Post-inflammatory hyperpigmentation (PIH) is an extremely common complication of acne. In fact, it’s estimated that somewhere between 45.5% and 87.2%
of people with acne experience post-acne hyperpigmentation, with cases being more common and more severe in people of color.
While it isn’t life-threatening, hyperpigmentation can be very frustrating and negatively impact self-esteem. Luckily, there are numerous treatment options available. In this article, we’ll explore the 11 best ways to get rid of hyperpigmentation, including over-the-counter products, prescription ingredients, and professional treatments.
Be sure to stay tuned, as I’ll be talking about which treatments worked for me and which ones didn’t. I’ll also be including some of my personal favorites so you’ll know where to start if a certain product catches your attention. With some new information and dedication, you’ll not only be able to see improvement but also feel more confident in your skin. Let’s get started! 😀
Table of Contents
What Is Post-Inflammatory Hyperpigmentation (PIH)?
Post-inflammatory hyperpigmentation, or PIH, refers to dark spots that appear on the skin in areas where acne occurred. Acne causes these dark spots to form because the inflammation associated with acne stimulates the overproduction of melanin – the pigment responsible for skin coloration.
How Long Does It Take for Acne Hyperpigmentation to Fade?
While PIH is not permanent, it can be long-lasting. According to the American Academy of Dermatology (AAD), hyperpigmentation typically takes six to 12 months to fade, with more severe cases taking several years.
What’s the Difference Between Hyperpigmentation and Acne Scars?
It’s important to understand the difference between hyperpigmentation and acne scars. While they’re both skin conditions that can occur as a result of acne, these terms actually describe two separate conditions.
As a reminder, hyperpigmentation involves darkening or discoloration of the skin without any textural changes. Acne scars, however, include sunken or raised areas on the skin that result from the acne healing process.
Acne scarring is often permanent, making it much more challenging to treat than hyperpigmentation. It requires a different set of treatment options, which I’ll talk about in a separate article. For now, let’s get back to hyperpigmentation and its best treatments.
Fun Fact: PIH is not considered true acne scarring because it doesn’t involve permanent, physical changes in the structure of the skin – only temporary dark spots or discoloration.
Top 11 Treatments for Hyperpigmentation
As a quick overview, here are the 11 best ways to get rid of hyperpigmentation:
- Sunscreen
- Vitamin C
- Retinol and tretinoin
- Tranexamic acid (TXA)
- Kojic acid
- Alpha arbutin
- Hydroquinone (HQ)
- Laser treatment
- Chemical peels
- Dermabrasion and microdermabrasion
- Microneedling
As a quick note, I’ve listed all of the treatments above in order of intensity, from least intense to most intense. Hopefully, this will give you an idea of where to start and help you find the approach that best suits your specific needs and preferences. 🙂
1. Sunscreen
Overview
Sunscreen has multiple benefits. Not only does it protect against harmful UV rays, but it also shields against further skin discoloration. Sun exposure can cause existing acne scars to darken more, making them even more noticeable and difficult to fade.
Strength & Availability
While sunscreen is crucial for preventing further darkening and protecting the skin from UV damage, it does not directly treat or fade existing dark spots. Therefore, sunscreen is considered to be a low-strength ingredient for hyperpigmentation. Accordingly, sunscreen is available over-the-counter.
How to Use
You should already be wearing sunscreen every day. (Yes, this also includes days when the sun isn’t out.). Although it differs from person to person, a general rule is that you should apply ¼ teaspoon (approximately two finger-lengths) of sunscreen to your face, neck, and ears every morning as the last step of your skincare routine and reapply every two hours.
Bonus Information: If you want to see the math on how the ¼ teaspoon amount of sunscreen was determined, check out this Youtube Short
Personal Experience & Recommendations
I have tried dozens of different sunscreens. Here are my two favorite, cruelty-free face sunscreens that leave no white cast:
2. Vitamin C
Overview
Another gentle ingredient that you might want to try is vitamin C. Vitamin C is an antioxidant that reduces inflammation, promotes collagen production, and brightens the skin. These properties combined can improve the appearance of acne-related hyperpigmentation.
Strength & Availability
In terms of strength, vitamin C is a low-strength ingredient for hyperpigmentation that can be found over-the-counter.
How to Use
The best time of day to apply a vitamin C skincare product is in the morning, after you wash your face but before you put on your moisturizer and sunscreen.
Personal Experience & Recommendations
While vitamin C has been helpful in terms of brightening my complexion overall, I haven’t found it to have a particularly noticeable effect when it comes to treating hyperpigmentation so I won’t be making any specific recommendations.
