Hyperpigmentation means extra pigment, not one specific diagnosis. Melanin, the substance that gives skin its colour, builds up in an area and makes it darker, without consulting the names on a concealer chart. The pattern matters as much as the colour: marks where pimples healed suggest a different cause from broad patches appearing on both cheeks.123
Which pattern are you seeing?
| Pattern | What it looks like | What helps distinguish it |
|---|---|---|
| Pigmentation after inflammation | Light brown to black marks, sometimes with a gray or purplish brown colour. | The marks occupy the sites of healed pimples, irritation or injuries. |
| Melasma | Flat, blotchy brown or bluish gray patches, sometimes resembling freckles. | Usually appears on both sides of the face, especially the cheeks, forehead, nose, chin or above the upper lip. |
| Sun spots | Darker spots also called age spots or liver spots. | Sun damage is the trigger rather than a recently healed pimple or wound. |
Melasma patches often have irregular edges and can join into larger areas. They can be more obvious in one area than another, including along the jawline. Melasma generally looks slightly darker than your natural skin colour, but shades can vary within the same face. Sun exposure makes it more noticeable.3
Does it look different on darker skin?
Hyperpigmentation can affect any skin tone. Pigmentation after inflammation is more common in darker skin, where the colour tends to be more intense and last longer. Deeper pigment can look slate blue or gray rather than brown, which makes 'dark spots' sound like a name chosen to save space on the packaging. In melasma, pigment closer to the surface tends to be dark brown with clearer borders; deeper pigment can be light brown or bluish with less distinct edges. Mixed melasma combines brown and bluish shades.2456
Should the patches feel different?
Hyperpigmentation itself does not cause pain or itching. Melasma patches are flat, and the skin does not feel different. Pigmentation after inflammation remains where the original problem has healed, so a leftover dark mark is not necessarily an active pimple. See a healthcare professional if the area is hot, painful, itchy, bleeding or leaking fluid, or if redness accompanies other symptoms.13
Can you identify it by looking?
Appearance gives clues, but different causes of pigmentation can look alike. A bathroom mirror can show the pattern, but it cannot confirm the diagnosis, even if the lighting has strong opinions. A dermatologist examines the skin and asks when the colour appeared, what happened beforehand and which medicines you take. A special light called a Wood lamp can help assess pigment. Occasionally, a small skin sample is needed. Melasma is not cancerous, but some skin cancers can resemble it, making confirmation worthwhile.156
What should you do next?
- Protect your face every day. Use tinted sunscreen containing iron oxide with broad spectrum protection and SPF 30 or higher. Apply before going outdoors, reapply every two hours outdoors and after swimming or sweating, and wear a wide brimmed hat.
- Address the trigger. Ongoing acne or irritation can keep producing new marks. Stop using a skincare product that burns or stings, and avoid picking pimples.
- Review medicines with the prescriber if pigmentation began after a medication change. Do not stop prescribed medicine yourself.
- Get help choosing treatment if the cause is unclear or the marks are not improving. Peels and lasers can worsen pigmentation, especially in richly pigmented skin.
How long will the colour last?
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. Melasma can persist and return with sun exposure. Pregnancy related melasma often fades after pregnancy.2456
Where this answer comes from
- 1Hyperpigmentation: What it is, Causes, & Treatmentmy.clevelandclinic.org
- 2How to fade dark spots in darker skin tonesaad.org
- 3Melasma: Signs and symptomsaad.org
- 4Postinflammatory hyperpigmentationdermnetnz.org
- 5Melasma: Treatment, Causes & Preventionmy.clevelandclinic.org
- 6Melasma (facial pigmentation)dermnetnz.org
- 7Dermatology: how to manage facial hyperpigmentation in skin of colourpmc.ncbi.nlm.nih.gov
