Medically reviewed by Joni Gunzburger, MSN, FNP-C on November 10, 2022
Have you noticed areas of hyperpigmentation on your skin? Maybe you’ve found a brown spot on your forehead, or skin discoloration on your cheeks?
Any time you see a significant change in your skin, your first step should be to consult a medical provider to rule out skin cancer or another skin condition. But once you’ve ruled out potentially serious scenarios, your main focus will likely be – how do I get rid of this?
Luckily, there are plenty of ways to treat dark spots. Whether yours are caused by sun damage, acne scars, or a condition like melasma, there’s a treatment out there that can help to minimize the appearance of dark spots and help you feel good about what you see in the mirror.
Nurx offers prescription treatment for acne, anti aging, melasma and rosacea for as little as $0 with insurance or $15 per month without insurance.
What Are Dark Spots/What Are the Symptoms of Dark Spots?
Technically speaking, any type of hyperpigmentation on the skin can be classified as a dark spot. You’ll notice they’re markedly different from surrounding skin and don’t fade or heal like pimples, blemishes or a sunburn.
What Are Dark Spots and What Are the Symptoms?
Dark spots occur when the skin produces too much melanin. Melanin is the pigment that gives you your skin tone, so you do want some of it. But for various reasons, such as too much sun exposure, your skin can become overstimulated and produce more than you need to maintain your usual coloring.
The symptoms of dark spots depend on what kind of dark spot you have. Age spots (or “liver spots”), for example, are usually small and flat tan or dark brown areas on the skin. Melasma can cause blotchy patches that are a shade or two darker than the surrounding skin. A condition called acanthosis nigricans, appears as dark and thick skin along the folds and creases of your body.
Finally, there’s a condition called postinflammatory hyperpigmentation that can happen after an injury. You might notice the area starts developing dark brown, tan, or sometimes blue-gray patches as the wound heals. Acne scars are a common example of this.
What Body Parts Are Affected by Dark Spots?
It’s typical to see dark spots on your cheeks, nose, forehead, chin, and above your upper lips. While dark spots are most common on the face, they can start showing up on any part of your body that’s regularly exposed to the sun. That means you might also see them on your chest, shoulders, and arms.
What Do Dark Spots Indicate?
In some cases, dark spots can be a warning of skin cancer. Basal cell carcinoma (cancer of the inner part of the skin) can cause blue, brown, or black spots, while squamous cell carcinoma (cancer of the outer part of the skin) can cause red patches or raised growths.
Melanoma is another less common type of skin cancer that happens when your melanocytes (the cells that produce melanin) start to grow unabated. You may develop a tumor that’s brown or black on your chest, back, or legs.
The American Cancer Society warns that these types of cancers most frequently occur in sun-exposed areas, so remember to always use SPF when going outside.
Causes of Dark Spots
As we noted above, dark spots are usually caused when your melanocytes produce too much melanin. But what causes this to happen? There are plenty of factors that can turn your melanocytes from no-nonsense 9-5 workers into overtime-clocking cells.
What Causes Dark Spots on Face?
There are plenty of things that can trigger hyperpigmentation. One of the primary causes is too much sun exposure. Harmful UV rays can penetrate the layers of the skin and cause damage – that’s how sunburn comes about. Your body produces melanin to protect you, but over time, things can go a bit awry. Your melanocytes might produce too much melanin in one spot, leading to age spots.
Skin discoloration can also happen because of hormonal changes in the body. In particular, the hormonal changes from pregnancy can flip your melanin production into overdrive, causing melasma and other conditions.
Certain medications, such as hormonal birth control, anti-inflammatory drugs, psychotropic drugs, antimalarials, and tetracyclines, can also trigger melanin production and lead to brown spots.
Finally, an uneven skin tone can sometimes be caused by a skin condition like acne, eczema, or psoriasis. These all cause small injuries to the skin, and as the skin heals, it can sometimes look darker.
Why Are Your Dark Spots Getting Worse?
For many people, getting treatment for their dark spots can actually make them darker at first. We know, it sounds counterproductive!
However, this is happening because your treatment is likely stimulating the production of new skin cells. This pushes hyperpigmented cells to the skin’s surface until you can shed them, temporarily making your dark spots seem worse than ever.
Additionally, if you have dark spots caused by an untreated condition or medication, your dark spots will likely keep spreading until you address the issue.
Can Dark Spots Be Permanent?
Luckily, most dark spots can be treated, at least to an extent. There are plenty of skin-brightening solutions, including topical creams and oral medications. In some cases a dermtologist may suggest and in-office treatment such as a chemical peel or laser treatment, for more resistant skin discoloration.
How to Diagnose Dark Spots
Diagnosing dark spots requires you to consult a trained medical professional. Only they will have the knowledge and experience to confidently determine what’s causing your discoloration. It’s never a good idea to self-diagnose based on a Google search. Dark spots can have a lot of complexity, and it takes a seasoned eye to tell various skin conditions apart.
As a part of your consultation, they’ll likely take two or three steps to diagnose your problem dark spot: asking your questions about your medical history, a visual inspection, and potentially a skin biopsy.
