Medically reviewed by Dr. A.M. van Coevorden, dermatologist, on
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. Learn what causes dark patches and how they can be treated.
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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 to the skin: after eczema, pimples, small wounds or scratching, a dark patch can remain on the skin. 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? Ask a dermatologist.
Dark marks after acne or skin inflammation (post-inflammatory hyperpigmentation)
Is there a dark mark where a spot, an eczema patch or a small wound used to be? This may be post-inflammatory hyperpigmentation. It is a darkening of the skin after inflammation or damage to the skin, for example from eczema, spots, scratches or burns. People with darker skin get it more often.
How does it happen? Inflammation triggers the pigment cells in your skin to make more pigment. Pigment that sits deeper in the skin is only cleared after months to years.
Does it go away? If the pigment sits near the surface, the dark mark usually fades on its own within 6 months to a year. If it sits deeper, it usually does not go away, or only after years. Sometimes it does not fade completely.
What helps? First treat the cause, so that no new marks appear. If you have eczema or acne, good treatment of that helps. Protect your skin from sunlight, including daylight, with sunscreen with SPF 30 or higher. Sunlight triggers the pigment cells to make more pigment. Creams that lighten dark marks can help with pigment near the surface. Some products can make the skin around the mark lighter or cause too much irritation, which can make the skin darker again later. Get advice first before trying products yourself.
Want to know whether your mark comes from inflammation or from something else? A dermatologist reviews your photos and symptoms. Choose whether you'd like a response within 12, 24 or 48 hours. You can read more about marks after acne on our page about dark spots after acne.
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
Not sure whether this needs a look? Have a dermatologist assess it: you get an answer within 12 to 48 hours, no referral needed. In an emergency, contact your GP straight away or call 112.
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.
Have a dermatologist look at your skin
Upload photos and answer a few questions. A BIG-registered dermatologist replies within 12 to 48 hours, no referral needed, from € 39.
If more is needed, the dermatologist refers you to a medical specialist.
Want to know what a dermatologist does, when you can see one and how quickly that can happen? Read more about the dermatologist.
Sources and more information
Related skin conditions
Melasma
Brown patches of pigmentation on the face, often triggered by sun and hormones.
Acne
Inflamed oil glands causing pimples, blackheads and sometimes scarring.
Vitiligo
Loss of pigment causing sharply defined white patches.
Age spots
Evenly light brown, benign spots on the face and hands caused by years of sun.
Skin tips from a dermatologist?
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