As a naturally clumsy person, I’m no stranger to scars. I’ve got a gnarly one on my left hip from slipping on ice in college, a pair of them on my right foot from when my friend dropped a glass on my foot a few birthdays ago (long story), and let’s not even mention the dark spots from picking at bumps and pimples on my face. (I know, bad move, but I can’t help myself!) It’s a pretty messy cycle: I freak out anytime I get a pimple because I’m scared it’ll leave me with a spot, and all that stress then leads me to pick at my zit…which leaves me with a spot.
Let’s set one thing straight though: There’s absolutely nothing wrong with having dark spots or hyperpigmentation. You’re human! And if you don’t GAF if they’re on your face, that’s completely fine! But I’d be lying if I said that I didn’t live in fear of the dark mark (no, not the Harry Potter one), and I also know I’m not alone.
As a beauty writer, you wouldn’t believe how many DMs I get about hyperpigmentation. And the vast majority of those “HELP ME!” messages come from Black women, which makes sense—a 2018 study showed that people of color are way more likely to develop hyperpigmentation than white people.
After yet another person slid into my inbox asking for help with their dark spots, I couldn’t help but wonder (*Carrie Bradshaw voice*), why is this such a common issue among deeper skin tones? And with all the serums and creams out there, why is it so freakin’ difficult to find a product that actually works on our skin?
So to help us all out, I put on my investigative hat and spoke to Joyce Imahiyerobo-Ip, MD, a dermatologist in Massachusetts, and Adeline Kikam, MD, a dermatologist based in Texas, on what causes dark spots, the best ways to treat them, and how to prevent them from popping up again in the future.
What is hyperpigmentation?
Okay, so let me back up for a sec: Most of the time when we say “hyperpigmentation,” we’re actually referring to “post-inflammatory hyperpigmentation, or PIH,” says Dr. Imahiyerobo-Ip. Quick bio lesson: When a zit pops up, your skin gets inflamed and your body works overtime to heal that skin trauma. As your skin heals, it produces a ton of melanin in that area, says Dr. Imahiyerobo-Ip. And with deeper skin tones, sometimes your body will send too much melanin, leaving you with hella-dark spots and uneven skin. Fuuun.
The most common causes of dark spots?
- Excess UVA/UVB ray exposure (more on that later)
- Inflammatory skin conditions, like acne or eczema
- Physical injury, like cuts, bruises—oh, and picking at your zits
- Blue light from computer and phone screens
- Genetics (TY, Mom and Dad)
- Rashes and allergic reactions
Wait, could I be making my hyperpigmentation worse?
Unfortunately, yes, you could be standing in your own way when it comes to clearing up your dark spots (you haaate to see it), including:
You’re skipping sunscreen
Remember a few months ago when we told you to wear sunscreen? Um, it wasn’t a joke, and I’m going to remind you again: Please wear sunscreen. According to Dr. Kikam, overexposure to the sun’s UV rays can stimulate the overproduction of melanin, making your existing dark marks even worse and causing old spots to come back with a vengeance. If you’re not slathering on sunscreen, all that work you put into your skincare routine is basically ineffective when it comes to fading dark spots.
You’re a bit aggro when dealing with your skin
I’m not just talking about picking at your pimples (which I need to stop doing ASAP). Doing the most with your skincare routine can cause irritation, which, in turn, can trigger excess melanin production. Before adding a product to your skincare lineup, ask yourself a couple of questions: Do I really need this? Could this ingredient be too harsh for my skin type? What do I expect this to do for me?
The best, most effective routine at fading dark spots is a targeted one. When you use too many products without a clear idea of what they’re even doing, you could stress out your skin, causing inflammation and irritation. Aim for a routine that is concise and features products that work well together (which, FYI, a dermatologist can help you identify).
Okay, so how do I clear up my dark spots?
When it comes to getting rid of PIH, don’t be afraid to reach out to a dermatologist (even virtually!) if you don’t know where TF to start or if you know you’re better off with adult supervision (hi, me). A derm can help diagnose the underlying cause, giving you the best plan of action for a targeted and effective treatment.
Your derm might decide, for example, that your PIH is being caused by eczema—something that can be made worse by using the wrong products at home. In this case, says Dr. Imahiyerobo-Ip, your derm can then suggest topical anti-inflammatories, like cortisone cream, to add into your routine. Basically, you’re not a doctor (sry).
Derms also have access to several ~fancy~ in-office treatments that can help fade PIH, including:
This is a process where laser beams (! it’s fine) are zapped directly onto your skin, targeting the PIH in order to gently break apart the pigment. If you choose to go this route, be careful. While laser technology is improving, says Dr. Imahiyerobo-Ip, some lasers can’t accurately target dark spots on deeper skin tones, which could leave you with burns, scars, and worsened PIH. Call ahead to double-check with your derm that the right equipment will be used before any zapping begins.
