Adult acne has been on the rise, with more people in their 20s-40s looking for solutions to unexplained breakouts.
Treating acne is one thing — but there's also the aftermath. Some people can develop post-inflammatory hyperpigmentation (PIH), a type of scarring that can be difficult to conceal and may darken over time — long after the initial pimples have cleared.
According to Dr. Hope Mitchell, a board-certified dermatologist and founder of Mitchell Dermatology, hyperpigmentation can occur from sun damage or melasma, but the type she sees the most occurs after skin trauma like acne, bug bites, eczema, and psoriasis.
It's also a skin condition that disproportionately affects people with darker skin tones — Black Americans make up to 10% of the world's population dealing with hyperpigmentation, and one study found up to 47-65% of non-white patients had acne-induced PIH. It's a large focus of #BlackGirlSkinCare on TikTok, where people ask for advice or post regimens they used. Sometimes, people just want to commiserate in the comments; a 2017 study found that PIH negatively impacted self-perception and social functioning.
Treating hyperpigmentation isn't always intuitive, but there are solutions. So we spoke to Dr. Mitchell about the best ways to prevent and fade dark spots.
Never skip sunscreen — one sunburn can undo everything
It's tempting to tan away the hyperpigmentation, with the hope that the spots will blend into darker skin.
However, sun exposure has the reverse effect and makes spots more prominent.
"Fading or improving pigmentation is impossible if we don't prevent the continued darkening of the areas of concern by ultraviolet and visible light," Mitchell told Insider. "I tell my patients all the time that we must protect what we correct."
All your progress can be undone from one bad sunburn, making sunscreen and minimal sun exposure the biggest step to keep in mind.
Since white cast is often a concern in finding sunscreens for darker skin tones, Mitchell recommended a few options:
- Supergoop Unseen for a lightweight option;
- Aveeno Ultra-Calming Daily Moisturizer that "blends nicely into darker skin tones";
- Aveeno Positively Radiant Daily Moisturizer with SPF 30 for a great 2-in-1 product;
- ISDIN Eryfotona Ageless SPF 50 which repairs sun damage;
- La Roche Posay Anthelios Melt-In-Milk and Anthelios Ultra Light Fluid Facial Sunscreen that use UV light filters to protect against skin cancer.
Address breakouts early
Hyperpigmentation is a secondary response to skin trauma like acne, so until the acne breakouts are reduced, you'll keep getting new dark spots even as you clear older ones.
Every person's skin is different, which is why Mitchell recommended "early prevention and treatment at the first sign of hyperpigmentation" and following the treatment plan recommended by your dermatologist.
Maintaining healthy skin is the best way to reduce acne, so sticking to a consistent routine and swapping sugary or caffeinated drinks with water are some key core habits.
Use gentler exfoliants
Mitchell said it's wise to "be proactive about using an acne regimen that gently helps with exfoliation." At the same time, harsh mechanical exfoliants that physically scrape away dead skin cells can lead to damaged, uneven skin, especially in people already more prone to hyperpigmentation.
Chemical exfoliants and gentler cleansers unclog pores without causing irritation. Mitchell's favorites include:
- Hyper Skin Gentle Brightening Gel Cleanser with Mandelic Acid (which fades dark spots);
- CeraVe SA Cleanser for gentle exfoliation;
- RoC Multi Correxion Revive + Glow Gel Facial Cleanser With Vitamin C for glowy skin.
Incorporate products that increase cell turnover or decrease pigmentation
After she addresses the primary skin condition causing hyperpigmentation, Mitchell creates a regimen for her patients to improve discoloration. It can include vitamin C serums and retinoids — which increase cell turnover and create fresh skin — or products with kojic acid, niacinamide, arbutase, hydroquinone, or alpha-hydroxy acids that have unique benefits in fading dark spots.
Mitchell's favorite products include:
- CeraVe Skin Renewing Vitamin C Serum (with hydrating hyaluronic acid);
- Resurfacing Retinol Serum, specifically designed for acne marks;
- RoC Multi Correxion Even Tone + Lift Resurfacing Serum for brightening skin.
If you have persistent scarring, Mitchell suggested following the above routine while seeking in-office procedures involving microneedling and lasers. They can be more expensive (at least $200 per session on average) but lead to faster results.
