Does hyperpigmentation itch?

Why does an itchy area turn dark?

Inflammation or injury can leave extra pigment behind. This is called postinflammatory hyperpigmentation: discoloration left after skin inflammation. It can follow acne, dermatitis, which means inflamed skin, or an infection. The remaining patches sit where the original problem occurred after it healed. Anyone can develop them, but they are more common, more intense and longer lasting in darker skin tones.2

Scratching can produce pink, scaly patches that later turn brown. Friction can also cause discoloration under the arms or on the inner thighs, even without sun exposure. If rubbing continues, the area can remain pink or brown. An itchy dark area therefore needs attention to the ongoing irritation, not just the color it leaves behind.3

Is it a dark mark, a scar or something else?

A flat pigmented spot left after acne is usually not a scar. These marks usually fade over time. A raised acne scar is different: scars can itch or hurt, especially raised ones. Tell your clinician whether the area is flat, raised or becoming thicker rather than calling every leftover mark an acne scar.4

Dry or irritated skin, eczema and fungal infections are possible causes of itching. Some specific pigment disorders also cause itch. Urticaria pigmentosa produces brownish patches with severe itching, and rubbing can make them form hives. Rarely, Dowling Degos disease, which causes a lacy pattern of dark pigmentation in skin folds, causes itching or burning triggered by sunlight, sweating or friction. Color alone cannot tell you which condition is present.567

What can you do for the itch?

• Pat or tap the area instead of scratching, and keep nails short, clean and smooth.
• Hold a cool, damp towel against the skin to ease itching.
• Use an unperfumed moisturizer regularly, and avoid perfumed soaps, deodorants and moisturizers.
• Take cool or lukewarm showers or baths, and avoid long soaking.
• Wear loose cotton or silk clothing rather than tight clothes that rub.

A pharmacist can help choose itch relief and advise whether you need a doctor. Explain where the itching occurs and mention any rash or other symptoms. Antihistamines help some causes of itching, but the right treatment depends on the cause.5

How do you help the dark mark fade?

Preventing further irritation comes first. After irritation stops, skin usually returns to its normal color, but fading can take many months. Lightening creams can help small areas and should be used only on limited areas as directed by a physician. Chemical peels and laser treatments can aggravate postinflammatory pigmentation by injuring the skin.23

Sun protection belongs in pigment care, even if its job title lacks the glamour of "brightening". Sunlight can darken postinflammatory marks; use broad spectrum SPF 50 or higher daily on exposed areas. Broad spectrum means protection against both UVA and UVB rays.12

Cosmetic camouflage is an option for covering pigmentation, which gives makeup a refreshingly straightforward job description.2

When should you see a doctor?

Arrange a medical assessment for a dark patch that is itchy, red, hot, painful or leaking blood, pus or other fluid. Also seek care if itching is severe, widespread, disrupts daily life, keeps returning or does not improve with self care. During pregnancy, contact your doctor or midwife about itching because it can sometimes signal a liver condition rather than a skin problem.15