Hyperpigmentation, melanin, sunscreen and skin tone

Acne dark spots

A pimple's inflammation leaves flat marks; azelaic acid, a retinoid, vitamin C or niacinamide fades them over months, while a sunken or raised scar needs a dermatologist.

  • Post-Inflammatory Hyperpigmentation (PIH)
  • Acne Scars
  • Daily Sunscreen
  • Over-the-Counter Actives

Last reviewed

Mark or scar check

One mark, three answers. The check sorts it by touch and color; it cannot see your skin.

Flat dark spotDeep pigmentSunken scarRaised scar
Acne dark spots sit in the skin's color; acne scars change its shape
Run a finger over it
What color is it
Your skin type or tone
Your result shows here Answer all three.

What acne dark spots are

Acne dark spots are flat patches of extra color left behind after a pimple heals, called post-inflammatory hyperpigmentation. It means the mark sits in the skin's color, not its shape, so a flat spot is usually not a scar. The cause of acne dark spots is inflammation: a pimple pushes pigment cells to make more melanin, and that melanin stays in the skin after the pimple is gone.

On lighter skin the mark is often red or pink. On medium or darker skin it is usually brown or bluish gray.

In a photo study of 2,895 women, hyperpigmentation showed up in 65% of African American and 48% of Hispanic women, against 25% of Caucasian and 18% of Asian women.

Causes and Differences

The difference between a mark and a scar is texture: a mark changes color and stays level, a scar changes shape.

Acne dark spots vs acne scars
TypeFeelsColorFades on its own?What helps
Post-Inflammatory Hyperpigmentation (PIH)FlatBrown, purple or gray-blueYes: 6 to 12 months if a few shades darker, years if grayDaily sunscreen and a fading active
Red markFlatPink or red (post-inflammatory erythema), more common in lighter skinYes, over months or longerTime, sunscreen, and treating the acne
Acne ScarsSunken: ice pick, rolling or boxcarSkin colored, or shadowed in side lightNoIn-office procedures
Raised scarFirm bump: hypertrophic or keloidPink, red or darkerNo; more common in darker skinA dermatologist; early pressure for a keloid

Triggers

  • Picking or squeezing a pimple raises inflammation, which means more pigment.
  • Sun darkens the patch and slows the fade.
  • A product that stings or burns irritates the skin and can cause new spots.
  • Some medicines can darken spots. Do not stop a medicine on your own; ask the doctor who prescribed it.

Brown spots that show up on sun-exposed skin with age, with no pimple first, are age spots, not acne marks.

Effective Treatments

Treatment for acne dark spots is daily sunscreen plus one fading active, kept up for months.

Daily Sunscreen
Use SPF 30 or higher, broad spectrum, water resistant and non-comedogenic (won't clog pores). A tinted one with iron oxide also blocks visible light. Outdoors, reapply every two hours.
Over-the-Counter Actives
Look for azelaic acid, glycolic acid, kojic acid, a retinoid such as retinol or adapalene gel, vitamin C or niacinamide. Start with one; marks fade over months, not days.
Targeted Products
Serums, creams and patches for dark spots work through what is in them, so check the label for one of the actives above. Buy a US-made product or one your dermatologist names: imported creams have been found with hidden steroids or mercury. Never put liquid bleach on skin.
In-Office Procedures
A dermatologist can prescribe stronger hydroquinone or use chemical peels and lasers. In darker skin, even at-home peels can leave permanent dark or light marks, so see a dermatologist who treats skin of color first.

Not sure if it is a mark or a scar? A photo check sorts it.

Treat the acne first

New marks stop when breakouts stop, so treat the acne and the dark spots at the same time. A retinoid plus benzoyl peroxide works well in skin of color, and the idea that benzoyl peroxide causes light spots is a myth. Adapalene 0.1% gel is sold without a prescription.

Related guides

A flat mark fades, but a pit or a raised scar stays, so it pays to know how to prevent acne scars before the next breakout heals.

When to see a dermatologist

  • A mark has not faded after 6 to 12 months of daily sunscreen.
  • The color is gray or blue-gray.
  • Skin thickens or grows past the old spot, a sign of a keloid; early pressure can help.
  • You see pits or raised scars.
  • Dark patches appear with no pimple before them.

Quick answers about dark spots

What fades dark spots the fastest?

Nothing works overnight. Stop new breakouts, wear sunscreen daily and use one fading active, like azelaic acid or vitamin C. Most flat marks still take months.

What are the treatment options for dark spots?

At home: daily sunscreen plus an active like azelaic acid, glycolic acid, kojic acid, a retinoid, vitamin C or niacinamide. At a dermatologist: prescription hydroquinone, chemical peels or lasers.

What are the causes of dark spots on the face?

After acne, it is inflammation telling pigment cells to make extra melanin, and sun makes it worse. Spots that come with age and sun, with no pimple first, are something else.

What are liver spots?

Flat brown age spots on skin that gets a lot of sun. They don't come from pimples, so they are not acne marks.

What are the most effective ways to remove acne scars?

Flat marks fade with time and sunscreen. Real scars, the sunken or raised kind, don't, so they need procedures from a dermatologist. Not sure which one you have? A photo analysis can tell you.

Sources

Last reviewed . This page is general information, not a diagnosis. See a dermatologist if a mark has not faded after 6 to 12 months of daily sunscreen, looks gray or blue-gray, is sunken or raised, or keeps growing.