Dark spots on the face can result from hyperpigmentation, which is a common skin condition that occurs when the skin produces too much melanin. Hyperpigmentation can be due to sun exposure, scarring, aging, and more.
Many dark spots are harmless. However, if a person wants to reduce their appearance, they can usually do by using topical treatments.
This article will look at dark spots that result from hyperpigmentation. It will discuss their causes, how to get rid of them, and some treatment options. It will also look at approaches and ingredients that people should avoid.
What causes dark spots on the face?
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Dark spots on the face can occur if the skin overproduces melanin, which is the pigment that gives skin its color. This is known as hyperpigmentation.
Hyperpigmentation can develop as a result of:
- aging
- hormonal changes, such as during pregnancy or menopause
- sun exposure
Skin damage can also cause post-inflammatory hyperpigmentation (PIH). People may develop PIH due to:
- acne
- bites, cuts, and burns
- excessive or incorrect hair removal techniques
- ingrown hairs
- harsh skin care products
- scarring from psoriasis or other skin conditions
Hyperpigmentation is not the only cause of dark spots on the face. For this reason, it is important for a person to speak with a doctor if they notice any changes to existing moles or dark spots — particularly changes in texture, color, and size.
Topical treatments for dark spots
There are many over-the-counter (OTC) products that can help fade dark spots. They will typically contain active ingredients such as:
- hydroquinone
- kojic acid
- retinoids
- chemical exfoliants
- vitamin C
- azelaic acid
These products will have instructions on how to use them on the label. However, it is best to speak with a dermatologist before trying them, as some have risks.
The following sections will look at some of the pros and cons of these products in more detail.
Hydroquinone
Hydroquinone is a popular ingredient in products for hyperpigmentation. It works by reducing the production of melanin. OTC products contain around half the amount of hydroquinone as prescription-only products.
Some countries have banned hydroquinone due to safety concerns. For example, research from 2007Trusted Source suggests that hydroquinone may cause cancer in rats. However, scientists have not proven that this also occurs in humans.
Hydroquinone can cause skin irritation, especially when people use higher concentrations of it. It may also lighten the skin surrounding the dark spots if a person does not apply it carefully.
Kojic acid
Kojic acid is another popular treatment for hyperpigmentation. However, it may not be as effective as other treatments.
One 2013 study Trusted Source compares 0.75% concentration of kojic acid with 4% hydroquinone for treating melasma in 60 people. The researchers suggest that hydroquinone works more effectively.
Kojic acid can also irritate sensitive skin, so it may not be suitable for everyone.
Retinoids
Retinoids are derivatives of vitamin A. They increase the turnover of new skin cells, which can fade dark spots over time.
Doctors may prescribe a professional-strength retinoid, such as tretinoin, for severe hyperpigmentation. These products can take 3–6 months to work. The stronger the retinoid, the more likely it is to cause irritation.
Products containing retinoids are not suitable for use during pregnancy, as vitamin A can sometimes cause birth anomalies.
Retinoids also increase the skin’s sensitivity to UV light, so it is important to use a safe SPF on the face every day while using retinoids.
Chemical exfoliants
Chemical exfoliants are acids that dissolve the top layer of skin cells. They include alpha hydroxy acids, such as lactic acid, and beta hydroxy acids (BHAs), such as salicylic acid.
Chemical exfoliants also work by increasing the turnover of new skin cells. They can also be suitable for dry or sensitive skin. However, as with retinoids, these acids increase the skin’s sensitivity to the sun.
Cosmetic procedures for dark spots
If topical products do not adequately reduce hyperpigmentation, some people may wish to consider cosmetic procedures.
Some potential options include:
- Laser therapy: This involves a dermatologist using a beam of light to target areas of discoloration. There is a risk that laser treatment will make discoloration worse, so patch testing beforehand is essential.
- Chemical peels: Professional chemical peels are stronger versions of OTC acid exfoliants. Stronger peels work on deeper layers of the skin, but they also have longer recovery times.
- Microdermabrasion: This exfoliating treatment uses minuscule particles to remove dead skin cells. There is no recovery period, though it can make the skin temporarily irritated or swollen.
People who are prone to PIH or scarring or who have used isotretinoin in the past 6 months may not be able to undergo microdermabrasion, chemical peels, or laser therapy.
