What Causes Skin Discolourations (and How to Get Rid of Them)

Skin discolourations are something everyone will experience at some point, particularly if you have a medium to dark skin tone. The following is our research-supported guide explaining the different types of discolourations, complete with tips on how you can get rid of dark spots—or at least minimise their appearance.

Different Types of Skin Discolourations

There are two primary types of discolouration:

• Hyperpigmentation: Hyperpigmentation involves the overproduction and uneven distribution of melanin, the pigment that gives skin its colour. This excess melanin leads to spots and patches that are noticeably darker than the surrounding skin. While hyperpigmentation can occur anywhere, it is most common in areas routinely exposed to UV light.
• Hypopigmentation: Hypopigmentation refers to a partial or total loss of and it’s primarily caused by cumulative sun damage, skin injury, and the skin disorder vitiligo. Vitiligo requires dermatologic attention, as no skincare product can stop its progression. However, some find that using self-tanner helps make their skin colour look more even. For this extra-vulnerable skin, daily use of sunscreen is essential for protection. 

Some people wonder if skin discolourations go away on their own. Besides post-inflammatory hyperpigmentation, discolourations don’t fade or disappear completely without the help of key skincare products and, in some cases, dermatologist intervention.

Skin discolouration treatments cover a wide range of topical ingredients, some of which are available by prescription. When used alongside essentials like a broad-spectrum non-comedogenic sunscreen rated SPF 30+ and a leave-on chemical exfoliant, they can make a big difference for many types of discolouration. The trick is patience and consistency. It’s easier said than done, but most people will find the results worth the wait.

Uneven Skin Tone

What does uneven skin tone look like: Skin on the face and neck areas with varied colours; sometimes sallow or grey, with or without clusters of dark spots. Skin may look dull in areas, normal in others, and its texture may also be uneven.

What causes uneven skin tone: Photoaging, also known as sun damage. It’s a cumulative process, which is why uneven skin tone often shows up in early adulthood and progresses as we age.

How can I visibly improve uneven skin tone: Introducing a leave-on AHA or BHA exfoliant into your routine can help shed the buildup of dead surface cells that contribute to dullness.

You can also pair this with a niacinamide product to not only potentially improve your skin tone, but also help with enlarged pores and rough texture. If you have an uneven tone on your body, a body treatment with a 5% concentration of niacinamide can help fight dullness and discolourations stemming from sun damage, aging, or shaving.

Vitamin C serums are also great for dark spots as well as wrinkles and loss of firmness, making it a must-have for any anti-aging skincare routine. Ascorbic acid (pure Vitamin C) is the most researched form, but there are other forms too, often combined in one formula.

Dark Spots

What do dark spots look like: Also known as age spots, sunspots, brown spots, and liver spots, these are smaller, concentrated discolourations that show up most often on the high points of the face, hands, and arms—areas routinely exposed to UV light. Flat and smooth, dark spots can also have an uneven border, and they tend to darken further with ongoing unprotected UV exposure.

Important note: Please visit a dermatologist if you notice dark spots that: 

• Have an irregular border
• Are wider than the tip of a pencil eraser
• Show two or more colours
• Scab and bleed

All of these can be signs of skin cancer requiring prompt medical attention.

What causes dark spots: Sun exposure is the primary culprit, but they can also be triggered by indoor tanning. Dark spots may also occur from injury to the skin.

How can I visibly improve dark spots: Research has firmly established that most people struggling with stubborn dark spots may need to use multiple products or ingredients to see a significant difference. This necessity stems from the spot’s complex formation process, which involves many pathways within the skin. Different topical ingredients target specific pathways in this process, each contributing to how skin looks over time.

The ingredients with the most research supporting their efficacy for fading the appearance of dark spots and larger areas of patchy discolourations include:

• Hydroquinone (available by prescription)
• Retinol and prescription retinoids
• Vitamin C (ascorbic acid) and derivatives
• Niacinamide
• Liquorice root and derivatives
• Azelaic acid
• Tranexamic acid (topical and oral)
• Cysteamine

Note: All these ingredients work well together. While you don’t need a product containing every single one, it can be highly beneficial to use at least two of these ingredients, or simply select a highly-quality product that features several of them.

