What causes dark spots? A guide to hyperpigmentation treatment and prevention
- Belinda Bennett
- May 4
- 7 min read
Ever glanced in the mirror and noticed a shadowy, dark patch; a stubborn reminder of sun-soaked days or hormonal shifts? Me too! These darker areas on our skin tell a story – the horror story of hyperpigmentation. But what exactly causes this uneven pigmentation, often referred to as dark spots, and what can we do to gently rewrite the narrative for a brighter, more even complexion?
Even in the depths of winter, when everyone else is a uniform shade of pale, your face can hold onto small patches of summer. If you have ever felt that your tan has a favourite spot that it loves to cling to, stop blaming the ghost of last August and start learning why.
Let’s take a look at the science behind these pigmentary puzzles and unravel clear pathways to both effective treatment and prevention.
The dark truth about hyperpigmentation
If you’ve suddenly found yourself sporting dark spots, you most definitely aren’t alone. Research suggests that as many as 33% of women will develop hyperpigmentation on their face at some stage in their lives. While men can also be impacted, women are up to nine times more likely to suffer from this often embarrassing condition.
Those with darker skin are more prone to uneven skin tone. Hyperpigmentation is also rarely seen in those aged under 20. So, this is a condition that mostly affects adult females.
Dark spots, often medically referred to as melasma, are primarily the result of the body overproducing a substance called melanin, a specific pigment that gives skin its colour. This excess melanin production can be triggered by various things, and we will explore each of those below.
The important thing to acknowledge is that overproduction of melanin can cause a frustrating skin condition that commonly takes time and effort to resolve. However, dark spots can be effectively treated - sometimes in as little as seven to ten days.
Hyperpigmentation is an issue because it often ages the skin and makes achieving a flawless look difficult. Yes, you can resort to full-coverage foundation and concealers, but is that the kind of faff you want to go through every day? If you are the type of person who would rather tackle the issue and go lighter on base makeup, finding the right remedy is a worthwhile exercise.
Causes of dark spots
Overproduction of melanin can be triggered by a multitude of factors. It’s important to determine the exact cause of your hyperpigmentation to ensure you reach for the right treatment.
The number one cause of hyperpigmentation is exposure to the sun. UV rays, a leading source of premature ageing, stimulate the production of melanin. This process is what most of us would refer to as tanning. But, sadly, not everyone ends up with bronzed skin. For many, sunlight can instead lead to hyperpigmentation.
In older adults, the same process can cause age spots. These areas of skin discolouration can occur anywhere on the body that has been exposed to the sun. They are commonly found on the hands, for example.
Another cause of dark spots is inflammation. Those most at risk from post-inflammatory hyperpigmentation include people who have experienced acne, general breakouts, and cuts or burns to the skin. It is also a known side-effect of certain cosmetic procedures - something to be aware of, if you are considering an invasive makeover.
Inflammation is deemed a cause of dark spots because, when the body is healing from any type of trauma, skin can sometimes produce more melanin. Think of it as an unwanted type of defence mechanism. The skin reacts to swelling in various ways and overproduction of melanin is one of them.
Hormonal changes have long been recognised as a cause of uneven skin tone. Pregnancy and the menopause are trigger points precisely because of the fluctuations in hormone levels.
Many women develop uneven patches of skin at these times in their life because hormone changes in the body impact melanin production. Women in their 40s and 50s are especially susceptible to stubborn outbreaks of hyperpigmentation.
Genetics can also play a role in who suffers from dark spots. It’s worth finding out if there is a history of hyperpigmentation in your family, because it can determine your chances of developing the condition. Prevention is easier than the cure!
For others, dark patches on the skin are the result of medical conditions or medications. For example, hyperpigmentation can be a symptom of Addison's disease.
Medications known to cause uneven skin colour issues include antibiotics and antiarrhythmics. If you are on any type of medication, including aromatase inhibitors, that makes the skin more sensitive to sunlight, you need to take extra precautions. It’s also worth pointing out that some skincare treatments, such as retinol, can increase the skin’s sensitivity to sunlight.
Some women aren’t sure if darker patches on their face are hyperpigmentation or not. Take Jo, one of our newsletter subscribers. She contacted me in February, worried that she had developed a darker patch of skin on one of her cheeks.
After a bit of to-ing and fro-ing, I was able to establish that Jo had recently been on an extended holiday to a country with a tropical climate. She readily admitted to spending hours every day in the sun - and without adequate SPF protection. I advised her to follow the routine below for two weeks. If there was no improvement, I made her promise that she would seek medical advice. The upshot? After those two weeks, the dark patch was gone.
