Hyperpigmentation
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Summary

  • Hyperpigmentation is a skin condition characterized by uneven patches of dark skin.
  • It might be caused by excess melanin, exposure to sun, or hormonal changes.
  • Treatments include off-label topical creams containing acids that can help lighten darkened skin patches.
Reviewed on December 02, 2025. by
Dr. Joseph Palumbo
Senior Medical Adviser
NPI (No. 1043478878)
Next review due on December 02, 2028
Dr. Joseph Palumbo

Last updated on February 16, 2026

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Hyperpigmentation

What is hyperpigmentation?

Hyperpigmentation is a term used to describe skin that has become darker and more uneven than before. It’s usually harmless, and the symptoms tend to involve changes to patches of your skin tone (pigment). The size of these affected areas can vary (they can be very small or cover large parts of your body). And they’re usually painless, but it could be the result of another health condition that needs addressing.

There are different types of hyperpigmentation. Some of the most common types are:

  • Sunspots – changes to your skin appearance as a result of too much sun. Tonal changes can affect any areas that have been overexposed to UV rays.
  • Melasma (chloasma) – usually caused by hormonal changes, such as pregnancy. Spots can appear anywhere on the body but typically show up on the face and stomach.
  • Post-inflammatory hyperpigmentation – areas that are affected by inflammation or injured skin. Acne is often responsible for these symptoms.

Who gets hyperpigmentation?

Hyperpigmentation can affect anyone.[1] Because there are lots of causes and factors involved in changes to your skin pigmentation, a doctor can advise you about possible causes and treatment options.

The location of patches of darkened skin on your body can often indicate the cause behind them. Preexisting health conditions can sometimes lead to changes to your skin, as can medications you take regularly. Providing as much information as possible during your initial consultation can help narrow down the reasons your symptoms have developed.

How common is hyperpigmentation?

It’s hard to say exactly how common hyperpigmentation is. There are lots of factors involved in developing changes to your skin pigmentation, including overexposure to UV rays, hormonal changes, and medications that can cause symptoms.

There are a wide variety of skin tones around the world. Some studies have shown people with certain skin tones are more susceptible to developing pigmentation disorders than others,[2] but hyperpigmentation can occur on any skin type.

Treated trusted source:

  1. Markiewicz, Ewa, et al. (2022). Post-Inflammatory Hyperpigmentation in Dark Skin: Molecular Mechanism and Skincare Implications. Clinical, Cosmetic and Investigational Dermatology, 15, pp. 2555–2565.
  2. Nayak, C.S., et al. (2016). Skin Hyperpigmentation in Indian Population: Insights and Best Practice.” Indian Journal of Dermatology, 61(5), p. 487.
Dr. Joseph Palumbo 29191
This page was medically reviewed by Dr. Joseph Palumbo on December 02, 2025. Next review due on December 02, 2028.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Hyperpigmentation

What causes hyperpigmentation?

There can be several causes of hyperpigmentation. One is excess melanin, a substance naturally produced by your body to give skin its pigmentation (color). Pigment cells called melanocytes, located at the base of the epidermis (outer layer of skin), produce melanin. Dark-skinned people make more melanin than those with lighter skin, which explains why pigmentation disorders can affect people of color more frequently.[1]

Hormonal changes, such as those that occur in pregnant women, can also cause hyperpigmentation. Medications, such as drugs used during chemotherapy, skin and endocrine diseases (such as Addison’s disease) can also produce darkened, uneven spots to appear on different parts of your body.

Overexposure to UV rays from the sun, due to prolonged periods of time in it without the right protection, can also contribute to increased melanin production.

What are the symptoms of hyperpigmentation?

The main symptoms of hyperpigmentation are:

  • Patches of skin that appear darker, and can look brown or black
  • Discoloration of these patches after injury to the skin or inflammation
  • Areas of skin that become darker after exposure to UV rays (sunlight)
  • Raised patches that seem to be getting bigger

Patches can develop anywhere on the body, depending on the type of hyperpigmentation that’s affecting you. It can be generalized, and affect larger areas, or be more localized, appearing only on specific areas like your face, hands, or stomach.

Can hyperpigmentation lead to other problems?

Hyperpigmentation won’t necessarily lead to other conditions developing, though you might want to treat it if you feel like it is impacting your appearance or making you self-conscious.

Sun exposure is responsible for lots of cases of hyperpigmentation, as UV rays activate melanin production.[2] Too much exposure to the sun, however, has been linked to cancer. Excessive UV radiation can damage the DNA in your skin cells and make them grow out of control.[3] So before spending long amounts of time in the sun, it’s best to get fully informed of potential risks and take all the proper steps to stay protected.

Treated trusted source:

  1. Oakley, A. (2009). Pigmentation Disorders.
  2. Brenner, M., and Hearing, V.J. (2007). The Protective Role of Melanin against UV Damage in Human Skin. Photochemistry and Photobiology, 84(3), pp. 539–549.
  3. Cancer Research UK. (2019). How Does the Sun and UV Cause Cancer?
Dr. Joseph Palumbo 29191
This page was medically reviewed by Dr. Joseph Palumbo on December 02, 2025. Next review due on December 02, 2028.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Hyperpigmentation

What medications are there for hyperpigmentation?

