The skin is the largest organ in the body! It protects our muscles, skeletal system, and organs. It’s also in charge of releasing some toxins. Since our skin does so much to protect and support our systems, it should be no surprise that skin conditions can be caused by several external and internal imbalances.
Dark spots on the skin are usually caused by outside traumas (inflammation, sun damage, or irritation) or internal causes, like medication side effects and poor liver function.
There are five main types of dark skin spots, including:
Also known as age spots or liver spots, sunspots are dark spots on the skin caused by sun damage. They can range in size, color, and shape, though they are usually light brown, dark brown, and even black.
These spots appear after too much exposure to the sun over time. Since they’re caused by sun damage, they only appear on areas of the body that aren’t covered by clothing or sunscreen.
Melasma is another common type of dark spot. These spots result from skin damage and appear most often on women of color and pregnant women. Also known as the ‘mask of pregnancy,’ these spots look blotchy and can cover large portions of the skin’s surface.
Melasma can look as mild as a scattering of light freckles or change the color of a patch of skin entirely. It’s often caused by overexposure to the sun, hormonal changes, and medication side effects.
Inflammation is possibly one of the most common types of dark spots (and can be one of the easiest to treat). Inflammation happens as the result of skin trauma, including acne, lacerations, cuts, cysts, and swelling.
During the skin’s healing process, the dermis boosts up its production of collagen. If the skin produces too much collagen, the inflamed area can turn a dark brown. If the skin doesn’t provide enough collagen, it will not grow back properly and leave an abscess in its place.
Diabetic dermopathy spots appear on the legs of diabetes patients. This happens when the blood in the legs leaks from the blood vessels and onto the skin. While this sounds awful, it’s actually not as bad as you’d think.
It’s a very common condition that doesn’t hurt or create any further problems. They even go away on their own once your blood/glucose levels return to normal.
Melanoma is a serious skin condition that can lead to cancer. It’s important to get dark spots on your skin (like moles) checked — especially if they look irregular.
Cancerous spots often look asymmetrical and/or raised from the skin or feel ‘bumpy.’ Again, if a new spot appears or if an old one suddenly changes in shape or size, it’s best to contact your dermatologist to schedule a check-up or get a biopsy.
While the reasons for dark skin spots can vary, all spots have common risk factors. The most common risk factors for these spots can include:
Medication side effects
Sun overexposure is one of the leading risk factors for dark spots on the skin. Nearly every cause of dark spots is worsened or affected by sun overexposure.
The sun’s UV and UVB rays can lead to skin pigmentation cells' reproduction and produce more pigment. This is why sun overexposure can lead to sunspots, dark spots, melasma, and melanoma.
Hormonal fluctuations are another main risk factor in developing dark spots. Women are more likely than men to develop dark spots, and pregnant women are more likely than non-pregnant women to develop these spots.
In fact, melasma is often referred to as ‘the mask of pregnancy’ since so many women develop dark spots on their skin (especially their faces) while pregnant.
Hormone replacement therapy and other hormonal-based medications can also lead to dark spots appearing on the skin.
Common skin issues, such as acne and eczema, can also lead to dark spots. These issues can cause inflammation on the skin and lead to scarring and lesions.
If you suffer from chronic acne or eczema (or even other issues like psoriasis), you may be predisposed to developing these dark spots. We recommend getting ahead of the issue by following the below preventative tips and treating dark spots on the face as soon as they appear.
Other types of skin trauma may also lead to dark spots and scars. This can include cuts, lacerations, burns, or bruising.
Most of the time, these dark spots can go away on their own. If the skin trauma is too severe, you may end up with a dark scar or spot until you have it removed or lightened.
Some medications may actually increase pigmentation in the skin. The most common medications that increase pigmentation include:
Non-steroidal anti-inflammatory drugs (NSAIDs like Ibuprofen)
In many cases, the dark spots should disappear once you stop taking the medication. If you’re on antipsychotic drugs or other long-term medications, you may want to talk to your doctor about mitigating side effects.
Certain medical conditions may also increase your risk of developing dark skin spots. The two most common conditions that heighten your risk of dark spots include liver disease and diabetes.
Some liver conditions can lead to dark spots on the skin, including liver disease and Hepatitis C. These spots are often large and patchy. Many patients often mistake these spots for psoriasis since they look like large, scaly patches.
People that suffer from diabetes are also more prone to dark skin spots. When blood glucose levels are off, the blood can leak out of the veins and onto the skin.
If you suffer from diabetes, you don’t need to worry about these spots. They’re harmless and will go away on their own once your glucose levels are back to normal.