Pro Tip: Make sure that any vitamin C product that you use comes in either a dark-colored or opaque container. This minimizes vitamin C degradation
3. Retinol and Tretinoin
Overview
Retinol and tretinoin are both forms of vitamin A that are effective for treating acne hyperpigmentation. They work by increasing cell turnover and promoting the growth of new skin cells, which actively helps dark spots fade more quickly.
Strength & Availability
The main difference between these two ingredients is that tretinoin is a much stronger active compared to retinol. Retinol is a medium-strength ingredient, while tretinoin is a high-strength ingredient. Consequently, retinol is available over-the-counter, while tretinoin requires a prescription.
Bonus Information: Retinol and tretinoin are not only effective at treating hyperpigmentation but also at preventing acne breakouts and wrinkles.
To learn more about the differences between retinol and tretinoin and figure out what the best option is for you, be sure to check out my “Best Over-the-Counter Acne Medications
How to Use
It’s best to use retinol or tretinoin at night, after you wash your face but before you apply your moisturizer. Since retinol and tretinoin are more potent ingredients, you should only apply a pea-sized amount, as the risk of skin irritation is greater.
Pro Tip: If you experience irritation, you can try the sandwich method, where you apply a layer of moisturizer first, and then the retinol or tretinoin, followed by a second layer of moisturizer.
Personal Experience & Recommendations
I’ve been using tretinoin for several years now, and it has done absolute wonders for my skin! I definitely recommend it for anyone with moderate to severe acne. To get a prescription for tretinoin, you’ll need to speak with a dermatologist.
4. Tranexamic Acid (TXA)
Overview
Tranexamic acid is an ingredient that helps with hyperpigmentation, amongst several other skin conditions. In addition to its anti-inflammatory properties, TXA inhibits melanin production, which helps lighten existing dark spots and prevent the formation of new ones.
Strength & Availability
Tranexamic acid is a medium-strength ingredient for combating acne hyperpigmentation. While it’s not as easy to find as some other hyperpigmentation-fighting ingredients, topical TXA is available over-the-counter.
Pro Tip: Even though it may be tempting to immediately go for the strongest active ingredient, I would recommend against this. Stronger ingredients usually come with more side effects so it’s usually best to start with a lower-strength ingredient and see how it works for you.
TXA can serve as a great substitute for tretinoin and the subsequent treatments discussed in this article because it can be highly effective with fewer unwanted side effects.
How to Use
Topical tranexamic acid should be applied at night, after you wash your face but before you apply your moisturizer.
Personal Experience & Recommendations
I’ve used TXA in the past, and, unfortunately, it didn’t do much for my skin so I won’t be making any recommendations. However, it’s worth a try, as it works for many people, is relatively inexpensive, and can be purchased without a prescription.
5. Kojic Acid
Overview
Kojic acid is a natural product that’s derived from certain types of fungi. Among several other uses, kojic acid is an active ingredient that can help combat hyperpigmentation caused by acne. Kojic acid works by inhibiting melanin production and is also a powerful antioxidant.
Strength & Availability
Kojic acid is a medium-strength ingredient for fighting hyperpigmentation and can be found over-the-counter. The selection of kojic acid skincare products isn’t as extensive as that of many of the other ingredients that we’ve talked about. However, kojic acid is gaining popularity, and more skincare brands are starting to include this active in their formulations.
How to Use
Kojic acid skincare products can be used both in the morning and at night, after cleansing and before moisturizing. For use in the morning, just be sure to apply sunscreen afterwards. If you’re noticing sensitivity, try using kojic acid only in the evening and make sure to use plenty of moisturizer. 🙂
Personal Experience & Recommendations
I haven’t tried any kojic acid skincare products yet so I won’t be making any personal recommendations for this ingredient.
6. Alpha Arbutin
Overview
Alpha arbutin is an incredible ingredient for hyperpigmentation. It works similarly to TXA and kojic acid in that it also inhibits the production of melanin, which helps to actively fade post-acne hyperpigmentation.
Strength & Availability
Alpha arbutin is a high-strength skincare ingredient. Despite this, alpha arbutin is available over-the-counter.
How to Use
The best time of day to apply an alpha arbutin skincare product is at night, after you wash your face but before you put on your moisturizer.
Personal Experience & Recommendations
I’ve found alpha arbutin to be the best over-the-counter ingredient for hyperpigmentation – second to only one other ingredient, which I’ll talk about next. My favorite is Alpha Arbutin 2% + HA Hyperpigmentation Serum by The Ordinary. It’s very effective and also budget-friendly. 🙂
7. Hydroquinone (HQ)
Overview
Last but definitely not least of the topical options is hydroquinone. HQ is a highly effective skin-lightening ingredient that works through a mechanism similar to that of alpha arbutin to fade dark spots. Hydroquinone blocks melanin production and is considered to be the gold standard for treating skin hyperpigmentation.
