Why Hyperpigmentation Can Be So Difficult to Treat
- 4 days ago
- 11 min read
Updated: 4 hours ago
By: 63° Editorial
August, 2026
Dark marks can take far longer to disappear than the breakout, bite or irritation that caused them. For darker skin especially, understanding why they happen is the first step towards treating them without accidentally making them worse.
There is a particular kind of frustration that comes with finally getting a breakout under control, only to realise that the spot has left something behind. The acne is gone, skin is flat again, nothing hurts. But there is a dark mark exactly where the spot used to be, and three months later, it may still be there.
So you try to fade it.
Perhaps you start with vitamin C. Then niacinamide. Someone recommends kojic acid. TikTok introduces you to tranexamic acid. There is an exfoliating toner in the bathroom already, so that joins the routine too. A friend swears by retinol. Another person says hydroquinone cleared everything. Then you hear that hydroquinone is dangerous, that sunscreen is essential, that sunscreen is unnecessary for dark skin, that chemical peels work faster, and that a laser will solve the whole thing.
At some point, treating one dark mark can begin to feel like a second job. The frustrating truth is that hyperpigmentation really can be difficult to treat, particularly in darker skin. But the other truth is that many of us are making it harder than it needs to be. The most useful place to start is not with another serum. It is with understanding what kind of pigmentation you are actually trying to treat.
First, “hyperpigmentation” is not one thing
Hyperpigmentation simply describes skin that has become darker in an area because of increased pigment. It is an umbrella term, not a diagnosis. One common form is post-inflammatory hyperpigmentation, or PIH. This is the dark mark that can remain after acne, eczema, a burn, an insect bite, shaving irritation, a rash, a scratch or another inflammatory injury to the skin.
Melasma is different. It tends to produce larger, often symmetrical patches of pigmentation, commonly across the cheeks, forehead and upper lip, and is influenced by a more complicated mix of light exposure, hormones and other factors. There are also other causes of pigmentation, including certain medications and medical conditions.
This matters because the product that helps an acne mark is not necessarily the answer to every dark patch on your face and that brings us to one of the biggest problems in the pigmentation market. We often buy treatments before we understand the problem. If pigmentation is new, changing, widespread, unexplained or simply refuses to behave as expected, getting the diagnosis right can save months of experimentation.
Why darker skin can hold on to marks for longer
Melanin is not the enemy here. It is the pigment that gives skin, hair and eyes their colour and plays an important role in protecting skin from ultraviolet radiation. The issue is what can happen after inflammation.
Inflammation can signal melanocytes, the cells that produce melanin, to increase pigment production. That pigment can then accumulate in the epidermis, the more superficial layer of skin, or sometimes deeper in the dermis. Darker skin is particularly prone to this response.
That helps explain why two people can have what looks like a similar breakout and end up with very different aftermaths. It also explains why pigmentation treatment needs to be approached differently from simply trying to “brighten” the skin.
The first thing to treat may not be the pigmentation
This is perhaps the most useful idea in the entire article. If acne is causing your dark marks and you are still getting acne, treating only the pigmentation is like mopping the floor while the tap is still running.
Every new inflamed spot creates another opportunity for PIH. The same principle applies to eczema, irritation from shaving, picking at the skin, an aggressive skincare routine or another recurring source of inflammation. If the trigger continues, new pigmentation can continue too. That means a good pigmentation strategy often begins with controlling whatever is creating the pigment in the first place.
For someone with acne, that may mean treating acne and PIH together. For someone whose marks follow eczema, controlling the eczema matters. If a product repeatedly burns or irritates your skin, adding another “brightening” active may not be the smartest next move. And this is particularly important for darker skin because irritation itself can create more pigmentation. Reviews of PIH in skin of colour specifically caution that treatments and procedures can sometimes exacerbate the very pigmentation they are intended to improve.
Which leads to a slightly counterintuitive rule that "More aggressive does not necessarily mean faster." Sometimes it means darker.
So, what actually works?
This is where skincare marketing makes things unnecessarily confusing. There are dozens of ingredients marketed for dark spots, but they do not all have the same quality of evidence behind them.
Retinoids: established, but irritation matters
Retinoids are among the better-studied topical options for PIH. They increase skin-cell turnover and can influence several processes involved in pigmentation. The 2024 systematic review of skin of colour found that topical retinoids were the most frequently studied treatment category. Tretinoin, adapalene and tazarotene all produced improvements in included studies, although irritation, peeling and burning were also reported.
A retinoid can help pigmentation, but an overly aggressive retinoid routine that leaves your skin persistently inflamed can become counterproductive. This is one reason gradually introducing potent actives is not just a “sensitive skin” preference. For pigment-prone skin, maintaining the skin barrier can be part of the pigmentation strategy itself.