There are several options available when it comes to managing hyperpigmentation, and there might be some trial and error before you find a medication that works best for you.

Some topical treatments can be prescribed off-label to lighten darkened spots and patches of skin. These include:

  • CeraVe SA Cream, which contains salicylic acid,
  • Azelaic acid cream (primarily used to treat acne),
  • Corticosteroids of varying strengths,
  • Tretinoin, which treats acne and sun-damaged skin, contains all-trans retinoic acid (A synthetic version of vitamin A.)

Using medications to treat hyperpigmentation can often be a process that involves time and patience before you start to notice changes. We recommend getting expert advice from a doctor before using over-the-counter products to manage your skin condition long-term.

Are hyperpigmentation treatments available over the counter?

There are lots of cosmetic creams available over the counter that contain ingredients designed to improve pigmentation-related skin conditions. They are sometimes sold as serums, toners, chemical peel creams, and moisturizers. Often, they contain ingredients such as vitamin C, alpha-hydroxy acid (AHA) and niacinamide. Some treatments, like prescription-only off-label treatments for hyperpigmentation, contain azelaic acid.

While over-the-counter products might offer some benefits to your skin, there is no guarantee they will work in the same way as prescribed medications. By using prescription-only treatment, you can ensure your treatment has been approved by a licensed healthcare professional. Speaking to a doctor also means you can get more specific help, by answering questions and providing more detail about your condition.

Does hyperpigmentation always need treatment?

Managing hyperpigmentation often comes down to how you’re personally affected by it. Because it won’t make you seriously ill or cause pain, the decision to get treatment to improve your skin is often cosmetic. So while skipping treatment for it won’t result in the darkened spots or patches getting worse, you might feel the need to improve your hyperpigmentation so you’re happier with your appearance.

Trying to manage your stress levels can also be a great help when it comes to dealing with IBS symptoms. In fact, managing stress can be great for your overall physical and mental wellbeing.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Hyperpigmentation

Hyperpigmentation: FAQ

Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

Can you get side effects from hyperpigmentation treatment?

Answer:
There are a lot of options available when it comes to managing hyperpigmentation. Most medications can cause side effects, but that’s not a guarantee you’ll get any. They often affect people differently and sometimes settle down once you adjust to a new medication.

Creams that contain azelaic acid can sometimes cause mild burning or skin irritation, but are often well tolerated. If side effects are bothering you to the point you want to stop using your hyperpigmentation medicine, speak to a doctor about trying an alternative.

If you ever have a reaction to a treatment that seems unexpected, and possibly allergic, you should stop taking it and immediately seek professional help.

Does hyperpigmentation treatment always work?

Answer:
Hyperpigmentation treatments have been shown to be effective in studies. In one trial of darker-skinned patients who used azelaic acid 20% cream to treat facial hyperpigmentation, the results were positive. After a period of 24 weeks, patients reported that the cream was more effective than previous treatments. It was also well tolerated and helped to improve pigmentation intensity.[1]

Improving dark spots and uneven patches of skin can sometimes be a long-term process that can often take months. There are effective medications available that have been proven to help manage hyperpigmentation, but sometimes the improvements you want to see can be a personal issue. You can talk to a doctor about what you expect from a treatment, and get advice about how long you’ll need to use any medication for.

How is hyperpigmentation diagnosed?

Answer:
A doctor will usually be able to diagnose your hyperpigmentation by examining your skin or looking at the photographs you’ve provided and asking about your symptoms.

You might also be asked to provide some test results. A skin biopsy can help determine what’s causing your hyperpigmentation, but it can also rule out anything more serious and highlight underlying conditions that might be behind it.

Will hyperpigmentation clear up without treatment?

Answer:
It’s hard to say whether your hyperpigmentation can clear up without treatment. Often it depends on the initial cause of it. Skin that’s changed color due to injury or inflammation may fade over time, but it can take a long time for the skin to fully heal. The discoloration can lessen, but there’s no guarantee it will heal completely.

To prevent sun spots or changes to your skin as a result of sunburn, you should always make sure you’re protected. This can be done by covering up if you’re light-skinned and prone to burning or making sure you use sunscreen with a high SPF (sun protection factor).

Melasma-related changes to your pigmentation might improve by using skin-lightening creams, such as hydroquinone creams. Dark spots or patches brought on by hormonal changes might fade over time once your hormones have settled down (such as after pregnancy or once you’re off medications that contain estrogen), but creams can help your skin return to its natural tone.

Treated trusted source:

  1. Lowe, N.J., et al. (1998). Azelaic Acid 20% Cream in the Treatment of Facial Hyperpigmentation in Darker-Skinned Patients. Clinical Therapeutics, 20(5), pp. 945–959.

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