Fading dark spots takes time, often up to 12 weeks of application of topical products, morning and night. Daily sun protection is a must. If you’re not willing to commit to applying a broad-spectrum sunscreen rated SPF 30 or greater, improving the appearance of your dark spots will be incredibly challenging (it’s akin to putting on a raincoat when you’re already soaked).

White Spots

Also known as hypopigmentation and medically termed as idiopathic guttate hypomelanosis, these spots involve a partial or total loss of melanin pigment.

What do white spots look like: These are small spots that show a noticeable loss or lightening of pigment. They will naturally be less apparent on lighter skin and significantly more noticeable on darker skin.

What causes white spots: Sun exposure is the most common cause (are you seeing a pattern here?). While sun-induced dark spots occur from the overproduction of melanin, white spots indicate areas that the skin has stopped making melanin or can no longer produce the normal amount of melanin. Once the melanin-making cells deeper in the skin are destroyed, the white spot unfortunately becomes permanent.

White spots can also have other causes that require evaluation by a dermatologist. These include exposure to harmful chemicals, yeast infections, autoimmune disorders, and nutritional deficiencies involving Vitamin B12, Copper, and Iron.

How can I visibly reduce white spots: Currently, no treatments exist to alleviate this concern. Your best option is to commit to the daily use of sunscreen and sun-protective clothing to prevent the occurrence of more spots and keep existing spots from enlarging. Some may find that using a self-tanner helps create a more even look with the surrounding skin.

Freckles

What do freckles look like: Freckles are small to medium-sized spots typically dotting the high points of the face, like the bridge of the nose and tops of the cheeks, though they can occur anywhere unprotected skin is exposed to the sun. Their colour varies: people with light skin tones tend to have reddish-tan to light brown freckling, while those with more melanin tend to see dark brown to black freckling.

What causes freckles: Freckles are typically triggered by unprotected exposure to UV light. They’re our skin’s effort to protect itself from sun damage, but they can also indicate an uneven or low amount of melanin. This explains why freckles are more common in those with very light to medium skin tones, although people with darker skin tones can get freckles as well. While research has shown there’s a genetic component to freckles, UV exposure is still part of the process that causes them to appear.

How to visibly improve freckles: Unlike more pronounced dark spots, most people are perfectly content with their freckles and don’t seek treatment. 

However, if you find them distressing, the same ingredients mentioned for improving the appearance of dark spots will also help fade freckles, alongside diligent use of sunscreen (and sun avoidance for very fair, highly freckled skin). Most people find that using a leave-on Vitamin C treatment, coupled with an antioxidant-rich sunscreen, does the trick.

Post-Inflammatory Hyperpigmentation (PIH)

What does PIH look like: For those with very light to light skin colour, PIH typically appears as pink to red marks where a skin disruption, like acne, has occurred. People with medium or darker skin tones will see a light tan, brown, or black mark, which can be confused with hyperpigmentation caused by sun exposure.

What causes PIH: PIH is triggered by any time of skin trauma, including acne, burns, picking at the skin, or laser treatments, which is why this type of hyperpigmentation is so common! It tends to fade on its own, but this process can take over a year to fully occur.

How can I visibly fade PIH: Since this type of hyperpigmentation tends to reside in skin’s uppermost layers, you can speed up its fading with the routine use of a leave-on chemical exfoliant containing glycolic acid and/or salicylic acid.

Daily sunscreen use is important, especially for darker skin tones, since PIH involves excess melanin.

Other options to help fade PIH include the same ingredients mentioned for dark spots, with special emphasis on tranexamic acid and azelaic acid. Furthermore, anything you do to soothe and calm skin will help; this can be as simple as avoiding common sources of skin irritation, such as fragrances and harsh scrubs.

Melasma

What does melasma look like: Melasma appears as brown to brownish-grey patches on the skin, often on the perimeter of the face and sometimes extending down both sides of the neck. It may also cluster around the nose and mouth. There’s usually a clear line of demarcation where the discoloured areas meet the skin’s natural colour. Freckling or diffuse clusters of dark spots may be visible within the larger areas of discolouration.

What causes melasma: The causes are complex and multifactorial, but they’re typically related to long-term sun damage from tanning, genetics, pregnancy, birth control pills, or other hormonal fluctuations.

