If dark skin spots due to hyperpigmentation bother you, one thing is clear: Today, more options are available for erasing that harmless but irksome discoloration than ever before.
Hyperpigmentation refers to any patch of skin that looks darker than your natural skin tone because the skin is producing too much of the brown pigment melanin. Causes range from sun exposure to inflammation to melasma to certain medical conditions or even medications. Liver spots (or age spots) and sunspots are examples of hyperpigmentation.
While your primary goal with lessening hyperpigmentation is to lighten the dark spots, an effective over-the-counter (OTC) moisturizer should contain ingredients that benefit the skin in other ways.
"In addition to addressing the pigment issues, a good product will have moisturizing agents like glycerin or hyaluronic acid, and maybe even a retinol to boost cell turnover," says Doris J. Day, MD, a clinical assistant professor of dermatology at NYU Medical School in New York City and the author of Beyond Beautiful: Using the Power of Your Mind and Aesthetic Breakthroughs to Look Naturally Young and Radiant. "These inactive ingredients allow the active brighteners to work more effectively."
A good moisturizer can also restore the skin’s lipid, or fat, barrier, helping new skin cells stay healthy as they rise to the surface in place of old ones, notes the University of Tennessee Medical Center.
2. Protect Your Skin From the Sun
The most effective way to prevent sun-induced discoloration is to diligently apply a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or greater every day, even on cloudy or cool days. "UV rays just send the pigment into overdrive, turning dark spots darker," says Dr. Day. "You must wear sunblock daily on exposed areas."
SPF refers to protection from UVB short-wave rays only. To also protect against UVA long-wave rays, choose a broad-spectrum sunscreen.
Additionally, the AAD recommends avoiding the outdoors between 10 a.m. and 2 p.m., when the sun is strongest. You can also wear a wide-brimmed hat to protect your head, face, ears, and neck.
7 Doctor-Approved Ways to Get Rid of Hyperpigmentation
Hyperpigmentation or dark spots on skin can be hard to erase. These recommendations are approved by medical professionals.
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3. Keep Your Hands Off Bug Bites, Blackheads, and Other Injuries
As tempting as it may be to scratch a mosquito bite or squeeze a stubborn blackhead, remember your mother's warning — "Don't pick!" — and follow that advice.
"Scratching and picking at a spot will only increase the inflammation that's responsible for skin discoloration," says Jeanine Downie, MD, a dermatologist and the director of Image Dermatology in Montclair, New Jersey. "The more you mess with it now, the worse it'll look later."
4. Explore OTC Whitening Options
The sooner you treat hyperpigmentation, the easier it will be to erase. “The pigment in brown spots can move deeper into the skin over time,” Dr. Downie says.
Spot-eradicating ingredients to look for in OTC treatments include azelaic and glycolic acids, vitamin C, and retinoids, says the American Academy of Dermatology Association (AAD).
“Treatments containing ingredients like vitamin C, licorice root, and kojic acid help reduce hyperpigmentation by inhibiting tyrosinase, an enzyme responsible for the formation of skin-darkening melanin," says Ni'Kita Wilson, a cosmetic chemist in New York City.
Research supports Wilson’s advice. A research review notes that the knowledge of the link between tyrosinase and excess melanin development has led to the rise of multiple OTC products with the aforementioned ingredients.
Also, products with tranexamic acid and beta and alpha hydroxy acids may be beneficial, says Neelam A. Vashi, MD, associate professor of dermatology and director of Boston University Center for Ethnic Skin at the Boston University School of Medicine. She says that, like kojic acid, azelaic acid and tranexamic acids work by inhibiting melanin production. “Alpha and beta hydroxy acids work by exfoliating the surface layer of the skin, promoting cell turnover and removing pigmented cells,” she says.
While many of these OTC ingredients have “bleaching” effects on dark spots, the AAD strongly cautions against applying liquid bleach to your skin. The group recommends sticking with products made in the United States, as some imported skin-lightening products have shown signs of mercury and steroid contamination, as well as the presence of other harmful ingredients.
5. Consider an Rx for Stubborn Skin Discoloration
If OTC remedies aren't helping, it's time to call in the pros. Dermatologists consider products with hydroquinone, alone or combined with other lighteners, to be the gold standard for fading dark spots because it slows the production of pigment. These are available by prescription, per the U.S. Food and Drug Administration (FDA).
“It's our go-to,” says Downie, “because unlike many of the ingredients in OTC products, it almost always works at eliminating hyperpigmentation.” Have your dermatologist closely monitor hydroquinone treatment, she adds. In high concentrations, hydroquinone can cause sun sensitivity and may bleach the skin.
In addition to hydroquinone, the American Osteopathic College of Dermatology (AOCD) notes that your dermatologist may prescribe other treatments, such as topical cortisone cream or tretinoin, a type of synthetic vitamin A.
6. Ask a Dermatologist About High-Tech Options
If topical solutions aren't fixing the problem, you may want to talk to your dermatologist about more aggressive ways to banish discoloration, such as chemical peels, microneedling, microdermabrasion, or dermabrasion, or a laser resurfacing procedure.
