Many patients may begin to notice the presence of tan to brown to gray patches on their skin, which are often worsened with sun exposure. This condition is called hyperpigmentation and affects both men and women. It can occur in all skin colors, but is typically more common in patients with darker skin tones.

True Skin Experts Instagram Live: "Hyperpigmentation – Dark Patches on the Skin Causes and Treatments" With Drs. Omer Ibrahim and Kemunto Mokaya

Why treat hyperpigmentation?

Physical, emotional and social reasons for treating hyperpigmentation include:

  • Improved appearance.
  • Enhanced self-esteem.
  • Promotion of better skin health.

Do's and Don'ts

  • Avoid excessive sun exposure to the areas of increased pigmentation.
  • Wear a hat, sunglasses, sun-protective clothing and seek shade when outside.
  • Wear sunscreen daily with an SPF greater than 45 and remember to reapply. 
  • Forget your sunscreen.
  • Aggressively scrub at your skin.
  • Use home remedies such as lemon juice or abrasive scrubs as these can worsen hyperpigmentation.



What you should know

Hyperpigmentation occurs when the pigment producing cells of the skin, called melanocytes, begin to produce too much pigment. This leads to the development of light to dark brown to grey spots or patches on the skin surface. Hyperpigmentation can appear anywhere on the skin. Common causes include inflammation and/or trauma on the skin, medications, contact with certain cosmetic or plants and melasma. Pigmentation that follows trauma to the skin, such as a cut, burn, abrasion or surgical incision, or inflammation in the skin, such as after a rash, acne or severe skin dryness, is known as post-inflammatory hyperpigmentation and is located in a pattern similar to the original event. Medications that can cause hyperpigmentation may cause more widespread hyperpigmentation. Your ASDS physician will help to diagnosis your underlying cause of hyperpigmentation and customize your treatment plan to fit your individual needs.

Most cases of hyperpigmentation can be improved over time after the underlying cause has been removed and managed. As sun exposure worsens hyperpigmentation it is important to protect the skin with sunscreen on a daily basis. Treatment often begins with a skin care regimen composed of a daily sunscreen, moisturizers, and skin care brighteners. Some of the more common skin brighteners include hydroquinone, vitamin C, azelaic acid, tretinoin and kojic acid.

For patients who don’t see improvement of their hyperpigmentation with a skin care regimen alone, procedures may be added. These include superficial chemical peelsmicrodermabrasion, intense pulsed light and/or lasers. Lasers should be used with care in patients with darker skin tones by an experienced laser surgeon.

General questions to ask before the procedure

  1. Is a doctor on site?
  2. Is the doctor board-certified in dermatology or in another specialty with equivalent training and experience in treating hyperpigmentation?
  3. Was my medical history taken?
  4. Was I given an initial evaluation to determine if the technique or procedure is appropriate for my skin type?
  5. Did the doctor show me before-and-after photos?

Questions to ask the dermatological surgeon 

  1. Which hyperpigmentation procedure is the correct one for me? (What are the options?)
  2. What is the estimated cost of the procedure?
  3. How long is one appointment?
  4. How often will I need to receive treatment to improve and/or clear my hyperpigmentation?
  5. How far apart are the treatments?
  6. What are the common side effects or complications associated with the procedure?
  7. How can I prepare for the treatment/procedure?
  8. Does the treatment hurt?
  9. How long is the recovery time associated with my procedure?
  10. Do you have before-and-after patient images to help to prepare me for what to expect?
  11. Will someone walk me through the process before going in for treatment?
  12. What are the risks?
  13. What should I expect after the procedure is performed? (i.e., short-term and long-term effects; activity restrictions; expected recovery period)