Effective treatments for hyperpigmentation
If your uneven skin tone is caused by hormonal imbalances during pregnancy, you may want to take a ‘wait and see’ approach. Often, the skin will return to its pre-pregnancy state a few months after the birth. Those who start a new skincare routine in the run-up to the arrival of a baby often find they are either too tired or too busy to keep it up once the little one has arrived.
Waiting until everything has settled into a predictable routine is better for new mums. And, as stated above, the skin may return to its pre-pregnancy state without any intervention. Having a baby is expensive, so just by waiting you may be able to save some cash.
For those who have a family predisposition to hyperpigmentation or suspect exposure to UV rays is to blame, starting treatment as soon as possible is best.
Anyone with dark spots induced by a medical condition should seek expert advice from a doctor.
Right, let’s get to the nitty-gritty! Follow this skincare routine for effective relief from hyperpigmentation.
Pease note: Always carry out patch tests before introducing a new skincare product into your regimen.
Anti dark spot skincare routine
Evenings
Remove makeup with a gentle balm or micellar water.
Twice a week follow this process with exfoliation. You can use either a gentle scrub or an exfoliating tool.
If you wear makeup, always double cleanse. That means following a balm or micellar water with a light gel or foam wash.
Pat dry and tone the skin with glycolic acid. There are lots of glycolic toners on the market but I recommend Revolution SKin Glyco Glow, which is a brightening AHA toner, or The Ordinary’s Glycolic Acid 7% Exfoliating Toner.
Next, apply The Ordinary’s Alpha Arbutin 2% + HA serum or a high-strength vitamin C serum. Choose one that is infused with ferulic acid. Why? Because ferulic acid will stabilise the vitamin C and enhance its benefits. Alternatives include high-strength niacinamide or azelaic acid serums.
Wait 30 seconds to one minute and then apply a brightening moisturiser. I recommend NIVEA Cellular Luminous 630 Anti Dark Spot Night Cream.
If you have sensitive skin and notice any irritation, discontinue the routine.
Mornings
Cleanse the face with a gentle foam or gel wash.
Tone with a glycolic product.
Apply your brightening serum (see above).
Wait 30 seconds to one minute and then apply NIVEA Cellular Luminous 630 Anti Dark-Spot Day Cream Moisturiser. This product includes SPF. Alternatively, use any brightening moisturiser.
Last, but not least, go over your moisturiser with a SPF 50 sunscreen. Always ensure your sun protection is applied after everything else. If your moisturiser includes SPF, you may still want to use sunscreen - to be on the safe side.
You can apply makeup over sunscreen.
The routines outlined above are effective for many people, but they aren't the only ones that will work to combat hyperpigmentation. The Journal of Integrated Dermatology notes a wide range of methods in a peer reviewed article, published in 2022. In 'Integrative approaches to hyperpigmentation therapy', the potential benefits of complementary and alternative treatments are discussed alongside mainstream therapeutics.
When following a strict skincare regimen, always avoid prolonged exposure to direct sunlight - especially during the hottest part of the day. If you are on medication that increases the risk of sunburn, this is essential.
While brightening agents can significantly reduce the appearance of dark spots, they don’t work for everyone. If you happen to be one of the unlucky ones, you may want to consider investing in professional treatments. Laser therapy, microneedling and chemical peels can help. However, they should only ever be carried out by a qualified practitioner in sterile conditions.
Never be tempted to use the services of an unqualified, home-based therapist or someone whose credentials cannot easily be checked. Refer to the British Association of Dermatologists (BAD) or Nuffield Health, if you are looking for a recommendation.
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Going forward
Taking an holistic approach to the prevalent menace of hyperpigmentation is best. As well as following a strict skincare regimen and always using high SPF products, you may want to consider the following:
Stick to a balanced diet. Food rich in antioxidants and vitamins will support skin health.
Drink plenty of water. Plain tap water can help keep skin healthy and prevent dehydration, which can worsen the appearance of hyperpigmentation.
Finally, recognise that treating hyperpigmentation can take several weeks. And you may need to persist with a routine to prevent dark spots from coming back once they are gone.
Consistency is the key to both removing hyperpigmentation and preventing it. If you want to learn more about the benefits of consistency in skincare, read our guide here.
For many women, dark spots are something that happens from time to time. They don’t have to be permanent and, by tweaking your skincare routine, you can oust them from your life once and for all.
Further reading:
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