“I treat hyperpigmentation regularly using a combined approach of topical treatments and procedures,” Dr. Vashi says. “Procedures include chemical peels with alpha and beta hydroxy acids, microneedling, and certain types of lasers.”
For those with very sensitive skin, broadband light therapy (BBL), which uses high-intensity light that’s gentler than a laser, may be a suitable alternative, Downie says.
Important note: Vashi says that some treatments, including laser treatments and BBLs or “photofacials,” can worsen discoloration if used incorrectly. For example, dark skin may absorb too much light from laser therapies or BBLs, causing hypo- or hyperpigmentation, burns, and scars, according to Duke Health.
Skin specialists who treat hyperpigmentation carefully assess patients’ skin before recommending procedures.
7. Try Aloe Vera
Social media is rife with recommendations for at-home skin-lightening solutions, most of which overpromise and underdeliver, says Susan Massick, MD, a dermatologist at The Ohio State University Wexner Medical Center in Westerville. However, some research suggests one popular remedy may be worth it.
“Aloe vera and the active chemical aloesin is known for its soothing, anti-inflammatory effects, which is why it is commonly recommended over the counter to help with skin irritation and sunburns,” Dr. Massick says. In higher concentrations, it may help with skin lightening by inhibiting tyrosinase and melanogenesis, both pathways to forming pigment in the skin, according to research.
Although some sites suggest using lemon juice for lightening skin, Massick warns against this. “Psoralen, found in the juice from limes and lemons, can actually cause hyperpigmentation if the juice applied to your skin gets exposed to the sun,” she says. (This is thanks to a skin reaction called phytophotodermatitis.)
8. Eat a Balanced Diet
Downie says skin health starts from the inside out, so a nutritious diet is essential.
“Nutrient-dense foods contribute to healthy skin, just as processed foods lead to a nonvibrant, dull, or unhealthy skin appearance,” she says. She continues that foods rich in vitamins A, B, C, and E, antioxidants, and minerals such as zinc, calcium, and magnesium are particularly beneficial for skin repair and cell renewal.
Supplements containing extracts from green tea, licorice, or mulberry may also help with skin brightening and inflammation, Downie says. Additionally, some evidence suggests supplements containing polypodium leucotomos, an extract derived from a fern native to Central and South America, may help protect the skin from sun damage, Vashi says.
In contrast, Vashi warns that while there are no foods that cause hyperpigmentation, some may intensify it. She says that foods with a high glycemic index — such as candy, sugary drinks, and white bread — tend to rapidly raise blood sugar levels, stimulating melanocytes — the cells that produce melanin.
Also, excessive alcohol can dehydrate the skin and dilate blood vessels. “This leads to a more flushed appearance that can make hyperpigmentation look more pronounced,” she says.
The Takeaway
Hyperpigmentation is a common condition, but if you’re self-conscious about your skin, plenty of solutions are available. Although dark spots are usually harmless, see a doctor, such as a dermatologist, if your skin is red, itchy, painful, or hot to the touch, or if you notice pus leaking.
Jacquelyn Dosal, MD, is a board-certified dermatologist at Skin Associates of South Florida in Coral Gables. She practices general, medical, cosmetic, and surgical dermatology.
Dr. Dosal provides compassionate care to all her patients, listening to their concerns and creating a treatment plan with each patient's priorities and real life in mind.
She is a member of the voluntary faculty at the University of Miami.
Jennifer Benjamin is a journalist who often writes about parenting, relationships, health and fitness. Her work has appeared in Real Simple, Parents Magazine, Redbook, Yahoo Parenting, The Bump, Women’s Health Magazine and Health Magazine. Prior to her freelance career, she was a senior editor at Cosmopolitan Magazine.
Kristeen Cherney, PhD, is a freelance writer, essayist, author, and poet with more than 15 years of health writing experience for digital platforms such as Healthline, The Mighty, and LiveStrong. She’s covered nutrition, women’s and children’s wellness issues, as well as specialized topics ranging from diabetes and thyroid disease to anxiety, depression, asthma, allergies, and skin conditions.
With a doctorate in English (rhetoric and composition), Dr. Cherney focuses her academic scholarship on the intersection between disability and literacy. She also holds a Master of Arts in English and a Bachelor of Arts in communication.
Cherney has contributed to the books The Wiley Handbook on Violence in Education: Forms, Factors, and Preventions, Composing in Four Acts: Readings for Writers, and Georgia State University's Guide to First-Year Writing, as well as to scholarly journals like Praxis, the Journal of Teaching Writing, and the Journal of Dracula Studies.
Cherney enjoys running, meditating, hiking, and paddleboarding.
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Sobhan M. A Comparative Study of 20% Azelaic Acid Cream Versus 5% Tranexamic Acid Solution for the Treatment of Postinflammatory Hyperpigmentation in Patients with Acne Vulgaris: A Single-Blinded Randomized Clinical Trial. Journal of Research in Medical Sciences. April 1, 2023.
FDA Works to Protect Consumers from Potentially Harmful OTC Skin Lightening Products. U.S. Food and Drug Administration. May 10, 2022.
