Skin pigmentation changes are very common, especially on areas exposed to the sun. Dark spots on the face, hands, or chest can feel cosmetically bothersome. Most pigmentation changes are harmless, but it is still important to tell them apart from changes that need review.
The key to managing pigmentation is sun protection. Good sunscreen helps prevent existing spots from darkening and new ones from forming.
The most common types#
Sun spots, also called lentigines, are small dark spots that form after repeated UV exposure. They are common on the face, the backs of the hands, and the shoulders. They are flat rather than raised.
Melasma is a broader, light brown or grey-brown area that usually appears on the face. It is often linked to hormonal changes and tends to worsen in sunlight. It may fade in winter and return again in summer.
Post-inflammatory hyperpigmentation means darkening that remains after acne, an insect bite, or another skin irritation. It usually fades on its own, but the process can take months.
Self-care and prevention#
Sun protection is the base#
Sun protection is the foundation of prevention and maintenance. A high SPF cream or a separate sunscreen helps keep existing spots from darkening and new ones from appearing.
Sunscreen should be used every day, even in cloudy weather, because UV radiation still passes through clouds. It also needs to be applied in enough quantity and reapplied during the day when you are outdoors.
Skin care products#
Serums with vitamin C and creams with niacinamide are often used to support a more even-looking skin tone. Niacinamide is usually well tolerated.
Exfoliating acids such as glycolic acid and lactic acid can also help the skin look smoother over time. With these products, sunscreen becomes even more important, because the skin is more sensitive to UV after exfoliation.
What cosmetics can do#
Cosmetics can support the appearance, moisture balance, and tone of the skin, but they are not a diagnosis or a treatment for a changing lesion. If a spot is new, changes quickly, or looks clearly different from other marks, it should not be hidden under cosmetics for long without review.
Long-term routine#
Pigmentation care is a marathon, not a quick fix. One product rarely changes the look of the skin in a week. A consistent routine with sunscreen and one or two active ingredients is usually more workable than starting many products at once.
What to avoid#
Exfoliating acids should be started at a low strength and used less often at first. Too much exfoliation or several active ingredients at once can irritate the skin and make pigmentation worse. Sunbeds also worsen pigmentation and should be avoided.
When to seek care#
Seek review if a pigmentation change becomes asymmetric, has irregular borders, changes colour, or grows. These can be signs that a skin lesion needs assessment. A new, rapidly changing, painful, itchy, or bleeding skin change should also be shown to a clinician.
Further reading and sources#
Further reading: