Hyperpigmentation Acne: Causes And Treatment

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What to know about hyperpigmentation acne

Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Jessica Caporuscio, PharmD on April 28, 2020

What it is
Causes
Treatment
When to see a doctor
Summary

Hyperpigmentation acne occurs when a dark spot appears in place of a pimple that has disappeared. People with darker skin tones are more at risk of developing hyperpigmentation scars. Dark spots appear when the skin cells produce too much melanin.

Hyperpigmentation acne may fade over time, but if the original spots were deep, it may be permanent. Although some topical and surgical therapies can speed up the fading process, it can take several months to years.

Keep reading to learn more about the causes of hyperpigmentation acne and how people can treat and prevent it.

What is it?

a woman with hyperpigmentation acne on her face — Hyperpigmentation acne appears as dark spots or patches on the skin.

Hyperpigmentation acne occurs when a dark spot appears on the skin after a pimple disappears. These dark spots may occur in all skin types, but they occur more commonly in people with darker skin tones. Populations at risk of developing hyperpigmentation acne after pimples disappear include:

African Americans
Hispanics
Asians
Native Americans
Pacific Islanders
people of Middle Eastern descent

Hyperpigmentation acne is different than other forms of acne because it does not appear as a raised pimple but rather a dark spot or patch on the skin. Other types of acne present as inflamed lesions called comedones.

The treatment for hyperpigmentation acne also differs from that of other types of acne. Acne treatments involve comedogenic agents that reduce the appearance of pimples, whereas hyperpigmentation acne treatments focus on skin-lightening products.

Causes

Dark spots may appear on the skin after a pimple resolves because the skin produces extra melanin. Melanin is the substance that gives the skin color. The overproduction of melanin in one spot or patch on the surface of the skin can cause it to appear tan, brown, or dark brown.

Some hyperpigmentation acne lesions can occur in the dermis. These deeper lesions will appear blue-gray and can be permanent.

Doctors are unsure what causes different intensities of hyperpigmentation. Further studies are necessary to determine what affects this factor.

The overproduction of melanin can occur following inflammation of the skin. Researchers suggest that some inflammatory and immune factors can stimulate the production of melanin. The exact mechanism behind this is still unclear, but these factors may include:

prostanoids
cytokines
chemokines
reactive oxygen species

Once a person develops hyperpigmentation acne, some external factors, such as sun or UV light exposure, may aggravate its appearance.

Treatment

The first tip that dermatologists recommend for people with hyperpigmentation acne is to determine its cause. If acne is causing dark spots, people need to manage acne to prevent the formation of hyperpigmentation spots following the disappearance of pimples.

Dermatologists also recommend treating hyperpigmentation acne early. Early treatment can speed up the process of fading. People using treatments for hyperpigmentation acne should be aware that fading can take time. Some spots may fade without treatment, but this can take 6–12 months.

Hyperpigmentation acne that is deep in the dermis of the skin can be more difficult to treat and possibly even permanent.

Before choosing a skin-lightening product, people should visit a dermatologist for a full examination of the skin.

Medications

Dermatologists recommend products that contain one of the following ingredients:

2% hydroquinone
azelaic acid
glycolic acid
kojic acid
retinoids (retinol, tretinoin, adapalene gel, or tazarotene)
vitamin C

These ingredients can lighten dark spots on the skin. Some of these ingredients can also slow down the production of melanin, which is the primary cause of hyperpigmentation acne.

Photoprotection

Photoprotection, or the use of sun lotions and creams, is an important practice for everyone. People with hyperpigmentation acne may notice their spots appearing more pronounced after sun exposure. Dermatologists advise that people with hyperpigmentation acne limit their exposure to the sun.

People should wear a sunscreen with a minimum sun protection factor (SPF) of 30 and wear clothing that protects them from the sun. They should practice these measures even when it is raining, snowing, or cloudy outside.

Other therapies

Depending on the severity of hyperpigmentation acne or the response to topical treatments, dermatologists may recommend surgical or nonsurgical therapies.

Chemical peels are one of the most common nonsurgical cosmetic procedures that take place in the United States, and hyperpigmentation is the most likely reason for using them.

Other therapies for hyperpigmentation acne may include laser and light-based therapies.

At-home options

Some people may resist using medication or surgical therapies to hide hyperpigmentation acne. Cosmetic camouflage, or using makeup to cover up dark spots, is another option for people wishing to avoid medical intervention or to complement medical treatment.

Camouflage may be more effective in people with darker skin because pigment changes to the skin are more noticeable.

Dermatologists recommend using a waterproof, long lasting, nongreasy, and noncomedogenic concealer. If acne is causing hyperpigmentation spots, people should avoid applying products that promote acne.

Some people also search for home remedies to treat hyperpigmentation acne, such as liquid bleach. However, this product can seriously damage the skin, so people should avoid applying it.

When to see a doctor

Hyperpigmentation acne is not harmful. However, some people may seek medical treatment for hyperpigmentation acne for cosmetic reasons. Although hyperpigmentation acne does not affect a person’s physical health, they may experience psychosocial effects if they dislike its appearance.

People can discuss their treatment options with a doctor or dermatologist who can suggest appropriate treatments. Some treatments require a prescription, whereas others are available over the counter (OTC).

People should be aware that some OTC products may contain ingredients that do not lighten the skin or other contaminants. It is important to check the ingredient list to ensure that a product is likely to be effective.

Researchers have also discovered mercury, steroids, and other contaminants in some products available in other countries. Due to this, doctors urge people to use recommended skin-lightening products only.

Healthcare professionals can help give people realistic expectations regarding their treatment. They can also recommend combinations of medical treatments to speed up the fading further.

»MORE:Get an online treatment plan for acne in as little as 15 minutes with Optum Now Online Care.

Optum Now is operated by RVO Health. By clicking on this link, we may receive a commission. Learn more.

Summary

Hyperpigmentation acne appears as dark spots on the skin after pimples disappear.

Dark spots may occur more frequently in people with darker colored skin, but they can appear in all types of skin. Hyperpigmentation acne is not harmful, but it can cause significant psychosocial effects.

People may seek treatment for hyperpigmentation acne for cosmetic purposes. Dermatologists can help evaluate the intensity of the dark spots and recommend the most appropriate treatment.

Some dark spots may disappear without treatment, but fading takes time. It can be months to years before the spots fade.

Dermatology
Cosmetic Medicine / Plastic Surgery

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Davis, E. C., & Callender, V. D. (2010). Postinflammatory hyperpigmentation: A review of the epidemiology, clinical features, and treatment options in skin of color. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921758/
How to fade dark spots in skin of color. (n.d.). https://www.aad.org/public/everyday-care/skin-care-secrets/routine/fade-dark-spots
Sutaria, A. H., et al. (2019). Acne vulgaris.http://www.ncbi.nlm.nih.gov/books/NBK459173/

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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Jessica Caporuscio, PharmD on April 28, 2020

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