Dark spots on the skin: Causes and how to treat them

Aging
Dark spots on the skin, or hyperpigmentation, occur when some areas of the skin produce more melanin than usual. Melanin gives the eyes, skin, and hair their color.

Dark spots on the skin are not a cause for concern and do not need treatment, though people may choose to remove them for cosmetic reasons. Depending on the cause, people may call some types of dark spots on the skin age spots or sunspots.

In this article, we look at what causes dark spots on the skin and how people can remove them using dermatological treatments and home remedies.

Symptoms

dark spots on a womans skin
Dark spots are common on the face, shoulders, and back of the hands.

Dark spots on the skin can range from light brown to dark brown. The color of dark spots may depend on the tone of a person’s skin. The spots are the same texture as the skin and are not painful.

Dark spots also vary in size and can develop on any part of the body but are most common in areas often exposed to the sun.

Dark spots are common in the following areas:

  • back of the hands
  • face
  • back
  • shoulders

In people with darker skin, a spot that is a few shades darker than the skin usually fades away within 6 to 12 months. Deeper coloration can take years to fade. Deep color changes often appear blue or gray, though a spot may also be a much darker brown than a person’s natural skin color.


Causes

There are several different causes of dark spots, as we describe here:

Sun damage

Also called sunspots, solar lentigines, or liver spots, people can develop dark spots on their skin after being exposed to the sun or tanning beds.

Areas of the body that receive the most sun exposure, such as the face, hands, or arms, are most likely to develop sun spots.

Hormonal changes

Melasma is a skin condition that leads to small patches of skin discoloration. The condition is more common in women, especially during pregnancy.

According to the American Academy of Dermatology, hormones may trigger melasma.

Medication side effects

Certain medications can increase skin pigmentation and lead to dark spots. The most common culprits are non-steroidal anti-inflammatory drugs (NSAIDs), tetracyclines, and psychotropic drugs.

Inflammation

Dark spots can develop after a bout of inflammation on the skin. Inflammation may occur for various reasons that include eczema, psoriasis, injury to the skin, and acne.

Wound healing

Dark spots may remain after an insect bite, burn, or cut heals. These may fade with time.

Irritation

Cosmetic skin or hair products can irritate the skin, causing dark patches to form.

Diabetes

Diabetes can cause areas of the skin to become darker.

Conditions associated with diabetes include acanthosis nigricans, which causes darkened, velvety skin, and shin spots or diabetic dermopathy, which people may confuse with age spots.

How to remove dark spots

laser treatment
Laser treatment can remove dark spots on the skin.

Dark spots on the skin do not require treatment, but some people may want to remove the spots for cosmetic reasons.

A dermatologist can offer creams or procedures to lighten dark spots, or in some cases, remove them. Procedures are more expensive than creams and are more likely to cause side effects, though they tend to work faster.

The best treatment option may depend on the cause, the size of the dark spot, and the area of the body.

A dermatologist may recommend one of the following treatments for dark spots on the skin:

Laser treatment

Different types of lasers are available. The most common laser to treat dark spots on the skin uses an intense pulse light laser. The light targets melanin and breaks up the dark spots.

Microdermabrasion

During microdermabrasion, a dermatologist uses a special device that has an abrasive surface to remove the outer layer of the skin. This treatment promotes new collagen growth, which may help reduce spots.

Chemical peels

A chemical peel involves applying a solution to the skin, which exfoliates the surface, leading to new skin growth. It may gradually fade dark spots on the skin.

Cryotherapy

Cryotherapy is a procedure that involves applying liquid nitrogen to the dark patches to freeze them, which injures the skin cells. The skin often heals lighter afterward.

Prescription skin-lightening cream

Prescription-lightening cream works by bleaching the skin. It typically works gradually and takes several months to decrease the appearance of dark spots.

Hydroquinone, which is the active ingredient in the creams, prevents the skin from producing melanin. Prescription products tend to have a strength of 3–4 percent.


