Hyperpigmentation is any patch of skin that has become darker than the surrounding skin because melanocytes produce and deposit excess melanin there. It can occur in every skin type and on any part of the body. The three forms seen most often are solar lentigines, the flat brown spots that accumulate on sun-exposed skin over decades; post-inflammatory hyperpigmentation, the discoloration left after acne, a burn, a rash or a procedure; and melasma, a hormonally driven facial pattern that behaves differently from the other two. Although hyperpigmentation is usually harmless, it can be cosmetically concerning. Dr. Julia Tzu examines the type and depth of pigment before selecting a wavelength. At her Financial District office, she treats sun-driven brown spots with lasers that selectively target melanin while leaving the surrounding unpigmented skin untouched.
5 min read · Last updated: 2026-02-08 · Reviewed by Dr. Julia Tzu , MD, FAAD, FACMS
At a Glance
- Hyperpigmentation occurs when skin cells produce excess melanin, causing darker patches [1]
- Post-inflammatory hyperpigmentation commonly accompanies acne, especially in darker skin tones [2]
- Most dark spots will fade over time after the underlying cause is treated, though it may take many months [1]
- Treatments can take several months to a year to show noticeable improvement [2]
What are the symptoms of Hyperpigmentation?
- Patches or spots darker than surrounding skin
- Flat, darkened areas of various sizes
- Brown, tan, or gray-brown discoloration
- Spots that may enlarge over time
- Clusters of freckle-like spots
- Darkening of areas where skin was injured or inflamed
When should you seek care for Hyperpigmentation?
- Brown or gray patches that bother you cosmetically and have not faded on their own
- A pigmented spot newly appeared, growing, changing color, or looks unlike your others, which needs a cancer evaluation before any cosmetic treatment
- Darkening that appeared where acne, a burn, a rash, or a previous procedure healed
- Facial patterning that arrived during pregnancy or after starting hormonal medication
- Pigment unmoved by over-the-counter lightening products after several months of consistent use
- Any plan to treat pigment with laser, as tanned skin has to be avoided for four weeks beforehand and pigment depth needs assessing first
Have questions about hyperpigmentation? Our team is here to help.
What causes Hyperpigmentation?
- Sun exposure (solar lentigines/age spots)
- Skin injury or inflammation (post-inflammatory hyperpigmentation)
- Hormonal changes (melasma)
- Acne scarring
- Medications causing photosensitivity
- Adrenal disorders
- Vitamin B12 or folic acid deficiency
- Genetic factors
How is Hyperpigmentation treated?
We offer a service to help manage this condition: Laser Treatment .
Prognosis
- Many dark spots fade over time once the cause is addressed
- Sun-related spots may not fade without treatment
- Post-inflammatory hyperpigmentation often improves but can take months to years
- Treatment can significantly lighten most hyperpigmentation
- Ongoing sun protection prevents new spots and recurrence
- Some stubborn pigmentation may require combination treatments
Frequently Asked Questions
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Sources & References
This article draws from 4 peer-reviewed sources.
Medical Institutions
- [1] Cleveland Clinic – Hyperpigmentation
- [3] Cleveland Clinic – Skin Discoloration
Educational & General
- [2] AAD – How to Fade Dark Spots in Darker Skin Tones
- [4] AAD – Melasma Diagnosis and Treatment
Medically reviewed by Dr. Julia Tzu , MD, FAAD, FACMS · Last reviewed: 2026-08-31
Medical Dermatology | Cosmetic Dermatology | Mohs Surgery
World-Class Cosmetic & Surgical Dermatologist in NYC
Julia Tzu, MD, FAAD, FACMS — Financial District, New York
Frequently asked questions
Who evaluates hyperpigmentation for laser treatment, and which type responds most predictably?
Dr. Julia Tzu examines pigment depth before selecting a wavelength and treats sun-driven brown spots with lasers at her Financial District office. Solar lentigines, the flat brown spots caused by cumulative sun exposure, respond most predictably. Laser energy is absorbed by the melanin in the spot and destroys it while leaving the surrounding unpigmented skin alone. Post-inflammatory pigment often fades substantially on its own and is usually approached with topical treatments first. Melasma is managed first with sun protection and topical therapy.
What is hyperpigmentation?
Hyperpigmentation is a common skin condition in which excess melanin makes patches of skin darker than the surrounding area. Common forms include sun spots, also called age spots; post-inflammatory hyperpigmentation left by acne or an injury; and hormonally driven melasma. It is usually harmless but may be cosmetically concerning.
What causes dark spots on the skin?
Dark spots develop when skin cells produce excess melanin. Common causes include sun exposure, which creates age spots; inflammation or injury such as acne; hormonal changes associated with melasma; certain medications; and genetic factors. The cause determines the appropriate treatment approach.
When should I see a dermatologist about dark spots?
See a dermatologist if dark spots bother you cosmetically, if a pigmented area is new or changing, if discoloration developed after acne or another skin injury, or if you want professional treatment options. A clinical evaluation can determine the type of hyperpigmentation and guide treatment selection.
How is hyperpigmentation treated?
Treatment begins with daily sunscreen to prevent the pigment from worsening, and the underlying cause must also be addressed. Options include hydroquinone, vitamin C, azelaic acid, retinoids, chemical peels and laser treatments. Improvement may take months.
Will dark spots fade on their own?
Some dark spots, particularly post-inflammatory hyperpigmentation from acne or an injury, may fade after the cause is treated, although this can take months to years. Sun spots often do not fade without treatment. Consistent sun protection helps prevent new spots and speeds fading.
How can I prevent dark spots from forming?
Prevention centers on sun protection. Use broad-spectrum SPF 30+ sunscreen daily, reapply it every two hours outdoors, wear protective clothing and hats, and avoid tanning beds. Prompt treatment of acne and rashes helps prevent post-inflammatory hyperpigmentation. Avoid picking at or otherwise injuring the skin.
How long before treated dark spots clear?
Complete clearance normally takes more than one session. Treated spots first darken and then flake away over the following weeks. Healing is generally finished within a few weeks per session. Results from laser brown-spot removal often last for several years, and sun exposure afterward determines whether the spots return.
Why is sun avoidance required for four weeks after laser treatment?
Freshly treated skin will produce new pigment if exposed to the sun, creating the same type of dark patch the treatment removed. Sun exposure during the four weeks after a session is the most common reason a good result reverses. Tanned skin before a session also creates a problem because the laser cannot distinguish the tan from the targeted spot.
Can dark spots be a sign of something other than sun damage?
Yes. Adrenal disorders, medications that cause photosensitivity, and vitamin B12 or folate deficiency can produce pigment changes. Separately, a pigmented lesion that is asymmetric, has an irregular border, contains multiple colors, is larger than a pencil eraser, or is changing needs evaluation for melanoma. These possibilities are assessed at the appointment before cosmetic treatment is discussed.
Ready to get started?
Call (212) 931-0538 to book with Dr. Julia Tzu at our Financial District office.