Understanding Hyperpigmentation and Dark Spots (Dermatologist Guide)

By Heather D. Rogers, MD, FAAD, Double Board-Certified Dermatologist

Dark spots develop when pigment-producing cells (melanocytes) are overstimulated by sun exposure, hormones, inflammation, or genetics. Treatment requires daily sun protection, pigment-suppressing ingredients, and consistent cell turnover over time. If dark spots persist or worsen, the next step is a dermatologist-guided treatment plan to prevent recurrence and rule out medical causes.

What Is Hyperpigmentation?

Hyperpigmentation is the darkening of skin caused by excess melanin deposition in the epidermis or dermis. It occurs when pigment-producing cells (melanocytes) become overactive in response to sun exposure, hormones, inflammation, or injury.

Types of Hyperpigmentation 

Freckles

Genetically determined clusters of pigment that darken with sun exposure and fade in winter.

Sun Spots (Solar Lentigines)

Flat brown spots that appear on sun-exposed areas such as the face, chest, and hands.

Post-Inflammatory Hyperpigmentation (PIH)

Dark marks that appear after inflammation such as acne or procedures.

Melasma

A hormonally driven form of hyperpigmentation that tends to be chronic.

Seborrheic Keratoses

Benign raised growths that require in-office treatment if removal is desired.

What Causes Hyperpigmentation? (Risk Factors) 

Hyperpigmentation develops when melanocytes are overstimulated by genetics, sun exposure, hormones, and inflammatory triggers.

Genetics

Family history plays a major role in how readily your skin produces pigment and how long it lasts.

Sun Exposure

UV radiation stimulates melanocytes. Over time, pigment production becomes uneven, leading to permanent spots.

Hormones

Pregnancy, fertility treatments, and birth control pills can trigger melasma due to elevated estrogen and progesterone levels.

Inflammation

Any injury to the skin—including acne, scratching, procedures, or harsh skincare—can result in pigment deposition at that site.

How to Prevent Hyperpigmentation

To prevent hyperpigmentation, focus on daily sun protection, minimizing skin inflammation, and supporting consistent cell turnover.

• Wear a zinc-based sunscreen every morning: Choose one with at least 10% zinc oxide and apply it generously. This is the single most important step in preventing dark spots.
• Reapply sunscreen when outdoors: Especially during summer, travel, or outdoor activities.
• Use gentle cell-turnover ingredients: Retinoids, bakuchiol, glycolic acid, and gluconolactone help shed pigmented cells.
• Avoid over-treating your skin: Irritation triggers pigment production. Consistency beats intensity.
• Do not pick or scratch the skin:  Trauma equals pigment.
• Follow post-procedure instructions carefully: This prevents rebound hyperpigmentation.

Why Hyperpigmentation Gets Worse in Summer

Hyperpigmentation worsens in summer due to increased UV exposure, longer daylight hours, and heightened melanocyte activity. Even brief unprotected sun exposure can undo months of progress—especially in melasma and PIH. This is why summer is the most common time I see flares in dark spots.

How to Treat Dark Spots (Dermatologist Guide)

 

Dermatologist-Recommended Treatment Plan for Dark Spots

Treating hyperpigmentation requires patience and a combination of prevention, pigment suppression, and controlled cell turnover. The most successful plans combine daily sunscreen with targeted actives and, when needed, in-office treatments.

Best Ingredients for Hyperpigmentation

Dermatologists use a combination of pigment-suppressing, antioxidant, and cell-turnover ingredients to treat hyperpigmentation.

• Vitamin C: Helps lighten existing pigment and prevent new dark spots by reducing oxidative stress. A lipid-soluble form like THD ascorbate penetrates better and is less irritating.
• Retinoids: Increase cell turnover and prevent pigment from accumulating.
• Bakuchiol: A gentler alternative to retinoids that supports cell renewal without irritation.
• AHAs (glycolic acid) and PHAs (gluconolactone): Exfoliate pigmented cells and improve skin tone.
• Hydroquinone (prescription): The gold standard for stubborn pigmentation. Must be cycled and used under supervision.
  

In-Office Treatments

In-office treatments may be recommended when pigmentation is severe, persistent, or unresponsive to topical therapy.

• Chemical peels: Lighten pigment without heat, making them safer for many skin types.
• Laser treatments:  Must be chosen carefully to avoid inflammation-induced pigmentation. Gentle resurfacing lasers like Clear + Brilliant are often safest.
• Oral tranexamic acid: For severe melasma, oral treatment is often more effective than topical forms and can significantly reduce pigment.
  

Ingredients to Avoid If You Have Dark Spots

Avoiding irritation is essential when treating hyperpigmentation.
Manual scrubs, harsh acids, frequent exfoliation, and aggressive treatments often worsen pigment rather than improve it. Gentle, steady progress is key.

