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If you’ve ever taken some time out from your day to look at your face in the mirror, or if you’ve ever zoomed in on one of your makeup-free selfies and noticed some changes in your skin that differ from your natural skin tone, this might be a sign of skin discoloration.
While these changes might alarm you initially, skin discoloration is a common skincare concern that takes many forms. To understand skin discoloration better, it can be helpful to know why it develops. Discolored skin occurs due to a difference in melanin levels. Melanin is what gives skin its color and protects it from the sun. But when there is an overproduction of melanin, it can cause differences in skin tone. While skin discoloration is treatable, it might take some time for it to fade depending on what’s caused it.
In a society that promotes unrealistic beauty standards, it can be easy to feel alienated if you are struggling with skin discoloration. The reality is that skincare concerns are common and you are not alone. With the help of board-certified dermatologists Dendy Engelman, MD, and Alexis Granite, MD, we dug into the many ways skin discoloration can be addressed. Keep reading for what they had to say.
Meet the Expert
- Dendy Engelman, MD, is a board-certified cosmetic dermatologist and Mohs surgeon based in New York City.
- Alexis Granite, MD, is a board-certified dermatologist based in London.
What Causes Skin Discoloration?
As skin discoloration is a broad term, we will explore a few of its causes before sharing the best treatment options
Acne scars are one of the most irritating skin care concerns. Depending on the type of acne you have, it could take months for the spots to disappear—and when they finally do, you might find yourself having to deal with scarring that leads to skin discoloration. “Darkening of the skin, or hyperpigmentation, is one form of acne scarring. This is very common if you pick your pimples,” Engelman says. We’ll delve a little more into treatment options later, but if acne scars are causing your skin’s change in color, Engelman recommends using exfoliants, skin-brightening products, and in-office treatments like lasers, light therapy, and microdermabrasion.
Exposure to free radicals from environmental aggressors like UV rays, blue light, pollutants, and more can cause skin discoloration, resulting in the appearance of hyperpigmentation on our faces known as age spots. It’s no secret that the sun does a great job of boosting our moods, but be mindful if you tend to spend a lot of time outside. “The more we protect our skin by staying out of the sun and applying SPF and antioxidants, the less likely we are to develop age spots,” Engelman shares. There are many treatments that can address age spots such as brightening ingredients, chemical peels, and lasers.
Inflammatory Skin Conditions
While acne is a common cause of skin discoloration, eczema can temporarily increase or decrease pigments as well. This can lead to the development of dark spots. “After the dark spots heal, they may leave darkened marks on the skin that can take time to resolve,” Granite explains. If an inflammatory skin condition is making your skin discoloration worse, you might want to adopt a holistic approach to your skincare regime. “The coloration caused by inflammatory conditions is usually more prominent during flare-ups," Engelman explains. "These can be triggered by weather, temperature, diet, alcohol consumption, and other factors."
You’re probably wondering why we’re talking about UV exposure again, but it is one of the biggest causes of skin discoloration. “Increased exposure to UV rays increases the likelihood of developing patches of pigmentation, as sunlight triggers the production of melanin,” Granite shares. An overproduction of melanin can cause melasma, which Engelman tells us is a “temporary darkening of the skin that is caused by exposure to UV rays.” Melasma usually appears on the face. It may also appear on other areas of the body and may range in size from small spots to large patches.
If UV exposure is causing changes in your skin color, the best thing you can do is adopt a preventative approach. “Layer on a broad-spectrum physical SPF and minimize your time in the direct sun," Granite says. "Invest in a wide-brimmed hat if you like to spend time at the beach."
Something many people may not be aware of when it comes to skin discoloration is that it may be a sign of a hormonal issue. Hormonal issues can cause a variety of skin conditions, and discoloration is one of them. “Estrogen and progesterone can stimulate the overproduction of melanin which may lead to discoloration in the form of hyperpigmentation,” Granite explains. A form of skin discoloration that can be caused by hormones is melasma, which, according to Granite, can present as blue-gray patches and is likely to appear during pregnancy. “Oral contraceptives and hormone replacement therapy (HRT) can also cause melasma,” she adds.
How Can Skin Discoloration Be Treated?
Just as there are many forms and causes of skin discoloration, there are many ways to treat it.
Hydroquinone is a prescription ingredient that inhibits tyrosinase, an enzyme within the skin that is involved in the production of melanin, the pigment that gives its color. Granite tells us that hydroquinone is often used as part of a triple-ingredient cream containing HQ, a topical steroid, and a retinoid. “Hydroquinone treats hyperpigmented skin discoloration including acne scars, melasma, and age spots," Engelman adds. "It usually works well over the course of several weeks and is not safe for women who are pregnant."