Hydroquinone: effective, but not something to use carelessly
Hydroquinone has been used in dermatology for decades because it inhibits tyrosinase, an enzyme involved in melanin production. It can be effective, particularly when appropriately selected and supervised, but it is not a product to use indefinitely without thought. Irritation can occur, and prolonged or inappropriate use has been associated with complications including exogenous ochronosis, a difficult-to-treat blue-black pigmentation disorder. That does not make hydroquinone “bad.”
It means powerful treatment and casual treatment are not the same thing. If you are considering stronger hydroquinone preparations, prolonged treatment or combinations with other prescription agents, this is an excellent point at which a dermatologist becomes more valuable than another TikTok routine.
Azelaic acid: a particularly useful multitasker
Azelaic acid deserves more attention than it sometimes gets because it can address both pigmentation and some of the processes that create it. It has anti-inflammatory and pigment-modulating properties and is also used in acne treatment.
For someone whose pigmentation follows acne, that makes it an interesting option because you are not simply fading yesterday's mark while ignoring today's breakout. It can still irritate some skin, particularly when first introduced, but it occupies a useful middle ground between treating the cause and treating the consequence.
Niacinamide and vitamin C: useful, but manage your expectations
Both ingredients have plausible mechanisms and evidence supporting roles in pigmentation and overall skin care, but this is where expectations matter. A niacinamide serum is not automatically going to erase deep, persistent PIH because the label says “brightening.”
Vitamin C is not useless because it did not remove a six-month-old mark in two weeks.
These ingredients can form part of a good routine. They are simply not magic erasers.
An ingredient having evidence is not the same thing as every product containing that ingredient being equally effective. Concentration, formulation, stability, frequency of use and what else you are putting on your skin all matter.
What about tranexamic acid, cysteamine and thiamidol?
This is where pigmentation treatment is getting more interesting. Tranexamic acid has become increasingly visible in skincare, particularly in products targeting melasma and uneven pigmentation. It can be used topically, while oral tranexamic acid is sometimes used off-label by dermatologists for selected cases of melasma.
Those are not interchangeable propositions.
Oral tranexamic acid is a medication with systemic effects and potential risks, including concerns around blood clots in susceptible people. It is not something to start because a skincare creator described it as the stronger version of a serum.
Cysteamine is another topical depigmenting agent that has attracted interest, particularly as an alternative to more established treatments.
Then there is thiamidol, a newer tyrosinase inhibitor appearing in pigmentation products and increasingly in the research literature. Early clinical evidence is encouraging, including research in people with skin of colour, but the evidence base is still smaller than that behind treatments dermatologists have used for decades.
Promising does not mean proven useless. But it also does not mean established. You should be allowed to know the difference before spending your money.
The sunscreen conversation is more interesting than “wear SPF”
If you have dark skin, you may have heard some version of this argument, "we have melanin, so why do we need sunscreen?"
Melanin does provide some natural photoprotection. It does not make darker skin immune to the effects of sunlight, and when pigmentation is the problem, the conversation becomes even more specific. Ultraviolet radiation can worsen PIH.
Researchers are now paying much more attention to something beyond UV, visible light.
This is why you are seeing more conversation about tinted sunscreens containing iron oxides. Iron oxides help protect against portions of visible light that ordinary transparent sunscreens may not adequately address.
This doesn't mean everybody needs to throw away their sunscreen tomorrow. It means that if pigmentation is one of your primary skin concerns, the type of sunscreen you choose may matter beyond the SPF number on the bottle.
There is also a very practical problem here that research papers do not always capture well and that is, sunscreen has to be wearable. If it leaves a grey or purple cast on dark skin, feels unbearable in humid Lagos weather, pills under makeup or costs so much that you ration it, the theoretically perfect formulation may be a poor real-world product.
The best sunscreen is not simply the one with the most impressive specification sheet.
It is one you can actually use properly and consistently.
The treatment mistake that deserves far more attention
If you take only one practical warning from this article, make it this. Do not turn your face into a chemistry experiment because you are desperate to clear a dark mark. Glycolic acid. Salicylic acid. Retinol. Vitamin C. Kojic acid. Alpha arbutin. Niacinamide. Tranexamic acid.
It is very easy to conclude that if each ingredient might help individually, using all of them must work even better. Skin does not necessarily cooperate with that logic. Over-exfoliation and irritation can damage the skin barrier and trigger inflammation. In pigmentation-prone skin, that inflammation can create or worsen PIH.
So if your face is burning, persistently red, unusually tight, peeling excessively or becoming darker while you are supposedly “treating” the pigmentation, adding another active is probably not the answer. Sometimes the intelligent intervention is subtraction.
And what about peels, lasers and microneedling?