What Questions Will a Medical Professional Ask Me?
First, your medical professional will ask you about the history of the spot. They’ll want to know when it first appeared and how it has evolved over time. Has it gotten bigger? Changed color? These factors can all help with their diagnosis.
They may also ask questions about any medications you’re currently taking. For example, meds like hormonal birth control with estrogen can sometimes cause hormonal-related skin discoloration known as melasma. In some cases, switching to a different birth control formula can usually help to clear your skin up.
It’s also common for your doctor to ask about how much sun exposure you get, if you suffer from excessive sweating, or if you have any other medical conditions. These can all be factors that predispose you to hyperpigmentation.
What Happens During a Visual Skin Inspection?
A visual inspection is when your doctor will take an up close and personal look at your skin, either in person or via submitted photos if you’re utilizing telehealth. They’ll first take a look at the color of the area, since a brown spot can have a much different cause than a black spot.
It’s also important for them to make notes on the shape of the spot. They’ll be checking to see if your spots are symmetrical or asymmetrical. Asymmetrical moles are more likely to raise skin cancer concerns, but spots that are in symmetrical patterns across the face could be melasma.
Size is another important determinant. Larger spots over ¼ inch could be a sign of cancer or seborrheic keratosis (a benign growth that looks waxy or scaly), whereas smaller spots are likely age spots or post inflammatory hyperpigmentation.
What Happens During a Skin Biopsy?
If your medical provider isn’t sure about your condition from a visual examination, they’ll likely order a skin biopsy. A skin biopsy is when your doctor removes some skin from your mole or dark spot and sends it to a lab for further analysis.
A pathologist will then inspect the skin material under a microscope. In most cases, they’ll be checking for cancer cells, but they can also diagnose actinic keratosis (a scaly and rough patch of skin), infections, and more.
How to Treat Dark Spots
Because dark spots have a variety of causes, there’s not one overarching treatment that works for everyone. Instead, you’ll need to work one-on-one with your medical provider to find the dark spot treatment that’s just right for you.
How Should You Treat Dark Spots and Discolorations?
The first step in any treatment is to address the underlying cause. For example, if your dark spots are caused by a skin condition like acne, psoriasis, or eczema, you’ll need to get that under control first. Once you’ve got any catalysts under control, it’s time to start fighting back against the spots themselves. Chemical exfoliators, such as azelaic acid and lactic acid, can help to remove the top layer of skin and promote the production of new, unpigmented skin cells. Melanin-blocking creams, like kojic acid and tranexamic acid, can slow down the production of melanin in your skin. Finally, more intense treatments like laser therapy and microdermabrasion can stimulate the production of fresh cells.
How Do Melanin-Blocking Creams Help With Hyperpigmentation?
The melanin-blocking cream hydroquinone blocks the production of melanin. They do this by inhibiting the formation of tyrosine, an amino acid that is crucial in the melanin production process.
Generally, you’ll use hydroquinone cream every day for three months, but no longer than that, as with prolonged use it can actually make discoloration worse. You should start noticing results after a few months. They can be used to fade acne scars or treat melasma.
How Do Laser Therapy and Microdermabrasion Help With Hyperpigmentation?
More intense treatments such as laser therapy and microdermabrasion also work to stimulate the production of new skin cells. With laser therapy, light penetrates the top layer of skin to target and destroy the melanocytes underneath. Microdermabrasion, on the other hand, creates a series of microscopic wounds on the top layer of skin, increasing blood flow and healing to these regions.
Tips for Preventing Dark Spots
Treating dark spots is one thing – but what if you could prevent them from ever forming in the first place? While it’s impossible to guarantee you’ll never develop dark spots, taking these proactive steps can certainly reduce your chances.
How Can You Prevent Dark Spots From Occurring?
If you want to know how to prevent dark spots, start with avoiding sun exposure. Sun damage is a major cause of sun spots, uneven skin tone and melasma. That doesn’t mean you have to become a cave dweller. Just make sure to use at least 30 SPF and wear hats and protective clothing as much as possible when you head outdoors.
A good daily skin care regimen may also help. Washing your face with a gentle cleanser and moisturizing twice daily can keep your skin healthy and hydrated. Beyond that, there are a few additional serums you should throw into your regimen to give your skin the nutrients it needs.
The prescription retinoid tretinoin can both prevent and treat dark spots related to sun damage.
Aloe vera can help hydrate dry skin and act as an anti-inflammatory agent, meaning it can reduce swelling and redness.
We’d be remiss if we didn’t mention vitamin C! It’s an anti-aging heavy hitter and works to give you a smooth and lightened complexion. In addition to providing hydration, it can reduce skin pigmentation and even protect against sun damage. Add a vitamin C serum to your daily skincare routine, applying after cleansing but before using moisturizer, for the best benefits.
Alpha hydroxy acids, such as mandelic acid or glycolic acid, can help to accelerate cell turnover and keep dead skin cells from accumulating on the skin’s surface. They also help to promote collagen production, which is essential for keeping your skin plump and full.
If you notice discoloration or dark spots on your face and want to know what your treatment options are, you can get started here by completing a skin assessment.