How to prevent hyperpigmentation

What are you trying to prevent?

Hyperpigmentation means areas of skin become darker, often because of extra melanin, the pigment that gives skin its colour. Marks left after acne, eczema or an injury are called postinflammatory hyperpigmentation. Anyone can develop these marks, but they are more common, more intense and longer lasting in darker skin. Sun spots and melasma have different triggers, so prevention starts with identifying the cause rather than buying every bottle with "brightening" on it.134

Build sun protection into your day

1. 1Choose a broad spectrum, water resistant sunscreen with SPF 30 or higher. For exposed areas with postinflammatory pigmentation, SPF 50 or higher is a useful choice. Broad spectrum means protection against both UVA and UVB rays.
2. 2Choose a tinted sunscreen containing iron oxide, especially for melasma or dark spots in darker skin. Iron oxide adds protection against visible light. Look for it in the inactive ingredient list and choose a tint that blends with your skin tone.
3. 3Apply sunscreen every day, including cloudy days, to skin that clothing does not cover. Apply it 15 minutes before going outside and reapply at least every two hours outdoors, and after swimming or sweating.
4. 4Add shade, protective clothing and a wide brimmed hat. Avoid outdoor exposure when the sun is strongest, between 10 a.m. and 2 p.m. Avoid tanning beds and sunlamps if you have melasma.

Stop the trigger, not just the mark

Treat active acne or eczema rather than focusing only on the pigment left behind. Do not pick pimples or injure healing skin again. Use gentle cleansing and a moisturizer that does not clog pores, especially while treating acne. An acne treatment that keeps causing irritation can create more pigmentation, which is an unusually poor performance review for a skincare product.125

Choose gentle, fragrance free products, particularly if your skin is sensitive. Stop a skincare product if it burns or stings. Retinoids can treat both acne and existing marks, but their irritation can also trigger further pigmentation. If a prescribed acne treatment irritates your skin, ask the prescriber about adjusting its use and protecting your skin barrier.245

What if hormones or medication are involved?

Pregnancy and medications such as oral contraceptives can trigger melasma. Daily sun and visible light protection remain useful, but melasma can persist for years and need a dermatologist's treatment plan. If you suspect a medicine is causing dark patches, ask the prescribing doctor whether it could be responsible and whether an alternative is appropriate. Do not stop prescribed medication yourself.24

Plan before a peel or laser

Peels, lasers and intense pulsed light can improve some surface pigmentation, but skin injury from these procedures can also produce more pigment. A pigment treatment can leave pigment behind, an awkward detail for the brochure. Before laser treatment, discuss prevention with the treating clinician, particularly if you have darker skin. Sun exposure, treatment intensity and inflammation affect risk. Sunscreen alone is not a reliable way to prevent pigmentation caused by laser treatment; additional clinician directed measures can help, although the best approach remains uncertain.367

When should you expect fading or get help?

Once the trigger stops, a mark a few shades darker than your skin usually fades within 6 to 12 months; deeper pigment can take years. Prevention does not erase existing marks overnight. See a dermatologist if spots persist despite treatment or their cause is unclear, because not every dark patch is ordinary hyperpigmentation. Seek medical care if the area is red, hot, itchy, painful or leaking blood or pus.126