Strength & Availability
Hydroquinone is a high-strength ingredient that is only available by prescription. It should be used with caution and under the guidance of a healthcare professional. Typically, it’s required that you take at least a two- to three-month break in between treatment periods of HQ to avoid undesirable side effects.
How to Use
Your dermatologist will give you specific instructions on how to use HQ. Usually, hydroquinone can be used twice a day, both in the morning and in the evening. Like with most other treatments, you should apply HQ after washing your face but before applying moisturizer.
Personal Experience & Recommendations
Hydroquinone is by far the best ingredient that I’ve found for acne hyperpigmentation. In my experience, it got rid of unwanted dark spots in a very short period of time and came with no unpleasant side effects. HQ was able to significantly lighten or completely eliminate areas of hyperpigmentation that everything else that I tried previously could not.
Important Note: The remaining options that I’ll be discussing in this article are all more in the realm of treatments and procedures that require specialized training. Accordingly, they can only be performed by licensed healthcare professionals (e.g. surgeons, physicians, physician assistants, and nurses) and certain estheticians.
Even though these treatments can be used to combat hyperpigmentation, it’s best to try over-the-counter and/or prescription ingredients first. Sessions for the following treatments are usually pretty pricey. Additionally, multiple sessions are typically required for best results so it can add up quickly.
Finally, I won’t be making any recommendations, as I haven’t personally tried the following treatments for hyperpigmentation. However, they are well-studied treatment options that you may want to consider if you have a severe case of hyperpigmentation.
8. Laser Treatment
Overview
Laser treatment, or laser resurfacing, uses targeted beams of light to get rid of hyperpigmentation. Laser therapy penetrates the skin, breaks apart pigmented skin cells, and stimulates collagen production, contributing to a more even skin tone.
Strength & Availability
There are two types of laser treatments: non-ablative and ablative.
Non-ablative lasers work by delivering heat without injuring the surface of the skin. They are more gentle and associated with fewer complications and a shorter recovery period. However, non-ablative laser treatments are often considered to be less effective than their ablative counterparts.
Ablative lasers work by removing certain layers of skin. They are more intense and come with a greater risk of side effects. However, ablative laser treatments are usually more effective at delivering results than non-ablative laser treatments.
9. Chemical Peels
Overview
Another option for treating hyperpigmentation is chemical peels. A chemical peel involves applying a chemical solution – usually an acid at a higher concentration – to the skin. Chemical peels work by removing the outermost layer of damaged skin, revealing smoother, brighter skin underneath.
Strength & Availability
There are many different types of chemical peels of varying strengths, all composed of different ingredients to target different skin needs. While there are some chemical peels that are available over-the-counter, you may want to consider a professional-grade treatment by a trained dermatologist, as they tend to be more effective.
10. Dermabrasion and Microdermabrasion
Overview
Dermabrasion is a skin-resurfacing procedure that involves gently removing the top layers of a skin with a handheld, high-speed, rotating device. The instrument removes scrapes away skin, and new, smoother skin grows back.
Strength & Availability
Another option is microdermabrasion, which is the less invasive form of traditional dermabrasion. Unlike dermabrasion, microdermabrasion involves no bleeding, minimal downtime, and fewer risks.
The better option really comes down to your specific needs. For overall clearer and more glowy skin, microdermabrasion is the way to go. However, if you’re looking to treat more stubborn skin concerns, you might want to consider traditional dermabrasion.
11. Microneedling
Overview
Last but not least for treating skin hyperpigmentation is microneedling. Microneedling is a procedure that involves creating tiny punctures in the skin using a device with fine needles. This process stimulates the skin’s natural healing response and promotes the production of collagen and elastin.
Strength & Availability
There are different types of microneedling, with the main differences being needle length and number of needles. Your licensed healthcare provider will determine the best option for your skin needs.
Summary
That just about wraps it up! Before you go, here’s a chart summarizing the 11 methods of getting rid of hyperpigmentation that we discussed in this article:
Feel free to refer back to this chart whenever you need! 😀
Conclusion
I hope you found this article helpful! Acne is already challenging enough without having to deal with hyperpigmentation on top of it. That’s why I wanted to write an article that’ll provide you with a good starting point. Keep in mind that it’s always best to speak with a dermatologist, as they’re specifically trained to treat complex skin conditions!
Lastly, I want to leave you with this. As you’ve probably heard before, prevention is the best medicine. While there are many options out there that can effectively treat post-acne hyperpigmentation, it’s most important to treat your acne first.
If you’re still having pretty consistent breakouts and don’t know where to start, check out my “Skincare Ingredients: The Best Over-the-Counter Acne Medications” article. In it, I talk about the top acne medications that you can get without a prescription, how they work, and where you can get them. This way, you’re not just doing damage control but also actively treating the root problem. 🙂
That’s it for now! See you in my next article. As always, stay healthy and keep learning.