How Do I Get Rid of the Dark Spots Once The Acne is Cleared Up.. (Those Spots Are Killing Me)?

Doctor Answers 4

Dark spots

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It sounds like you have developed post-inflammatory hyperpigmentation after your acne has cleared up. Chemical peels with Jessner's solution/TCA can be effective; further there are lightening creams (hydroquinone, lytera, elure, triluma) that can accelerate the process of diminishing the dark spots. Eventually these dark spots will fade on their own, but depending on sun exposure and how dark the skin is, it can take months or even 1-2 years. 

Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Post Inflammatory Hyperpigmentation (PIH) After Acne Responds Well To Combined At-Home & In-Office Treatments

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Inflammation of any kind, regardless of whether the preceding cause is acne, rosacea, psoriasis, eczema or trauma (surgery or injury) typically resolves in an orderly progression of discolorations in the skin. In general, this fading process involves going from reds, to pinks, to browns (often dark brown) to finally fawn color and back to normal skin tones (assuming no scarring has taken place). The dark brown color, known as post-inflammatory hyperpigmentation or PIH can be quite troubling and can persist for weeks to months following the resolution of the active inflammation (in this case, the acne pimples and pustules).

One approach to treatment is benign neglect, i.e. leaving the spots to fade spontaneously over time and simply covering them with coverup makeup in the interim. Many people, however, are so troubled by the persistant pigmentation that they seek treatment to hasten the fading process.

While I have not been impressed with the results of light and other energy-based treatments for treating this condition, I have found that the most consistent and gratifying results can be achieved through a combination approach of at-home topical PRESCRIPTION-strength lightening creams and a series of in-office peels, either alpha or beta hydroxy acid full strength peels, Jessner's solution (a combination of peeling agents) or TCA 10%-25% peels performed at 2-4 week intervals. The precise lightening agent (and there are now many in addition to hydroquinone) and the particular peeling solutions are best determined after an in-the-flesh examination. Of course, if there is any active acne, this must be first controlled before treating the skin stains. Treatment is best performed by a board certified dermatologist with extensive experience in treating these problems.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Treatment for dark spots (hyperpigmentation) as a result of Acne

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I agree that you most likely are seeing dark spots due to post-inflammatory hyperpigmentation.  In most cases it is best to resolve the active acne first and then you may work on reducing the pigmented areas.  Our practice has seen great results utilizing BroadBand Light therapy for both active acne and PIH.  You can also look into chemical peels and medical grade skin care products containing lighteners to reduce the pigment.

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.8 out of 5 stars 48 reviews

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Dark Spots after acne

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it sounds as if you have post-inflammatory hyper pigmentation. This is very common. It generally goes away but can take many many months. You may want to see someone for possible peels and some skin products that may help. For example, my medical esthetician has done amazing things to help people with problems like yours.

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.