Azelaic Acid or Kojic acid
“Azelaic acid is an over-the-counter and prescription strength ingredient that is a great alternative for those who cannot or don’t want to use hydroquinone,” Engelman says. Like hydroquinone, azelaic acid targets melanocytes in hyperpigmented areas of the skin to lighten spots. One reason why azelaic acid is such a popular ingredient is that it’s well tolerated. It’s gentle enough to use on sensitive skin and has antioxidant, anti-inflammatory, and anti-microbial benefits.
Kojic acid is quite similar to azelaic acid. While azelaic acid is found naturally in wheat, barley, and rye, kojic acid is produced by fungi and can also be an effective treatment for skin discoloration.
Topical corticosteroids may be helpful in reducing inflammation associated with active flare-ups of conditions such as eczema, and help prevent post-inflammatory discoloration from occurring. “While topical corticosteroids may be helpful with post-inflammatory discoloration, they aren’t really used for pigmentation,” Granite says. Due to their ability to inhibit the production of chemicals that cause inflammation, corticosteroids can help with a variety of conditions such as rosacea, eczema, and psoriasis.
For those who want professional results when treating skin discoloration, a variety of peels can be used. Peels can be mild or strong and they usually include one or more active ingredients—mandelic acid, glycolic acid, and lactic acid peels are available at most clinics. “Dermamelan is a great peel for melasma,” Granite tells us.
So what do chemical peels actually do? According to Engelman, they utilize hydroxy acids and other ingredients to exfoliate and resurface the skin. “Chemical peels help remove hyperpigmentation spots while making skin brighter, clearer, and more youthful,” she says. For beginners who like the idea of an at-home peel, Engelman recommends Hydra-Bright AHA Glow Peel, while those who feel more confident with at-home peels can take their results to the next level with the GlyPro AHA Resurfacing Peel.
If you’ve exhausted all other options and can’t seem to find the right treatment for your discoloration, then you might want to consider giving laser treatments a try. Laser treatments come in two main categories: ablative lasers and non-ablative lasers. “Ablative lasers remove the outermost layer of the skin (epidermis) and heat up the lower layers (dermis), which helps remove skin discoloration by triggering collagen production, the foundation for stronger, more youthful skin,” Engelman says.
Non-ablative lasers heat up the epidermis but they don’t trigger collagen production. “Both can effectively diminish skin discoloration like age spots and acne scars,” Engelman adds. If you are thinking about using laser treatments to treat skin discoloration, Granite emphasizes the importance of finding a practitioner you trust—and who has plenty of experience with your skin type. “A strict topical regimen with sunscreen and topical treatments should always be used in conjunction with laser treatments,” she adds.
If you’re looking for a treatment that will target any additional skincare concerns you have, then microneedling might be for you. Microneedling is a procedure that uses a pen-like device with tiny needles to create channels in the skin to stimulate controlled wound healing. “It’s safe for all skin types and can be used to treat melasma and uneven complexions,” Granite says. Like chemical peels, microneedling can be done in the comfort of your own home. “The difference between at-home and in-office treatments is that in-office microneedling treatments will be slightly more aggressive and achieve quicker results,” Engelman explains.
For those who want to improve skin health while treating skin discoloration, microdermabrasion might just fit the bill. “Microdermabrasion treatments are performed in-office and use a special tool to gently but thoroughly exfoliate the skin, helping to fade hyperpigmentation while leaving skin softer, brighter, and more youthful looking,” Engelman says.
Microdermabrasion addresses skin discoloration of the face such as age spots and acne scars, but do keep in mind that it won’t provide a quick fix to great skin: According to Engelman, it usually requires several visits to notice visible results.
What to Consider
While you decide which treatment option for skin discoloration may be best for you, there are a few things you need to consider. “Speaking with experienced, certified professionals is always important as this will allow you to pursue the right treatment options for your specific concerns,” Engelman says.
Something else to keep in mind is the time it takes to see results, which will vary depending on your preferred treatment method. When treating skin discoloration, patience is important. You’ll also need to pay attention to how your skin is reacting to treatments. If you experience any unanticipated adverse reactions, look into other treatments. Additionally, women who are pregnant or nursing should be careful when selecting topical ingredients as certain products such as hydroquinone, for example, are not recommended.
Lastly, if one ingredient doesn’t appear to be resolving your discoloration, Granite suggests considering a combination approach as an alternative. “Using ingredients at home to help support any in-clinic procedures will typically yield the best results,” she adds.