark skin and occurs when an area of skin becomes darker than the surrounding skin, usually in a patch or spot. It is typically longer lasting and more challenging to treat in darker than lighter skin tones.
According to the Skin of Color Society, over 65% of African American people experience symptoms of hyperpigmentation due to skin damage or irritation.
Hyperpigmentation is not harmful but may cause some people to feel anxious or self-conscious about their appearance.
This article examines hyperpigmentation on dark skin and its causes. We also discuss how doctors diagnose hyperpigmentation and potential treatment and prevention methods.
The skin contains melanocytes — the cells that produce melanin, which gives skin its color. Hyperpigmentation happens when too much pigment settles into a small spot in the skin.
Hyperpigmentation can come in many forms. Common examples include:
- lentigines — commonly known as liver spots or age spots
- melasma — patches of dark skin due to hormonal changes
- freckles — tiny brown spots, often in areas visible to sun exposure
- post-inflammatory hyperpigmentation — discoloration following injury to the skin
Hyperpigmentation may worsen after sun exposure, as melanin absorbs UV rays. Sunscreen may help protect against further darkening of hyperpigmented spots. The sunscreen needs to be broad-spectrum, which blocks UVA and UVB rays.
Hyperpigmentation appears darker than the surrounding skin and is generally flat.
Skin pigment disorders are common in People of Color and one of the
The discoloration may stem from hereditary factors such as freckles or trauma to the skin, medication, or hormones. The shape and color vary depending on the cause, but it typically appears tan or brown, blue-gray, or black.
Hyperpigmentation can occur anywhere on the body. It may be more widespread when it happens as a reaction to a medication or localized after trauma to the skin.
Hyperpigmentation may appear different depending on the cause and the individual’s skin. It commonly occurs following skin trauma, such as:
To diagnose hyperpigmentation, a healthcare professional will check for areas where the skin is darker than the skin surrounding it. They will then aim to determine the cause of the hyperpigmentation.
A healthcare professional may ask about the progression of the discoloration, current medications, diet, and any other symptoms. They may also perform a physical examination and take a biopsy to rule out severe conditions such as skin cancers.
Other tests may include:
- thyroid function test
- Wood lamp test
- KOH test
- adrenocorticotropic hormone stimulation test
Treating the underlying cause of hyperpigmentation is generally the initial course of action, followed by options for lightening darkened areas.
Treatment for dark spots will depend on the cause.
If a topical agent, such as a skin or hair care product, irritates the skin and causes breakouts, a person should stop using it. The irritation will usually resolve, and darkened areas should fade over time, generally 6–12 months for hyperpigmentation on the skin’s surface.
For discoloration deep in the skin, it can take years for the darkened color to fade. These spots might be a blue-gray to gray color or much darker brown than the rest of the skin.
While hyperpigmentation is fading, people should use broad-spectrum sunscreens to protect the area. Sunscreen should be SPF 30 or higher and contain titanium oxide or zinc oxide.
Products that can fade hyperpigmentation are available over the counter (OTC), and people should use them alongside a high SPF sunscreen. Products for hyperpigmentation often contain ingredients such as:
- azelaic acid
- glycolic acid
- kojic acid
- vitamin C
A doctor may adjust medication levels for hyperpigmentation from medication or hormones to ensure it does not worsen.
Potential causes for hyperpigmentation include:
- sun exposure
- certain medications
- hormone changes
- trauma to the skin
Different causes have different identifying patterns. For example:
- Hormone changes: Changes to hormones appear as a mask across the lower portion of the face and the forehead.
- Skin trauma: A reaction to skin trauma is visible at the point of injury.
- Medication reaction: A skin response to medication may be more widespread across the body.
A healthcare professional can aim to pinpoint the cause of the discoloration through consultations and create a treatment plan.
Strategies to prevent hyperpigmentation depend on the cause.
Exposure to the sun prompts melanocytes to produce more melanin, darkening hyperpigmented areas. Using sunscreen is a key step in preventing hyperpigmentation and slowing its progression.
If hair care products cause hyperpigmentation, stopping their use or switching to another product may stop its progress.
People experiencing discoloration from hormonal changes can consult a doctor to establish a treatment plan.
Individuals with hyperpigmentation may wish to try changing products and using sunscreen or OTC products to address the discoloration. Fading happens slowly, over 6–12 months, or can take years for darker areas.
If hyperpigmented areas are not fading or a person has a suspected underlying medical condition, they should consult a healthcare professional about developing a treatment plan.
Hyperpigmentation on dark skin will appear darker than the surrounding skin, small or large, depending on the cause. Trauma to the skin, medication, hormones, and sun exposure can cause hyperpigmentation.
Hyperpigmentation is common on dark skin and can be challenging to treat. It is not physically harmful but may cause a significant mental impact for some people.
Treatment for hyperpigmentation is twofold. A doctor will identify and treat the cause of the hyperpigmentation and prescribe lightening treatments. A doctor may also recommend protective barriers, such as sunscreen.