Recommended Skincare Routine for Hyperpigmentation

A consistent morning and evening skincare routine focused on sun protection, barrier support, and gentle cell turnover is essential for managing dark spots.

Morning Skincare Routine

• Splash face with water
• Apply antioxidant serum with vitamin C (Doctor Rogers Day Preventive Treatment) 
• Moisturize with a barrier-supportive lotion (Doctor Rogers Face Lotion or Face Cream) 
• Apply zinc-based sunscreen. Recommended sunscreens 
  

Evening Skincare Routine

• Cleanse with a gentle cleanser (Doctor Rogers Face Wash) 
• Apply cell-turnover treatment (Doctor Rogers Night Repair Treatment, retinol or prescription with hydroquinone)
• Moisturize with a richer cream
  

If irritation develops, pause active treatments and focus on barrier repair before restarting.

Common Questions About Hyperpigmentation

These are the most common questions I hear from patients about dark spots and hyperpigmentation.

How long does it take to fade dark spots?

Most pigmentation takes 8–12 weeks to improve with consistent treatment.

Can hyperpigmentation go away on its own?

Some PIH fades naturally, but sun exposure often prevents full resolution.

Is hyperpigmentation permanent?

Not always, but melasma requires long-term maintenance.

What is the fastest way to fade dark spots?

Daily sunscreen plus a retinoid or hydroquinone (under supervision) works fastest.

When to See a Dermatologist

You should see a dermatologist if pigmentation is spreading, darkening, recurring, or not improving after three months of consistent care.

This is especially important for melasma and for ruling out skin cancer.

How to Prevent Hyperpigmentation From Returning

Preventing hyperpigmentation from returning requires consistent sun protection, avoidance of skin irritation, and ongoing pigment control.

Daily sunscreen is non-negotiable. Gentle cell turnover prevents pigment buildup, and minimizing inflammation keeps melanocytes calm. Prescription treatments and in-office procedures can accelerate improvement, but long-term success always depends on consistent sun protection, barrier-supportive skincare, and patience.

While hyperpigmentation and dark spots can be stubborn, they are very treatable with the right long-term strategy. Daily sun protection is non-negotiable, gentle but effective cell turnover prevents pigment buildup, and avoiding irritation keeps melanocytes calm. For more persistent conditions like melasma, ongoing diligence is key.

When needed, prescription treatments and in-office procedures can accelerate improvement, but the foundation is always the same: consistent sunscreen use, barrier-supportive skincare, cell turnover products, limiting skin irritation and avoidance of direct sun. These steps will improve pigmentation and slow the signs of aging giving you luminous skin at any age.

Featured Articles & Press Coverage by Heather D. Rogers, MD

Author and double-board certified Dermatologist, Heather D. Rogers, MD has contributed to a variety of publications regarding this topic, including 

• Harper's Bazaar: The 8 Best Hyperpigmentation Serums For Brighter, Clearer Skin
• Camille Styles: Hyperaware of Your Hyperpigmenation? 3  Experts Weigh In on the Best Treatment Creams 
• Doctor Rogers Blog: Dermatologist Answers "What's The Most Effective Product for Hyperpigmentation?"

 

Selected References

Mahmoud BH, Ruvolo E, Hexsel CL, et al. Impact of long-wavelength UVA and visible light on melanocompetent skin. Journal of Investigative Dermatology. 2010;130(8):2092–2097.

Humbert PG, Haftek M, Creidi P, et al. Topical ascorbic acid on photoaged skin: Clinical, topographical and ultrastructural evaluation. Dermatology. 2003;206(1):27–35.

Kafi R, Kwak HS, Schumacher WE, et al. Improvement of naturally aged skin with vitamin A (retinol). Archives of Dermatology. 2007;143(5):606–612.

Draelos ZD. Skin lightening preparations and the hydroquinone controversy. Dermatologic Therapy. 2007;20(5):308–313.

About the Author: Dr. Heather D. Rogers, MD

Dr. Heather D. Rogers, MD is a double board-certified procedural dermatologist and Mohs surgeon and the co-founder of Modern Dermatology in Seattle, where she sees patients full-time. She is nationally recognized for her expertise in skin health, aging, and skin cancer prevention, and for her clear, evidence-based skincare guidance. Dr. Rogers serves on the American Academy of Dermatology Media Team, the Credo Beauty Council, the Sorette for Motherhood Scientific Advisory Board, and the NewBeauty Brain Trust.

She is the founder of Doctor Rogers Skincare, a dermatologist-developed line reflecting her less-is-more, science-backed approach to healthy skin. Dr. Rogers is a graduate of Stanford University, the University of Washington School of Medicine, and completed her dermatology training at Columbia University Medical Center.

Instagram: @drheatherrogers
Practice: mdinseattle.com
Skincare: doctorrogers.com

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