Hyperpigmentation in Darker Skin Tones: Pictures, Causes, and Treatment

Hyperpigmentation happens when areas of skin become darker than the skin surrounding them. It’s also one of the most common reasons why some Black people and those with darker skin tones see a dermatologist. While not physically harmful, hyperpigmentation can be distressing. To make it better, you need to address the cause, protect the skin, and even out the pigment.

How hyperpigmentation looks in Black people and those with brown skin tones

Here are some pictures of dark patches and hyperpigmentation in Black people and those with darker skin tones. 

Close-up of dark patches on the face.

Close-up of leg with hyperpigmentation on Black skin.

EXPERT PICKS: WHAT TO READ NEXT

• Need to get rid of acne scars? These treatment options can help you clear your skin and relieve discoloration.

• Eczema and hyperpigmentation: When left untreated, eczema can lead to hyperpigmentation in those who are Black or have darker skin tones. Here are some eczema treatments you can try.

• Skin care tips for melasma: Learn all about what causes melasma and how you can treat it.

What causes hyperpigmentation?

Dark marks on your skin can happen for a variety of reasons. But the treatments can differ. That’s why the most important thing is to identify the root cause. Let’s take a closer look at some common reasons for skin darkening.

Skin injury and post-inflammatory hyperpigmentation

Injury to the skin is a common reason for hyperpigmentation. As the skin tries to heal itself, inflammation can occur. Inflammatory cells arrive to clear damaged skin tissue and prepare for rebuilding. This inflammation causes hyperpigmentation in two ways:

• It turns up activity of melanocytes, the cells that make the pigment melanin.

• It disrupts skin cells, making them leak melanin. 

Any type of injury to the skin can cause hyperpigmentation. But this response is often triggered by an injury to the skin, like a: 

• Wound or cut

• Burn

• Rash

• Acne breakout

Melasma 

Melasma is brown or gray hyperpigmentation that usually happens on the face. It’s common to see melasma in places like the:

• Cheek

• Chin

• Bridge of the nose

• Forehead

• Upper lip

Experts don’t know exactly why it happens, but melasma has some key differences from other types of hyperpigmentation. For starters, melasma is related to sun exposure and not to skin trauma (like post-inflammatory hyperpigmentation). 

Hormones also play a role in melasma, which is why it’s much more common in women and those who are pregnant or taking birth control pills. There are also other factors that can make you more likely to develop melasma, such as:

• If you have medium or dark skin tones

• If you’re between 20 and 40 years old

• If you have a family history of melasma 

Medications

In about 10% to 20% of cases, medications are the cause of hyperpigmentation. Some common medications known to cause hyperpigmentation include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Tetracycline antibiotics, like minocycline (Minocin)

• Phenytoin (Dilantin, Phenytek)

• Anti-malaria medicines like chloroquine and hydroxychloroquine (Plaquenil)

• Amiodarone (Pacerone)

• Blood pressure medicines like diltiazem (Cardizem), hydrochlorothiazide, and amlodipine (Norvasc)

• Psychotropic medicines like chlorpromazine and tricyclic antidepressants

Medical conditions

Hyperpigmentation in the skin can sometimes be a sign of a medical problem. This includes conditions like:

• Acanthosis nigricans: In this condition, you can get dark, velvety patches on the back of the neck or in the armpits. It can be a sign of prediabetes or even cancer.

• Hemochromatosis: This condition causes the body to absorb too much iron. The first sign is often bronzing or darkening of the skin, especially in sun-exposed areas. 

• Addison’s disease: People with this condition don’t make enough of the stress hormone cortisol. This can cause the skin to darken in sun-exposed areas, over joints, on scars, in nails, and in the mouth. The color change is often the first sign of the condition. 

• Vitamin deficiencies: Low levels of vitamins like B12 or folate can also cause hyperpigmentation.

• Thyroid disorders: Conditions like hypothyroidism have been associated with an increased risk of melasma.

Why is hyperpigmentation more common in people with darker skin tones?

Hyperpigmentation is more common in people with darker skin tones. This is because darker skin makes pigment more easily than lighter skin. Melanin is also more abundant in response to skin traumas like sun exposure, skin injury, and inflammation. Other skin cells, called keratinocytes, hold the melanin that gives the skin its tone. This pigment is then released below the surface of the skin to cause hyperpigmentation.

Hyperpigmentation treatment options for Black and brown skin tones

If you have hyperpigmentation, the first step is to find out why. The only way to get lasting results from treating your hyperpigmentation is to identify and address the root cause. Getting to the cause of your hyperpigmentation may take some investigative work. But here are some questions to help get you started:

• Do you have a rash (like acne or eczema) that’s not being treated? 

• Are you pregnant?

• Are you using any pigmentation-causing medications?

• Do you wear sunscreen every day?

