Color Changes: Spots May Fade with Right Treatment
When acne clears, spots sometimes
appear on the skin where the acne once was. These spots may be pink,
red, or purplish in people with lighter skin and tan to dark brown
in people with darker skin. Many people believe these spots are
scars. The good news is that these are not scars.
Unlike scars, these spots will eventually fade. Fading, however, can
take months. Dermatologists offer treatment and advice that can help
you fade these spots more quickly.
Avoid the Sun and Protect Your Skin with Sunscreen
Yes, that right. Even people with brown and black skin need to
protect their skin from the sun. Sun exposure can make these spots,
which your dermatologist may call “postinflammatory
hyperpigmentation” (PIH), darker and even more noticeable.
To prevent the spots from darkening, dermatologists recommend
sunscreen. To get the best results, you should:
Apply sunscreen to all skin that
will be exposed, such as your face and neck
Wear sunscreen daily
Apply the sunscreen 20 minutes
before going outdoors
It is important to use a sunscreen that
is broad spectrum, has a Sun Protection Factor (SPF) of 30 or
higher, and is oil-free. Broad-spectrum means the sunscreen protects
the skin from both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
An oil-free sunscreen will help prevent new acne breakouts. New
breakouts can lead to more spots of discolored skin. The label may
not say “oil-free.” It may say “won’t clog pores” or “non-comedogenic.”
While it can be tempting to skip the sun protection and just try the
treatments, don’t. Sun protection is essential. Without it,
treatment will likely be less effective.
To treat color changes on the skin, your dermatologist may recommend
a combination of treatments. Combining treatments often works best
for treating dark spots. Your treatment plan may include:
For fading tan to dark-brown spots, a bleaching cream that contains
hydroquinone can be effective. Some bleaching creams are available
without a prescription. By law, these can contain up to 2%
When buying bleaching creams, be sure to read the bottle to find out
how much hydroquinone is in the bleaching cream. If the bottle does
not say how much hydroquinone is in the product, it is best not to
risk using it. Some products contain much more than 2% hydroquinone.
Using a product that contains a lot of hydroquinone can cause severe
skin discoloration — and this discoloration can be nearly impossible
Your dermatologist may prescribe a product that contains 4%
hydroquinone. These products are safe when used as directed by your
Other Skin Lighteners
You may be able to lighten your skin more effectively with a
prescription cream that contains a few active ingredients instead of
just one. One cream that your dermatologist may prescribe contains
hydroquinone, a corticosteroid, and tretinoin. This combination
often helps to lighten the dark spots without irritating the skin.
Irritation can cause more spots of darker skin.
Some medications used to treat acne also can lighten the skin. These
include tretinoin, tazarotene, adapalene, and azelaic acid.
Light Chemical Peels
A series of light chemical peels can help fade spots of dark skin.
Your dermatologist can tell you if these may help. Usually a minimum
of 4 to 6 chemical peels is needed.
While chemical peels are available for at-home use, these peels may
not effectively treat skin discolored by acne. If the peel irritates
the skin, the irritation can cause more dark spots to appear.
This can be an effective part of your treatment plan. To perform a
microdermabrasion procedure, a dermatologist uses a machine to
remove the top surface layer of skin. With a series of
microdermabrasion sessions, the spots of discolored skin tend to
Dermatologists generally do not recommend the at-home
microdermabrasion kits. New spots of discolored skin can appear if
the kit is used too aggressively.
In some cases, laser treatment may be an option for treating skin
discolored by acne. Lasers are generally only used on darker skin
when other treatments do not work.
Trust Your Dermatologist
Treating the spots of discoloration that can appear after acne
clears can be like walking a tightrope. Both require a fine balance
of skill and training. Dermatologists have the skill and training to
help you fade these spots.
Alexis, AF. “Issues and approaches in skin of color.” Presented
during focus session U012 at
the Summer Academy Meeting of the American
Academy of Dermatology, July 2009: Boston.
Halder RM. “The role of retinoids in the management of cutaneous
conditions in blacks.” Journal of the American Academy of
Dermatology, August1998; 39: S98-103.
Halder RM, Nootheti PK. “Ethnic skin disorders overview.” Journal
of the American Academy of Dermatology, June 2003; 48: S143-8.
content solely developed by the American Academy of Dermatology
patient’s jawline shows the spots that can develop after
acne clears. These spots are not scars.
This photograph was published in the Journal of the American Academy of Dermatology, 1998 Aug; 39(2 Pt 3):S98-103. Halder RM. “The role of retinoids in
the management of cutaneous conditions in blacks.”
Copyright Elsevier (1998).