Professional procedures can help some people, but darker skin requires particular care.
Chemical peels can improve PIH, but the strength, agent, preparation and person performing the treatment matter. Too much inflammation can produce more pigmentation.
Lasers present a similar trade-off.
Another systematic review covering 877 patients similarly found that complete responses were uncommon overall, including across topical and device-based treatments. That does not mean “lasers are dangerous for Black skin.” Modern dermatology is far more sophisticated than that.
It means that the practitioner matters enormously. If you have darker skin and are considering a laser, peel or other energy-based pigmentation treatment, ask how often the practitioner treats your skin tone and your specific pigment disorder. Ask what device is being used. Ask about PIH risk. Ask what happens if pigmentation worsens.
A beautiful clinic and an expensive machine are not substitutes for expertise.
How long is this actually going to take?
Probably longer than social media has trained us to expect.
Superficial PIH can gradually fade over months, while deeper pigment can persist considerably longer. Treatment can accelerate improvement, but there is no credible universal promise that every mark disappears in two weeks, four weeks or even twelve.
That is also why before-and-after photographs deserve scrutiny.
Was the lighting identical? Was makeup used? How much time passed? Was the person treating acne simultaneously? Did the image show PIH or a different condition? Was a professional procedure involved?
The skincare industry is exceptionally good at selling speed. Biology is less interested in marketing deadlines.
If money is limited, start here
Living better should not require an unlimited skincare budget. If you cannot buy six serums, that does not mean you cannot make progress. The priorities are surprisingly unglamorous.
Identify and control the cause of the inflammation, avoid picking or traumatising the skin, use a treatment with reasonable evidence that your skin can tolerate, protect the skin from relevant light exposure, moisturise when needed, and give the routine enough time to work.
You do not need every trending ingredient. You certainly do not need to buy everything at once and if a product is irritating your skin, continuing simply because it was expensive does not make the purchase more worthwhile.
If you can spend more, spend it on certainty before complexity
There is an equally important lesson at the other end of the market. Having more money can give you access to dermatologists, prescription treatments, sophisticated lasers, peels and elaborate skincare routines.
It can also give you access to more ways to overtreat your face. Before spending heavily on procedures, it may be more valuable to spend on a good diagnosis.
Is it actually PIH? Is it melasma? Are acne, eczema or another condition driving it? How deep is the pigment likely to be? Would a topical treatment be safer than a procedure? What is the realistic chance of improvement?
The most expensive intervention is not automatically the most advanced one. Sometimes expertise saves money precisely because it tells you what not to do.
When should you stop experimenting and see a dermatologist?
If the pigmentation is appearing without an obvious cause, spreading, changing rapidly, accompanied by other symptoms, affecting large areas, following a medication, or simply not improving despite a sensible routine, professioal assessment is worthwhile.
You should also consider seeing a dermatologist if the underlying acne, eczema or another inflammatory condition is significant, because controlling that condition may be the most important pigmentation treatment you receive.
If you are considering prescription-strength hydroquinone, oral tranexamic acid, strong chemical peels or lasers, professional guidance becomes particularly important.
For darker skin, ideally look for someone with meaningful experience treating skin of colour, rather than assuming every practitioner has equivalent expertise.
63° Take
Hyperpigmentation is difficult partly because pigment biology is complicated, but the wellness and beauty industries have made the problem harder by convincing us that every dark mark needs another product.
It usually doesn't. If we strip away the marketing, the strategy is much clearer.
Treat what is causing the inflammation. Do not create more inflammation while trying to remove the pigment. Use ingredients with evidence rather than building a routine around trends. Protect pigment-prone skin from light. Give treatment enough time to work and when the problem is persistent or complicated, spend money on expertise before spending it on more products.
For darker skin in particular, gentleness and effectiveness are not opposites. Sometimes restraint is part of the treatment and perhaps the most important thing to know is that the science is still developing. The 2024 review focused on skin of colour found significant gaps in the evidence and no universally effective treatment. That is worth remembering whenever a product promises to clear every dark spot.
Established: controlling the underlying inflammation, appropriate topical treatments including retinoids, and photoprotection all have meaningful evidence behind them.
Promising: newer pigment-targeting agents and better visible-light photoprotection are expanding the options available.
Emerging: increasingly sophisticated combinations of topicals and procedures may improve outcomes for specific pigment disorders and skin types.
Unproven: the idea that one viral ingredient, aggressive exfoliation or a universally applicable “dark spot routine” can reliably clear hyperpigmentation for everyone.
The goal is not perfectly uniform skin at any cost. It is healthier skin, better information and knowing which interventions actually deserve your time, money and attention.
Sources
This article provides general information about skin health and photoprotection and is not a substitute for individual dermatological advice.
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