Ask Curology: Post-inflammatory hyperpigmentation

Deep-set or brand new, here’s what to do for fading dark marks.

Welcome to Ask Curology, penned by one of our in-house medical providers in response to your questions about all things skincare. This week: hyperpigmentation. Dark spots and patches are one of the most common skin concerns — and they can last long after your breakouts clear.

Dear Curology,

Over the years, my skin has seen some stuff. For a long time, I thought my skin was scarred, but then I learned about hyperpigmentation. I’d really like to fade some of these marks on my skin left behind by too much acne and sun-and-fun, if you know what I mean.

How do you treat different types of unwanted spots (including deep hyperpigmentation)?

Signed,
See Spot Fade

Dear S.S.F.,

I hear you, and you’re definitely not alone. Our skin is with us every day; it protects our body so all the things inside of us can keep on ticking. Those little patches of pigment are a natural consequence of existing in a body!

If they bug you, there are steps you can take to work toward a complexion with the right glow for you. But first, it’s important to understand some of the different types of hyperpigmentation that can happen in skin.

Types of hyperpigmentation

1. Post-inflammatory hyperpigmentation (PIH). Sometimes — incorrectly — referred to as “acne scars,” these are the marks left behind after an inflammatory disorder (like acne) or an injury (like a burn) has cleared.¹

2. Sunspots. These dark spots on the skin, including freckles and age spots, are usually the result of prolonged sun exposure.²

3. Melasma. Typically characterized by brown or gray patches on the face, melasma has a range of causes, from hormones to environmental triggers.³

Treating hyperpigmentation

Sun protection: No matter which kind of hyperpigmentation you have, it’s important to practice sun protection! UV damage can make every type of hyperpigmentation worse.⁴ Fortifying your skin = more chance your treatment will help you achieve your skin goals.

Don’t pick: I know it’s tempting, but try not to mess with your face too much! You could accidentally injure your skin, making it take longer to heal and possibly making your hyperpigmentation worse.

Skincare: You’ll want a skincare routine that incorporates products with ingredients known to help treat spots of unwanted color in the skin. While you can find these ingredients over-the-counter, you may want prescription-strength products if your hyperpigmentation is especially stubborn — we’ll circle back to this later!

• Tranexamic acid slows down pigment build-up and reduces inflammation to help lighten hyperpigmentation.⁵
• Vitamin C stimulates collagen production, helps reverse hyperpigmentation, and neutralizes skin-damaging free radicals.⁶
• Niacinamide helps reduce fine lines and wrinkles and fade dark spots.⁷

I’d recommend learning more about each ingredient to figure out which ones may be right for your specific skin before making decisions about skincare products. You can also consult with a Curology provider (like me!) to receive a custom, prescription formula for your unique skin concerns. If you haven’t tried it yet, your first month is free! Just pay $4.95 to cover shipping + handling.

I hope this advice helps! As always, feel free to sound off in the comments with any additional questions :)

All my best,
Nicole Hangsterfer, PA-C

We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions

P.S.

We did our homework so you don’t have to.

1. Chere Lucas. Post-Inflammatory Hyperpigmentation (PIH). Skin of Color Society. (2021, n.d.).
2. Amanda Oakley. Brown spots and freckles. DermNet NZ. (October 2018).
3. American Academy of Dermatology. Melasma: Overview. (2021, n.d.).
4. Mayo Clinic. Sun Damage. (2018, July 13).
5. Seemal Desai, et. al. Effect of a Tranexamic Acid, Kojic Acid, and Niacinamide Containing Serum on Facial Dyschromia: A Clinical Evaluation. Journal of Drugs in Dermatology. (May 2019).
6. Juliet M. Pullar, et. al. The Roles of Vitamin C in Skin Health. Nutrients. (2017, August 12).
7. Jamie Zussman, et. al. Vitamins and photoaging: Do scientific data support their use? Journal of the American Academy of Dermatology. (2010, September 1).
8. Jasmine C. Hollinger, et. al. Are Natural Ingredients Effective in the Management of Hyperpigmentation? A Systematic Review. The Journal of Clinical and Aesthetic Dermatology. (February 2018).