If you have any of the above predispositions, you’re more likely to develop dark spots on your skin. The main causes of dark spots on the skin include:
Sun damage is one of the main causes of dark spots — specifically sunspots. People that spend large amounts of time in the sun have a higher risk of developing these spots.
Couple that with any of the other above risk factors? You’ll be more likely to develop not only sunspots but also melanoma, melasma, and scarring.
If you spend any amount of time in the sun or live in a sunny area of the world, you should wear sunscreen with a high SPF and consider wearing long sleeves, pants, and a hat to protect yourself from dark spots appearing on your face.
Hormonal fluctuations are another known cause of dark spots on the skin. These fluctuations happen most frequently in pregnant women and women on hormone replacement therapy (though they can happen due to natural hormonal fluctuations as well).
Certain medications, such as NSAIDs and antipsychotics, can also cause dark spots to appear on the surface of the skin. This is referred to as drug-induced hyperpigmentation.
Medications cause 10-to-20% of hyperpigmentation cases. This pigmentation can look like intense bruising or scarring. The shapes of the dark spots can be circular or look like long scrapes.
This can also be caused by high levels of heavy metals in the body.
Skin issues, such as acne, psoriasis, and eczema, can damage the skin and lead to dark spots and scarring. These issues can lead to inflammation and force the skin to overproduce collagen. While collagen is ‘good’ for healthy and firm skin in most instances, too much of it can lead to dark spots.
Scarring is another leading cause of dark skin spots. Lacerations, cuts, and bruises can lead to a build-up of tissue as the skin grows back. This can also happen because of inflammation from acne too. If you’re prone to acne or bruise easily, you may want to consider some of the below preventative measures to ensure your dark spots don’t become permanent.
Skin irritations such as perfumes, cosmetics, dyes, and chemicals can also cause dark spots. If you think irritants may cause your dark spots, you may want to stop using all perfumes, cosmetics, and hairsprays to see if the spots go away. If they don’t, you may want to order a home testing kit with an allergen panel.
Unbalanced blood glucose levels in diabetes patients can also lead to dark spots. If you suffer from diabetes, you may want to chat with your doctor to see how you can get your glucose levels under control with lifestyle changes and medications.
If you’re at high risk for developing dark skin spots or have suffered from such spots in the past, we recommend taking preventative measures. This will lessen the chance you’ll develop spots; even if you do still develop them, ideally, your spots will be less noticeable or go away faster.
If your skin spots result from (or worsened by) sun exposure, you should prevent sunburns and brown spots by wearing sunscreen with a high SPF and protective clothing. Incorporating SPF into your daily skincare routine is an easy way to combat the dark spots on your face.
People with darker skin tones are more susceptible to sun damage and the appearance of dark spots.
Popping your own pimples and trying to remove dark patches on your own can lead to further skin damage. When you pop your own pimples, you risk infecting your skin and increasing collagen production (which can lead to dark spots).
Over-the-counter topical moisturizers, cleansers, and spot treatments can only go so far as to reduce melanin production. If you suffer from chronic dark spots or have any of the above issues that raise the risk of developing dark spots (such as a darker skin tone or hormonal fluctuations), you may want to consider prescription skincare.
Exfoliating may seem like a no-brainer when it comes to lightening dark spots. But exfoliating incorrectly can actually worsen dark spots. ‘Home remedies’ such as using lemon juice or other acids to lighten the skin can actually worsen scarring and create more inflammation.
If you’re already suffering from dark skin spots, there are plenty of treatments that are known to brighten skin.
Prescription skincare can both help prevent dark skin spots and treat them. Prescription cleansers, moisturizers, and spot treatments often contain lightening agents such as hydroquinone, vitamin C, and glycolic acid.
Dermatology treatments such as microdermabrasion gently remove the top layers of the skin, brightening dark spots.
Chemical peels are a more aggressive form of microdermabrasion and are used in more severe cases to treat dark spots.
If your dark spots are chronic or haven’t faded after other treatment options, you may want to consider laser treatments. While more invasive, laser treatments can help reduce the appearance of such spots when other treatments just won’t do the trick.
It’s important to get your dark skin spots checked by a doctor or dermatologist. Don’t rely solely on estheticians to check your spots because, in some cases, they may be an indication of skin cancers, like melanoma.
If you’re worried about heading to a doctor or don’t live near a good dermatologist, you can always get your spots checked online.
Simply upload photos of your dark skin spots onto any telehealth dermatologist platform, and you should find out if your spots need to be biopsied.
Waiting to get your dark skin spots treated will only worsen the spots and make them harder to treat. We recommend reaching out to an online dermatologist to get a personalized treatment plan to eradicate uneven and dark skin spots.