Acne discoloration marks or blemishes (also known as post-inflammatory hyperpigmentation) are those dark or red spots left behind after acne lesions heal. These spots are caused by increase in melanin in your skin, resulting from the skin’s inflammatory reactions during the healing process. Although hyperpigmentation spots are not usually permanent, it can take months or even years for them to fade. If you suffer from post-inflammatory hyperpigmentation, try these methods to minimize or get rid of these spots.[1]
Method 1 of 3: Treating Hyperpigmentation Spots at Home
1
Protect your skin with sunscreen. This procedure, also called “photoprotection,” is essential to prevent the worsening of the condition because UV irradiation can cause darkening of hyperpigmentation spots.[2]
Apply broad-spectrum sunscreen with an SPF factor of at least 30 daily over the affected area.
Regular application of sunscreen is particularly important if you do not normally wear sunscreen due to the color of your skin.
2
Avoid sun or use protective clothing. In order to prevent the darkening of the hyperpigmentation spots, cover the affected area from direct sunlight and/or avoid prolonged exposure to sun.[3]
If the spots are on your face, wear a hat or a scarf to cover your face.
Opt to sit in the shade if you are outside during a sunny day.
3
Prevent acne lesions. The best way to prevent the post-inflammatory hyperpigmentation spots is to prevent or treat acne itself.[4]
Mild acne (whiteheads, blackheads, pustules) should be treated by washing your face twice per day with warm water and a gentle cleanser.
Use an over-the-counter acne lotion or cream per the label directions. Do not overuse as they may dry your skin.
If over-the-counter creams do not work, your doctor may prescribe a lotion or cream containing benzoyl peroxide, salicylic acid, a topical antibiotic, a topical retinoid, sulfur, resorcinol, or an oral medication (such as antibiotics, hormonal contraceptive or isotretinoin).[5]
Consult your doctor if your acne does not get better after 6 to 8 weeks of treatment or if you suffer from severe acne.
4
Do not use abrasive scrubs. You might be tempted to scrub the skin to remove the spots but this can actually worsen the condition and prolong their duration. It can also worsen acne.[6]
5
Try topical moisturizers or cosmetics. Many creams and cosmetics available over-the-counter contain plant-based and other natural ingredients that may help lighten the skin. These are usually safe for daily use.[7]
Soy (derived from the soybean plant) is commonly used in skin-lightening moisturizers. It works by inhibiting the transfer of melanosomes into the top layer of the skin.
Niacinamide (a form of vitamin B) acts like soy and is used in many cosmetics.
Ellagic acid, derived from strawberries, pomegranates, and cherries, works as an antioxidant and inhibits enzyme needed for melanin production.[8]
Lignin peroxidase (enzyme derived from a fungus) breaks down melanin in the skin and may have skin-lightening properties.[9]
Arbutin (a natural derivative of hydroquinone) is available in many skin-lightening cosmetics up to 3% concentration.[10][11]
Kojic acid (derived from a fungus) is an antioxidant that works by breaking down melanin. It is available in skin-lightening cosmetics in 1-4% concentrations.[12]
Licorice extracts (such as liquiritin) have been shown to lighten skin and are available in some cosmetics.[13]
Use these products according to the product labels and consult your doctor if you have any questions or side effects.
Please note that although some clinical studies have shown promising effects with the above products for the treatment of hyperpigmentation, larger studies are needed to confirm these results.
6
Try natural remedies. Certain natural remedies may also help reduce or eliminate hyperpigmentation. However, keep in mind that there is little or no scientific evidence to back these approaches, although some evidence suggests that they may be beneficial. Consult with your doctor or dermatologist to determine whether natural remedies are safe for you and your skin.[14]
Aloe vera gel is used for numerous ailments, such as sun burns and dry skin, and it may also work to reduce hyperpigmentation.[15] Create a mask by combining aloe vera, seaweed and raw honey. Allow the mixture to settle for 10 minutes before applying it over the affected area. Leave it on for a few minutes and then rinse it away with lukewarm water.[16]
Lemon and potato juice. The citric acid in lemon juice has bleaching qualities, while the catecholates in potatoes help lighten the skin. Blend the juices and apply the mixture over the pigmentation.
Alternatively, use the lemon juice alone or in combination with almond or coconut oil.[17].
Lemon, milk, honey and orange peels. The combination of citric acids, fruit peels, honey and milk make a paste that soothes your skin and may help lighten hyperpigmentation spots. Make a powder using dried orange peels by adding lemon juice, milk and enough honey to create a proper consistency for a mask. .
Honey and almond. Make a mask by mixing together a tablespoon of almond powder, a teaspoon of honey and a teaspoon of lemon. Apply the mask over the affected area for 15 minutes, then rinse away with water.
Cucumber and mint. Make a mixture using six leaves of fresh mint and one raw egg white beaten until frothy. Crush a half of a cucumber to form a fine paste, then add it to the mint-egg mixture and blend. Apply the mask over the affected area for 15 minutes and wash away with water.