Home remedies

In addition to dermatological procedures and prescription medications, people may find that some home remedies might fade dark spots on the skin, as the following sections discuss.

Over-the-counter creams

Over-the-counter skin creams to lighten skin are not as strong as prescription medications, but they may also work.

Creams and serums contain various ingredients, including retinol or alpha hydroxy acid, which may speed up the exfoliation of the skin and promote new skin growth.

When looking for a skin-lightening cream, always choose one recommended by a dermatologist, as some products can be harmful.

Natural remedies

Products with certain natural ingredients may help treat dark spots on the skin.

Researchers published a systematic review of clinical studies that used natural products to treat dark spots on the skin. They looked at several ingredients including niacinamide (a form of vitamin B-3), soy, licorice extracts, and mulberry.

Although studies were limited, the researchers said that these natural treatments showed promise in lightening hyperpigmentation.

Results of a small-scale 2017 study suggest that applying an aloe vera gel to the skin could help reduce melasma during pregnancy after 5 weeks.

Cosmetics

Although cosmetics do not lighten dark spots, they might cover them up. People can consider using a cream-based concealer to decrease the appearance of spots.

Home remedies to avoid

People may wish to keep in mind that many of the home remedies that webpages recommend may have side effects or no evidence of effectiveness. Examples include lemon and apple cider vinegar. No studies back the claims that these treatments work.

In some cases, unproven treatments may aggravate the skin. For example, the American Society for Dermatological Surgery do not recommend lemon juice or abrasive scrubs, as these methods could make dark spots worse.

Some skin lightening products can do more harm than good. Many contain ingredients that can harm the skin or overall health, such as mercury or steroids. Applying these can cause pimples, rashes, and fragile skin over time.


Diagnosis

A Wood's lamp skin exam being used on a womans face
A doctor or dermatologist may use a Wood’s lamp skin exam to diagnose dark spots on the skin.

A doctor or dermatologist can often work out the cause of dark spots on the skin by examining them and taking a medical history.

During a physical exam, the healthcare professional might perform a Wood’s lamp skin exam, where they view the spots through a special device that emits black light.

In some instances, specific characteristics of a spot might require more tests to make sure skin cancer is not causing the spot.

Risk factors

Anyone can develop dark spots on the skin. Certain risk factors appear to increase a person’s chances including:

  • sun exposure
  • pregnancy
  • skin conditions, such as acne, eczema, or psoriasis
  • trauma or injury to the skin
  • medications that increase pigmentation
  • liver disease
  • diabetes


Prevention

It may not always be possible to prevent dark spots on the skin from developing. For example, hormonal changes during pregnancy that may lead to melasma are not preventable.

There are, however, a few things people can do to decrease the chances of dark spots and prevent them from getting darker:

  • Use a sunscreen with an SPF of at least 30 every day, even when the sun is not bright.
  • Wear a wide-brimmed hat and sunglasses to protect the skin further.
  • Treat skin conditions, such as acne, which may lead to inflammation.
  • Avoid the sun between 10 a.m. and 4 p.m. when it tends to be strongest.

When to see a doctor

In most cases, dark spots on the skin are not harmful. But in some instances, it might be hard to tell the difference between a dark spot and other skin changes, such as melanoma, which is a type of skin cancer.

People who are unsure what a dark spot is or have not been able to get rid of it can see a doctor to find out more.

It is important to talk to a doctor if any dark spot on the skin:

  • appears suddenly
  • itches
  • tingles
  • bleeds
  • changes color or size

Learn about how to identify melanoma and other forms of skin cancer here.

Outlook

Dark spots on the skin, or hyperpigmentation, can have a range of causes. They are usually harmless and do not need treatment. If a person wants to get rid of dark spots, they can try a range of treatments, including working with a dermatologist for cosmetic procedures or using over-the-counter products.

The effectiveness of treatment may depend on the cause of the dark spots and their extent. Dark spots on the skin may not completely fade. It may take a while to see a difference, but treatment often lightens the spots.

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