How can I visibly improve melasma: Pack your patience! Melasma is stubborn and demands strict adherence to sun protection measures. Sunscreen is essential, but so are hats, sunglasses, sun-protective clothing, and avoiding extended periods of time in direct sunlight. The infrared (heat) energy the sun emits is a hidden trigger of melasma, as are other sources of heat, such as a hot stove.

Combination therapy is necessary to give you the best chance of satisfying results. That means using topical over-the-counter and, possibly, prescription treatments (often hydroquinone or a hydroquinone-retinoid blend) with OTC options. These include products with tranexamic acid, higher concentrations of ascorbic acid (Vitamin C), retinol with bakuchiol, and azelaic acid. These ingredients can potentially further improve signs of discolouration. You can begin with the over-the-counter options, used at least once daily for 12 weeks, and evaluate results before determining if prescription options are needed.

It’s also a good idea to consult your dermatologist about having a series of laser treatments for melasma. Since melanin is responsive to a wide range of laser frequencies, no single laser is deemed best for this concern. Instead, research has shown positive results from different types. Research has also indicated that such treatments should be performed alongside skin care options and daily sun protection.

Another point to keep in mind: Blue light exposure can trigger or worsen melasma. The biggest culprit is the blue light emitted by digital devices. Holding that smartphone close to your face multiple times a day risks hyperpigmentation unless you set your display to night mode (the name varies by phone model). This step disables blue light in favour of harmless yellow light. You can do this on your tablets, laptops, and desktop displays, too! This concern is more pronounced for those with darker skin tones, since they literally have more melanin for the blue light to “excite”. The melanin “senses” the blue light and reacts by speeding up processes that create excess melanin, leading to hyperpigmentation.

Does Hyperpigmentation Look Different on Darker Skin Tones than Lighter Skin?

Hyperpigmentation will present itself differently depending on a person’s skin colour. Those with a darker complexion have more melanosomes, the cells that make and store melanin. The more melanin-rich the skin, the more likely it is to experience hyperpigmentation.

The flip side is that those with lighter skin tones (less melanin) are generally more prone to hyperpigmentation related to unprotected sun exposure. The extra melanin in people of colour offers some built-in environmental protection—melanin is an antioxidant—which explains why darker skin tends to show signs of aging later in life than those with light skin. Although that’s a plus, it doesn’t mean people with melanin-rich skin can skip the sunscreen.

Shop Paula’s Choice pigmentation removal products.

References for This Information

Indian Journal of Dermatology, September-October 2016, pages 487–495

Journal of the European Academy of Dermatology and Venerology, September 2017, pages 17–21

American Journal of Clinical Dermatology, August 2018, pages 489–503

Annals of Dermatology, June 2016, pages 279–289

Journal of the American Academy of Dermatology, May 2019, pages 1,233–1,250

Pigment Cell Melanoma Research, November 2016, pages 607–618

Journal of Cutaneous and Aesthetic Surgery, January–March 2013, pages 4–11

Journal of Oral and Maxillofacial Pathology, May–August 2020, pages 374–382

The Journal of Clinical and Aesthetic Dermatology, February 2015, pages 43–47

 Journal of Drugs in Dermatology, Volume 18, Issue 8, August 2019, ePublication

Madireddy S, Crane JS. Hypopigmented Macules, Updated October 2020. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2021

Forensic Science International, Genetics, September 2019, pages 252–259

Journal of Drugs in Dermatology, Volume 19, Issue 8, July 2020, ePublication

Indian Journal of Dermatology, January-February 2020, pages 5–10

Journal of Cutaneous Medicine and Surgery, January-February 2021, pages 77–86

Dermatology Online Journal, Volume 25, Issue 10, October 2019, pages 1–6

Anais Brasileiros de Dermatologia, September-October 2014, pages 771–782

The Journal of Dermatological Treatment, February 2020, pages 77–83

Journal of Investigative Dermatology, January 2018, pages 171–178

International Journal of Molecular Sciences, September 2018, pages 1–44

Journal of Drugs in Dermatology, March 2021, pages 344–345

Cutis, February 2006, Supplement 2, pages 22–24

International Journal of Cosmetic Science, October 2021, pages 495–509