- Chemical peels
There are several different types of in-office chemical peels (your derm will help you choose which one is best for you), but they all basically work the same way: The high concentration of exfoliating ingredients in the peels work to break down the top layer of dead skin cells, allowing the clearer, spot-free skin underneath to rise up.
Think of this in-office treatment as an intense face scrub. Using a handheld exfoliator, your derm will either spray your skin with teeny-tiny crystals or polish your face with a diamond-tipped wand. Both methods remove dead skin cells, leaving behind brighter, clearer skin. Buuut if you have sensitive skin that’s highly reactive or you’re currently dealing with an acne flare-up, you’ll want to skip this option—it can irritate your PIH even more.
FYI though: These treatments are not cheap. Depending on what you choose, the derm you see, and where you live, in-office treatments can range from a few hundred dollars to a couple thousand. Plus, you might need several sessions to see a major difference in your skin. Just something that you (and your wallet) should keep in mind.
Can I even out my skin tone at home?
If you don’t have access to a derm or you’d rather DIY your treatment, don’t stress—you’ve got options. According to Dr. Kikam, when it comes to putting together a solid skincare routine that treats PIH, you need to follow these six steps.
Step 1: Use a gentle cleanser
This is a no-brainer: You need to wash your face before putting a drop of product on your skin. In order for all those active ingredients to fully absorb and do their thing, you need to clear out the oil and grime first.
Even though it can seem like a hassle, a double-cleanse is the most effective way to prep your skin for the rest of your routine. First, dissolve makeup and skin oils with a gentle, non-stripping cleansing balm or cleansing oil, then follow up with a creamy cleanser to rinse everything away. Oh, and for your own sake, skip the makeup wipes—they can leave behind a pore-clogging film, and the rubbing/wiping action isn’t doing your PIH any favors.
Step 2: Exfoliate
Next, chemically exfoliate—no gritty scrubs, please!—with a blend of gentle liquid exfoliants, like AHAs (alpha hydroxy acids, like glycolic and lactic acids) and BHAs (beta hydroxy acids, like salicylic acid). These ingredients work to “unglue” and dissolve the dead skin on your face, evening out your skin’s tone and texture over time.
Chemically exfoliating also helps your other skincare products work better. When you don’t exfoliate regularly, you basically have an army of dead skin cells blocking your expensive serums and moisturizers from sinking in and doing their jobs. Once you start exfoliating, you’ll find that your skin is finally able to truly soak in all the goodness you’ve been layering on.
Step 3: Add a potent serum
Serums are usually packed with a high percentage of active ingredients that work to either deeply hydrate your skin or brighten/smooth/resurface your skin. For dark spots, you want a serum that puts in work. Look for a formula that’s filled with one (or more!) of these ingredients:
- Kojic acid: While most acids work to exfoliate your dark spots away, kojic acid also works to prevent them by interfering with your skin’s melanin production. So not only will kojic acid fade your current discoloration, but it’ll also help block new spots from sticking around.
- Niacinamide: This superhero ingredient is a form of vitamin B3 that helps balance out your oil production (which can curb breakouts) while also fading your dark spots.
- Vitamin C: An antioxidant that protects your skin against environmental aggressors that cause inflammation. It also helps to fade acne scars and dark spots while helping to smooth fine lines over time. It’s basically a do-it-all ingredient.
Step 4: Layer on retinol
Retinoids (that’s the umbrella term for all forms of vitamin A, including retinol) do two major things: (1) boost collagen production and (2) increase cell turnover for brighter, plumper, and smoother skin. There is a catch though: Not only does it take at least three months to see difference (and six months until that difference is significant), but retinoids can also irritate TF out of your face if you use a too-strong formula or use it too quickly.
To make the transition easier, Dr. Kikam recommends starting with a gentle formula (don’t worry, it’ll still work) and gradually introducing it into your p.m. routine. Apply it twice a week for a few weeks, see how your skin reacts, and then slowly bump it up from there.
Step 5: Moisturize
Moisturizer is another must-have in your routine. Not only does it infuse your skin with hydration (a literal requirement if you’re using retinoids and dark-spot treatments), but it also keeps your skin barrier—aka the outermost layer of your face—strong and healthy, which helps calm PIH in the first place. Layer it on morning and night, k?
Step 6: Protect with SPF
Apply a layer of sunscreen Every. Single. Day. (Yes, even when it’s cold or cloudy outside.) Skipping sunscreen while using retinoids and/or chemical exfoliants can actually make your skin even more susceptible to PIH and also make your current dark spots even worse. Look for a lightweight and fluid SPF of at least 30, says Dr. Kikam.
The final word
It’s super important to remember that none of these solutions work overnight, so you’re going to need to practice some patience in order to see your tone even out. If you stick with this routine, you’ll start to see clearer skin within a few weeks, and after a few months, you’ll know whether or not you need to change things up or check in with a derm.
So while there sadly isn’t one holy-grail, miracle treatment that’ll keep dark spots and PIH away forever, there are preventative steps and a targeted routine you can follow that’ll give you major results—eventually.