Other natural ingredients to try include wheat germ, argan, tamanu, and rosehip oils, rhassoul (red) clay, and turmeric.[18]
Do not use the remedies if you are allergic to any of the ingredients
Method 2 of 3: Treating Hyperpigmentation Spots Medically
1
Talk to your doctor. You should always consult with your doctor before trying medical treatments for hyperpigmentation. Mention if you are pregnant, or are trying to become pregnant. Many of these treatments are not for use during pregnancy.
2
Use hydroquinone therapy. Hydroquinone is the only lightening treatment approved by the FDA and it works by blocking the conversion of dihydroxyphenylalanine to melanin.[19]
Hydroquinone is available over the counter at 2% in the United States and is commonly used between 2 and 4% concentration. However, your doctor can prescribe strengths up to 10%.
Although hydroquinone can be used alone, it has been recently formulated with other agents, such as antioxidants, corticosteroids, glycolic acid, retinoids, and sunscreens to increase efficacy.[20][21][22]
Long-term use of hydroquinone at concentration of 4% or higher can be irritating, particularly when used in combination with other agents such as retinoids, and adverse events can occur, such as contact dermatitis and hypopigmentation of the surrounding normal skin.
You may want to consult your dermatologist if you decide to use over-the-counter hydroquinone, especially if you use it in combination with other agents.
3
Ask your dermatologist if you can use tretinoin therapy. Tretinoin creams are used to treat hyperpigmentation spots, acne, and fine wrinkles. It lightens the skin, helps replace older skin, and slows down the way your body removes skin cells harmed by the sun.[23]
Tretinoin is only available as a prescription medication.
You should not use tretinoin if you are allergic to it or pregnant or trying to get pregnant.
4
Ask about mequinol therapy. Mequinol is available at 2% concentration by prescription. Although its exact mechanism of action is unknown, it has been shown to be effective in treating post-inflammatory hyperpigmentation.[24]
Although mequinol is a derivative to hydroquinone, it is believed to be less irritating to the skin than the latter.
Mequinol is typically formulated in a combination with tretinoin, retinoic acid and penetration enhancer.
5
Use a gel or cream containing retinoids. Retinoids are derivatives of vitamin A and research has demonstrated they are effective alone or when used in combination with other agents for the treatment of hyperpigmentation spots.[25]
Retinoids are available both over-the-counter and as a prescription medication.
However, there may be side effects with retinoid therapy including, retinoid dermatitis.
Consult your doctor before starting treatment and consider starting therapy at lower concentrations and titrating up the concentration based on treatment response.
6
Ask your doctor if you should try azelaic acid therapy. This is a naturally occurring acid that has been demonstrated to be effective in the treatment of post-inflammatory hyperpigmentation spots in clinical trials. It can be used during pregnancy in most cases.[26]
Azelaic acid is available only by prescription as a 15% gel, often used to treat rosacea, and a 20% cream, more commonly used for hyperpigmentation spots.
Some side effects can be associated with its use, including itching, burning, stinging and tingling.
Method 3 of 3: Treating Hyperpigmentation Spots Professionally
1
See your dermatologist. Although spas and beauty salons may offer services such as chemical peels or microdermabrasions, these procedures should always be done by a dermatologist if possible. Treatment by a dermatologist will be safer and more effective, and the doctor will be able to monitor your condition to ensure that you stay healthy.
Often, combining professional treatment with medical treatment is the best way to reduce acne blemishes.
2
Get a chemical peel. Post-inflammatory hyperpigmentation is one of the most common indications for a chemical peel. Superficial chemical peels are generally well tolerated with good clinical results.[28]
However, it is essential to select the correct chemical peel to avoid irritation, which in turn can worsen hyperpigmentation spots and cause other complications, including new areas of dyspigmentation and scarring.
Chemical peels involve the application of an acid to the skin, which will remove the top layers of the skin and induce color changes.
Glycolic acid peels induce epidermolysis, disperses melanin, and increases dermal collagen synthesis.
Salicylic acid peels induce keratolysis.
Trichloroacetic acid and Jessner’s solution peels may be used but clinical evidence supporting the use of these agents for post-inflammatory hyperpigmentation is lacking.
Consult your dermatologist if you should get a chemical peel and be sure to mention any underlying health conditions you may have or any topical or oral medications you are taking.
Avoid significant sun exposure for at least a week after getting a chemical peel. Always wear sunscreen after getting a chemical peel.
3
Get a laser treatment. Lasers and light sources may be an effective treatment form for post-inflammatory hyperpigmentation if topical skin-lightening agents fail. However, certain complications have been noted, including dyschromias, blistering, and scars, and more research is needed to evaluate the efficacy of laser treatment for post-inflammatory hyperpigmentation spots.[29]
Laser and light treatments are safest and most effective when performed by a dermatologist.
4
Get a microdermabrasion. This is an easy, painless, non-invasive skin rejuvenation procedure that uses a combination of crystals and vacuum suction to gently remove “plaque” and skin debris. Microdermabrasion is less invasive than dermabrasion and can be used to treat post-inflammatory hyperpigmentation spots.[30]
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