Once you’ve addressed the root cause, there are ways to fade the dark spots and even out skin tone. This may include sunscreen, prescription and over-the-counter (OTC) medications, and procedures. Here’s a closer look at hyperpigmentation treatments and how they work. 

Sunscreen 

One of the most important treatments (and prevention strategies) for any type of hyperpigmentation is sun protection. The best way to do this is to use a tinted broad-spectrum sunscreen every day. In addition to blocking ultraviolet (UV) rays, the iron oxides in tinted sunscreens block the blue light emitted by screens and devices that can also darken the skin. The different tints can also help make mineral sunscreens blend easier on darker skin tones.

Pigment suppressors

Hydroquinone

Hydroquinone works by blocking the enzyme that makes pigment. It also has the potential to damage pigment-producing cells directly. The typical prescription strength is hydroquinone 4%. Higher strengths are available at compounding pharmacies. Tri-Luma is a combination product that contains hydroquinone 4% along with a light steroid and tretinoin. 

Arbutin

Arbutin is a milder form of hydroquinone that’s plant-derived. It blocks the pigment-making enzyme without damaging cells. Arbutin-based products can be found OTC.

L-cysteamine

L-cysteamine is a topical antioxidant that effectively evens hyperpigmentation. You can get it from some doctors’ offices or online by prescription. 

Tranexamic acid

Tranexamic acid can be taken as a pill or applied as a topical to improve melasma. It’s an option for people who don’t see improvement with other forms of therapy. The pill version has been called a “game changer” by a leading U.S. dermatology journal. However, there’s a higher risk of blood clots in people who take tranexamic acid. Your dermatologist can help you decide if it’s a good treatment option for you. 

Exfoliating acids 

Alpha hydroxy acids

Alpha hydroxy acids work to treat hyperpigmentation by increasing skin turnover and slowing pigment production. Examples of this type of medication include: 

• Kojic acid

• Glycolic acid

• Lactic acid (Lactinol)

• Azelaic acid (Finacea)

• Mandelic acid

These are all available OTC, with the exception of azelaic acid 15%, which is by prescription.

Retinoids

Retinoids are derived from vitamin A. They work by increasing how quickly new skin cells are created and help to spread pigment over a wider area. Retinoids are available by prescription. The lighter version, called retinol, is available OTC.

Vitamin C

Vitamin C is a natural antioxidant available OTC. It helps lighten skin by blocking melanin production. It usually comes in concentrations between 5% and 10%, and it may be mixed with other lightening ingredients like hydroquinone. 

Dark spot serums

Many OTC dark spot treatments combine different lightening creams like kojic acid, hydroquinone, and vitamin C into one serum. These combination treatments may be more effective, since serum penetrates the skin better than other formulations. But some ingredients used together, like hydroquinone and retinoids, can also be more irritating when combined. 

Procedures

Cosmetic dermatology procedures can help even the skin tone faster. These include:

• Microdermabrasion: This process uses a rough crystal to gently exfoliate the outer, dead skin cell layer. This helps with penetration of topical treatments that work to improve skin tone. 

• Chemical peels: Chemicals are applied to the skin to exfoliate the outer layers and reveal the more even skin from below. 

• Lasers: Lasers are used to target pigment and reduce hyperpigmentation. 

Finding a dermatologist to treat darker skin tones

If you’re looking for a dermatologist who has experience in treating people with darker skin tones, you have a few options. The following organizations have a database where you can search for dermatologists with expertise in treating darker skin tones:

• Skin of Color Society

• Black Derm Directory

• Blackdoctor.org

• American Academy of Dermatology

How long does hyperpigmentation take to go away?

It usually takes months to years for hyperpigmentation to fade. In rare cases, it can be permanent. The most important thing is to identify the root cause and address it early. Once the hyperpigmentation is there, combining adequate sunscreen, medications, and procedures will work fastest to treat it. 

Can I prevent hyperpigmentation?

If you’re prone to hyperpigmentation, there’s no way to completely prevent it. But you can take measures to minimize it by following these tips:

• Address any inflammation in the skin right away. If you have a rash or breakouts, getting treatment early can help lessen the aftermath of hyperpigmentation. 

• Avoid scratching, rubbing, or skin friction. This can add to inflammation and darken the skin over time. 

• Be gentle with your skin and avoid irritating products and aggressive scrubbing. 

• Protect your skin from skin-darkening UV rays and blue light by wearing a broad spectrum sunscreen with iron oxides every day.

Why trust our experts?

Written by:

Maryann Mikhail, MD

Maryann Mikhail, MD, is a board-certified dermatologist and medical writer based in South Florida. She is the founder of Waverly DermSpa in Fort Lauderdale and holds a voluntary faculty position at the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami MIller School of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Our editorial standards

Meet our experts

Images used with permission from VisualDx (www.visualdx.com).