How to Fade a Dark Mark

When you have acne, an infection, a rash, or some other skin problem, you're probably anxious for it to clear up. Yet even after these complexion woes heal, they may leave a visible reminder that they were once there — a dark mark on your skin.

"Dark marks and scars are the result of inflammation and injury to the skin," says Susan Massick, MD, a dermatologist with the Ohio State University Medical Center in Columbus. "This inflammation induces melanocytes, the pigment- producing cells of the skin, to produce more melanin, which results in darkening in the areas of inflammation. The dermatologic term for this is post- inflammatory hyperpigmentation, or PIH."

Older people may also experience dark marks from hyperpigmentation, commonly called liver spots or age spots, but these are related to sun exposure.

Dark Mark: About PIH

Acne, the most common skin condition, is often to blame for hyperpigmentation. "When an acne pimple or blemish resolves, it can leave these dark marks," says Dr. Massick. The hyperpigmented scars are not permanent, but they can be slow to fade. In fact, an acne mark may persist for as long as three to six months after the pimple has disappeared.

If you develop acne marks or other dark spots on your skin, be patient. "Much can improve just with time," says Massick. She also stresses how important it is to avoid a lot of sun exposure because ultraviolet light induces continued melanin production, which can darken skin spots. "I advise patients to be very consistent with sun protection — and with sun avoidance if possible," Massick adds.

Treating Hyperpigmentation

While over-the-counter (OTC) products with alpha and beta hydroxy acids may help fade hyperpigmentation spots, Massick says the ingredient that provides the most benefit is hydroquinone. It’s available in different strengths — a prescription strength of 4 percent and OTC products in the 1 to 2 percent range.

Keep in mind that even an OTC hydroquinone product must be used carefully, and you need to follow the instructions. Massick says that the U.S. Food and Drug Administration has considered removing most of the OTC hydroquinone products from store shelves because of safety concerns. Before you use an OTC "fade cream" or other treatment for hyperpigmentation, talk to a dermatologist, who can provide patient safety information and teach you how to properly use the product. A dermatologist may also suggest a prescription strength treatment that is more effective.

People may also seek professional skin treatments to fade dark marks on their skin. However, Massick says that although procedures like a chemical peel or microdermabrasion can help alleviate some skin problems, "some patients may experience PIH from the procedures themselves. I advise patients not to be overly aggressive with pursuing these in the beginning."

Properly treating acne will help prevent acne marks from scarring the skin. "If acne isn’t controlled, patients will experience more breakouts, more blemishes, and more PIH," says Massick. Protecting yourself from the sun and working with a dermatologist can further help you prevent and lessen other dark marks on your skin.

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