Hyperpigmentation

A darker patch here, an uneven tone there. These concerns are common, very treatable, and almost always mishandled when the cause isn't identified first.

Hyperpigmentation is a broad term for any area of skin that is darker than the surrounding tissue. It covers everything from sun spots and acne marks to melasma and post-inflammatory discoloration. Each type has a different underlying cause and responds to different treatments, which is why a dermatologist's assessment is the best first step. At Element Dermatology in Sartell, MN, we identify the type of hyperpigmentation before recommending treatment.

About This Condition

Types of Hyperpigmentation and What Causes Them

All hyperpigmentation involves an overproduction of melanin, the pigment that gives skin its color. But the trigger for that overproduction varies widely, and the depth at which the excess pigment sits in the skin affects which treatments will reach it effectively. A treatment that works well for surface-level sun spots may do nothing for deeper dermal pigmentation, and a treatment appropriate for post-inflammatory marks may actively worsen melasma.

This is why identifying the type matters before choosing a treatment. The visual appearance of different types of hyperpigmentation can look similar on the surface, and misidentifying the cause can lead to wasted money and, in some cases, a worse outcome than before treatment.

The main types of hyperpigmentation we treat:

Post-Inflammatory Hyperpigmentation (PIH)

Dark marks left behind after skin inflammation from acne, injury, eczema, or other irritation. PIH spots are more common and more pronounced in patients with medium-to-deep skin tones. Often mistaken for scarring, but it's a pigmentary response, not structural damage. Responds well to chemical peels, gentle exfoliation, and brightening treatments over time.

Sun-Induced Hyperpigmentation

Flat brown patches (age spots, solar lentigines, freckles) caused by UV-stimulated overproduction of melanin. Predominantly surface-level and responds well to BBL Hero, which selectively targets and clears excess pigment without affecting surrounding skin. Sun protection is essential afterward to prevent recurrence.

Melasma

A pigmentation condition presenting as symmetrical brown or grayish patches, most commonly on the cheeks, forehead, and upper lip. Melasma is multifactorial, meaning hormones are a common driver, but it can develop even without a hormonal imbalance. It sits deeper and is more reactive than sun-induced pigmentation and requires a more cautious treatment approach. See our dedicated Melasma page for more detail.

Drug-Induced or Dermal Pigmentation

Certain medications, including some antibiotics, antimalarials, and chemotherapy agents, can cause pigmentation changes in the skin. Dermal pigmentation sits deeper than epidermal hyperpigmentation and is harder to treat. Assessment of cause and depth is necessary before any treatment is recommended.

Treated spots are eliminated, but the melanocytes that produced them are still present and will respond to UV exposure by producing more pigment. It’s incredibly important that you apply a broad-spectrum SPF 50 daily after treatment, regardless of cloud cover, to ensure your treatment results last. Without it, hyperpigmentation returns faster than with consistent sun protection.

Targeted Treatments

How We Treat Hyperpigmentation

Schedule Your Hyperpigmentation Consultation Today

Two clinicians in scrubs reviewing information on a tablet at Element Dermatology

Frequently Asked Questions About Hyperpigmentation

Can hyperpigmentation be treated on darker skin tones?

Yes! At Element Dermatology, we use VISIA analysis before any pigmentation treatment to assess subsurface pigmentation and confirm the approach is appropriate for your skin tone. SkinPen, carefully formulated chemical peels, and certain laser and light settings are all effective and safe for a wide range of skin tones when used correctly.

How long does it take to see results?

It depends on the type of hyperpigmentation and the treatment used. Sun-induced spots treated with BBL Hero often show visible fading within one to two weeks as the treated pigment rises to the surface and sheds. Chemical peels and Moxi produce more gradual improvement over a series of treatments, with results building over several weeks. Post-inflammatory hyperpigmentation responds more slowly than UV-induced pigmentation and may take several months of consistent treatment to clear substantially.

Will the dark spots come back after treatment?

The treated spots are completely cleared, not temporarily suppressed. But the melanocytes responsible for producing the excess pigment are still present, and without sun protection, new spots will form over time. Patients who maintain a consistent SPF routine and return for periodic maintenance treatments once or twice a year find their results hold up well over time. For post-inflammatory hyperpigmentation, addressing the source of inflammation (acne, eczema) alongside the pigmentation gives the most durable results.

Are over-the-counter brightening products worth using?

Some can be! Products containing niacinamide, vitamin C, azelaic acid, kojic acid, and alpha arbutin all have evidence supporting their ability to suppress melanin production and help surface pigment shed faster. They work best as maintenance tools between professional treatments rather than as a standalone solution for established hyperpigmentation. The concentrations in over-the-counter products are regulated, which is why prescription-strength topicals and professional treatments produce faster and more pronounced results.