Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Hyperpigmentationdark patches from excess pigment
Hyperpigmentation means the skin is darker in some places than the skin around it, caused by an excess of pigment. It is almost always harmless, but it can be bothersome. Read here where dark patches come from and what can be done.
What is hyperpigmentation?
Your skin gets its colour from pigment (melanin), made by pigment cells in the lowest layer of the epidermis. In hyperpigmentation these cells produce too much pigment in some places, and dark patches appear. Hyperpigmentation is an umbrella term: several forms exist, with different causes.
Where do dark patches come from?
The three most common causes. Sunlight: UV radiation drives pigment cells to make extra pigment; this is how sun spots appear and existing pigmentation darkens. Hormones: female hormones can drive pigment production; that form is called melasma and often appears during pregnancy or with the contraceptive pill. Inflammation or damage of the skin: after eczema, pimples, small wounds or scratching, the skin can leave a dark patch behind. That is called post-inflammatory hyperpigmentation and occurs mainly in darker skin.
How do you recognise it?
Dark, usually brown patches with sharp or irregular borders. The location and pattern often reveal the cause: patches exactly where a pimple, wound or eczema patch used to be point to post-inflammatory hyperpigmentation; irregular facial patches point to melasma. Unsure about a dark spot, or is it changing in shape or colour, or behaving differently from the rest? Put it to a dermatologist.
What can be done?
First address the cause: as long as the sun, the hormones or the skin inflammation continue, new patches will keep appearing. If eczema or acne is the driver, treating that comes first. Superficial pigment then usually fades by itself, in 6 months to a year. Deeper pigment often does not fade, or only after years. To speed up the fading there are options: bleaching creams (for example with hydroquinone, azelaic acid or a vitamin A acid derivative), chemical peels and camouflage therapy by a skin therapist. Important to know: bleaching creams and peels can also backfire and make the skin darker instead, especially in darker skin. Doctors are cautious with laser treatment for the same reason. So get advice before you start, also with products from the drugstore.
What can you do yourself?
Protect the patches from the sun: UV light darkens every form of hyperpigmentation. Use sunscreen with at least factor 30 and do not use the tanning bed. Do not scratch pimples or eczema patches; that increases the chance of a dark patch afterwards.
Frequently asked questions about hyperpigmentation
Are dark patches dangerous?
Hyperpigmentation is almost always harmless. Is a patch changing in shape or colour, or does it stand out from the rest? Have it assessed by a dermatologist.
Do the patches fade by themselves?
Superficial pigment usually fades by itself, in 6 months to a year. Deeper pigment often does not fade, or only after years.
Does a bleaching cream help?
Sometimes, with superficial pigment. But bleaching products can also backfire and make the skin darker instead, especially in darker skin. Ask for advice first.
Why does my darker skin have more of this?
Darker skin has more active pigment cells. After inflammation or damage they produce extra pigment more readily, and it takes longer for the patch to fade.
Sources and more information
- NVDV patient leaflet Melasma (nvdv.nl)
- Patient leaflet Post-inflammatory hyperpigmentation (huidziekten.nl)