How to Get Rid of Dark Spots

Ever since letting you all in on the fact that I'm going into dermatology, the number one question I have gotten by far is how to get rid of dark spots! Anyone with a little pigment to their skin knows exactly what I'm talking about - the dark spots left over from healed pimples, bug bites, or even scratches. And those who are more pigment challenged I'm sure are also familiar with this, more likely in the form of redness. These spots are annoying to have and annoying to treat, but there are definitely things you can do to get rid of them! So let's get to it!

Control. These spots are known medically as post-inflammatory hyperpigmention (different from melasma which is another disorder I won't address much in this post). In clinic we see lots of patients who want to get rid of their dark spots, but still have very active acne, which will only lead to more spots! The number one priority for these spots should be to get whatever is causing them under control. Here's a list of a few common causes and treatments:

- Acne: This is probably the biggest offender, especially in teenagers and young adults. Try over the counter treatments like face wash with salicylic acid or benzoyl peroxide (or glycolic acid, which I'll talk about more in a bit), and a spot treatment containing either of those ingredients as well. For more stubborn acne see a dermatologist who can prescribe you something like a retinoid, oral contraceptive pills (most helpful for hormonal acne), or even antibiotics (something I used for my skin while wedding planning and cleared me right up)!

- Eczema/dryness: This is another big offender. Try keeping moisturized with Aquaphor (see this post for more on dry skin). Many people need more than just moisturization, though, and for this a mild steroid cream can be a huge help! Most people don't find hydrocortisone (what you can buy at the drugstore) helpful enough, so see your PCP or dermatologist to get something a little more potent!

- Itching: This frequently is due to dryness, but the scratching itself also leads to inflammation that can cause darkening of the skin. Figure out the source, whether it's dryness, allergies, or some other type of sensitivity, and try your best to keep from scratching!

- Bug bites: I feel like all summer my legs are riddled with dark spots from previous bug bites - try your best to wear insect repellant when outdoors!


Exfoliate. Now that you've addressed the root of the problem, we still have spots to deal with! So the first step will be to exfoliate to increase cell turnover and get to newer skin more quickly! I'm not a huge fan a mechanical exfoliation (using scrubs or rough poufs, etc.), as this can sometimes lead to more inflammation. I prefer chemical exfoliation, and think using it in a face wash is one of the easiest ways to do it! Washes with glycolic acid are some of my favorite; retinols and salicylic acid can also do the trick. Most chemical peels use glycolic acid (at much higher concentrations than what you'd find in a face wash), and many people find these effective as well.


Treat. These spots are due to increased melanin (the stuff that gives our skin its color), so treatment should target this! Hydroquinone is the classic ingredient here, since it blocks the enzyme that makes melanin. You can find it in low concentrations over the counter and higher concentrations by prescription. Pairing this with an exfoliator like a retinoid makes it most effective! It's usually best to use treatment creams at night, although some people (with less sensitive skin) can get away with twice a day treatment in the AM and PM. I would definitely start with only once a day and see how your skin reacts.


Prevent. Melanin's role is to protect us from the sun, and our bodies are smart - when we're exposed to sun, the body makes more melanin to protect us. This is nice if you want a little tan, but if you have any dark spots (or acne), the sun will only make these spots darker and take much longer to fade. Sunscreen is your BEST FRIEND! You really should wear a face cream with at least SPF 30 every single day, even if it's cloudy or even if you think you'll be inside all day. No exceptions.


Hide. Even with the strongest prescription creams and chemical peels, these spots still just take time to fade. All of the things mentioned will certainly help them fade faster, but none of them work magic. Some people like to hide their spots as they continue treating them, and that's absolutely fine, but the key is to use a product that won't make the spots worse - anything not labeled as non-comedogenic can potentially make things worse by causing more breakouts! This is the cycle I find lots of women stuck in - they can't get the spots to go away so they cover them with tons of foundation, but then breakout because they're clogging their pores and get more inflammation that leads to more dark spots! I must say that I really think the most effective regimen for clearing up sots leaves out any makeup, but I know that's hard for many people! One of my favorite light foundations is this one by Neutrogena that is made specifically for acne-prone skin and even has salicylic acid (the concealer is an even better option since you can just spot hide instead of covering your whole face).

So with all of these steps in mind, the perfect combination for treating those dark spots would look something like this:
Morning //
1. Face wash with glycolic acid
2. AM face cream with SPF 30
3. (optional) non-comedogenic foundation or concealer

Evening //
1. Face wash with glycolic acid
2. Hydroquinone spot treatment and retinol cream

{ 1 // 2 // 3 // 4 // 5 }

As with any other skin product, make sure sure to read the labels for instructions on how to use, and make sure to start slow and work your way up. If you have particularly sensitive skin make sure to introduce one new product at a time (as opposed to starting them all at the same time) so that if anything causes a reaction you can identify it!

I hope you all found this post helpful and can find some direction in treating those pesky dark spots!! Have a great weekend and as always thanks for reading!