How to Remove Black Marks on my Face From Pimples? (photo)

Hi, This is the first time i got a big pimple and i started pinching it and the pimples spread over just like anything on my left cheek and the result is full of black marks which are just like chicken pox black marks. Could you please look into the below picture once and let me know the solution so that it will a great help for me. Thanks in advance, Sravanthi

Doctor Answers 19

The PIH will resolve in most cases

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Thanks for the question and including the photos that show what we call post-inflammatory
hyperpigmentation or PIH as a result of the acne and your pinching or picking at them. You need a
consultation with a board-certified dermatologist to get your acne under control and to determine the
best treatment for the PIH. Over time, the PIH will resolve in most cases. Various bleaching creams,
including hydroquinone and some of the “active” fading cosmeceuticals can also work well here. Light
chemical peels also can improve PIH when needed, so find the right provider and see what will work best
for you.


Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Sunscreen, Hydroquinone, Lytera and chemical peels

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You have what is known as PIH or post inflammatory hyperpigmentation- a super common condition that occurs in darker skin patients after the event of acne. The treatment of this condition is as follows-

1. Sunscreen and sunprotection- this forms the absolute cornerstone of management. You need to be on this for the duration of any treatment .

2. If you can get hold of HQ or bleaching cream (hydroquinone), I would use 5-7 % daily. For at least 8 weeks. 

3. If no HQ is available, Lytera is a good agent. 

4. Chemical peels such as glycolic acid can help. You will need 4-7 treatments over the next few months. 

5. Vitamin A such as tretinoin can help. 

The best treatment is a combination of the above. 

Cheers

Dr Davin Lim 
Laser and aesthetic Dermatologist
Brisbane, AUSTRALIA

Treating Discoloration From Acne

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Based on what I see in your pictures, it appears you have mostly discoloration (hyperpigmentation) from the acne lesions.  This is very common, especially in darker skin types. In addition to treating the active acne, there are treatments that can help fade the dark spots, specifically topical RetinA (tretinoin) and hydroquinone which can both help to lighten the color.  There are also office-based treatments such as Silkpeel Dermalinfusion which can help exfoliate the skin and improve the discoloration. I recommend you consult with a board-certified dermatologist to discuss what will work best for your skin. 

How to treat discoloration from acne

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Hi Sravanthi,

Thanks for the question. Acne is an inflammatory problem and the inflammation from acne bumps can irritate the color producing cells in the skin. This can result in darker (hyperpigmented) or lighter (hypopigmented) skin in the area of an acne bump. Discoloration from acne can be very frustrating for patients. Here is how I treat it.

1) Treat and cure the patient's acne. This is most important. The inflammatory process of acne must be shut down in order to prevent skin discoloration. Each patient is different, however, all patient's must be put on a successful regimen for their acne before the discoloration can truly improve.

2) Treat the discoloration. There are multiple ways to help with the discoloration. The most often successful and important are to practice sun protection with strict sun screen use and to use a fade cream such as hydroquinone. In addition to these basic treatment, select patients may benefit from chemical peels, retinoid creams, and laser treatments.

Hope this helps! Take care!

Tarek M. Fakhouri, MD
Houston Dermatologic Surgeon

Dark spots from pimples

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You have what's called post inflammatory hyperpigmentation (PIH).  It is very common in dark skin individuals following any type of inflammatory process (pimples, burns, cuts, chemical peels or laser treatments).  It can improve on it's own but you need to use sunscreen over it while it is healing and protect it from direct sun exposure.  Prescription strength skin lightening creams such as Hydroquinone 4% can also speed up the process.  It not meant to be used for long term as it can cause side effects.  Intense Pulsed Light (IPL) is a great options as it is safer on darker skin types, but will require multiple treatments.  Fractional lasers can also lighten the skin and is usually safer for darker skin types than traditional CO2 lasers (which can cause a lot of uneven pigmentation in dark skin individuals).  It can also improve the appearance of the scars as well.  A series of light chemical peels may also help but you have to be very careful with the chemical peels with your dark skin type since they can make the PIH a lot worse if they are the deeper peels.  Best wishes.

Dark stains from acne

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Dark stains from acne usually resolve by themselves after many months. Avoiding sun exposure, especially when they are red, may help reduce the risk of getting dark spots somewhat. There are over-the-counter bleaching creams that help lighten the spots and prescription creams that work much better.

Black marks after acne are PIH

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Post inflammatory hyperpigmentation is not permanent but occurs in non-Caucasian skin tones after acne has resolved. Sun avoidance, sun screen, a comprehensive cream program can keep this at bay. Chemical peels such as the 3 step peel assist in this great. 

Zein E. Obagi, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Start Slow

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Hello,

Thank you for your question. Acne scars can be difficult to treat. Based on your pictures it may be best to start slow. You may consider a skin care regime like Obagi. It can help to fade some of the dark spots and even out skin tone. It is best to consult with a local physician. Good luck!

Black Marks after Acne

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When Dark skin heals – it heals with pigmentation – called post inflammatory hyper-pigmentation. 

Typically it can resolve in 8 months on its own.  Dr. Ebrahim strongly recommends against the use of lasers or light based therapy.  Sun block is really important to protect the face.  If skin is exposed to the sun it can actually make the pigmentation worse

The only thing that Dr. E recommends is a topical bleaching creams to lighten and fade the pigmentation. 

Pigmentation Treatments

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Hello,

To treat this pigmentation, depending on your needs I would recommend a combination of treatments. These include laser therapy, chemical peels, microneedling, (with or without PRP), microneedling with radio frequency, and topical products.  It's important to see a dermatologist so they can identify which treatments will work best for the pigmentation you're experiencing.
Best,
Dr. Elkeeb

Laila Elkeeb, MD, FAAD
Corona Del Mar Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.