Choosing a treatment
How a person uses products for hyperpigmentation will depend on a number of factors. The following sections will look at these in more detail.
Skin tone
People with dark skin tones need to exercise caution when using treatments for hyperpigmentation. This is because using the wrong product or a highly concentrated product can lighten other areas of the skin. There is also a risk that products will cause more hyperpigmentation.
The American Academy of Dermatology (AAD) recommends the following treatments for dark spots in skin of color:
- 2% hydroquinone
- azelaic acid
- glycolic acid
- kojic acid
- retinoids, such as retinol, tretinoin, adapalene gel, or tazarotene
- vitamin C
A dermatologist with experience in treating hyperpigmentation in dark skin can advise on the best approach.
Underlying conditions
People may need to address skin conditions that are causing hyperpigmentation in order to prevent dark spots from appearing.
For example, if a person has PIH as a result of acne, treatment can focus on fading discoloration as well as preventing acne and acne scarring.
Treatment may involve:
- BHAs, which can both fade discoloration over time and help treat acne
- retinoids, which people can use topically or orally
- diet or lifestyle changes
Sun damage
If a person has dark spots as a result of sun damage, they should add an effective sunscreen to their skin care routine. Sunscreen stops the darkening of existing hyperpigmentation and prevents more UV damage from occurring.
Everyone should wear sunscreen every day, regardless of their skin tone. The AAD recommends choosing one that:
- has an SPF of at least 30
- protects against UVA and UVB rays
- is water resistant
Vitamin C may be an especially helpful treatment for sun damage. One 2017 review Trusted Source notes that topical vitamin C is effective for preventing melanin formation and protecting against premature skin aging as a result of UV exposure.
Medications
Some topical and oral medications may cause or worsen hyperpigmentation. People can check the label on any medication to see if this side effect is a possibility. If it is, a doctor can advise on the best course of action.
The AAD states that once a person removes the cause of their hyperpigmentation, existing spots should fade in 6–12 months. However, very dark spots may take longer than this to fade.
Hormonal changes
Dark spots that arise due to hormonal changes are not always avoidable. However, some mild discoloration may fade over time once a person removes the cause.
For example, if a person is pregnant, the marks may start to fade when the pregnancy is over.
Melasma can be more stubborn to treat. Melasma is a deeper form of hyperpigmentation that can occur due to hormonal changes. Even when melasma fades, it can come back if a person has exposure to the sun.
If a person is pregnant or nursing, they should check with a doctor that any hyperpigmentation treatments or procedures are safe to use.
Do home remedies work for dark spots?
Many products and online sources claim that various home remedies can fade hyperpigmentation. Some examples of these include:
- aloe vera gel
- beta carotene
- green tea
- licorice root
- pomegranate extract
- soy milk
- tea tree oil
- turmeric
- lemon juice
However, there is limited or no evidence to back up most of these claims.
Some home remedies for dark spots can be harmless, but others may cause damage to the skin.
For example, lemon juice is very acidic and too harsh to use undiluted. Similarly, people should not use undiluted essential oils on the skin.
Things to avoid
Some skin-lightening practices can be dangerous. For example, the AAD warns against using liquid bleach on the skin. This can cause serious burns.
Some skin-lightening products can also contain unlisted ingredients, such as steroids, which people should not use without medical supervision. Others can even contain mercury, which is highly toxic.
Mercury may appear on ingredient lists as:
- mercuric
- calomel
- cinnabaris
- hydrargyri oxydum rubrum
- quicksilver
People should always purchase products for hyperpigmentation from reputable companies and online stores. Alternatively, they can obtain safe products from a dermatologist.
Even with safe products, it is important to follow the instructions on the label unless otherwise instructed by a doctor. People should not use the product more often than the instructions state.
If side effects occur, people should stop using the product immediately and speak with a dermatologist.
Summary
In many cases, hyperpigmentation on the face will fade on its own with time. OTC and prescription treatments can safely fade areas of discoloration. A dermatologist can advise on the best approaches depending on a person’s skin type and tone and the cause of their hyperpigmentation.
It is important that people contact a doctor straight away if existing dark spots grow, change, or multiply.
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