Spot On: How to Reduce Dark Spots on the Face

Anything from acne scars to excessive sun exposure can cause dark spots known as hyperpigmentation or discolouration. When you spend excessive time in the sun, the skin reacts by producing melanin, which helps prevent further damage.

“Dark patches form on the face when melanin accumulates excessively due to different triggering factors, leading to an overproduction of melanin as a reaction to inflammation. At times, the melanin can get deposited in uneven bunches over different areas of the face resembling islands of dark spots,” says Dr Madhuri Agarwal, founder and medical director at Yavana Aesthetics Clinic.

So, what are the triggers that cause the skin to produce dark spots? Dr Agarwal shares the various causes:

• Ageing
• Sun exposure
• Acne
• Vitamin deficiency
• Hormonal changes
• Certain medications

There are several other factors, like pregnancy and side effects of chemotherapy and antidepressant medications, that can cause dark spots. However, “sun exposure is the most common cause of dark spots followed by acne,” she mentions. 

While most dark spots can be prevented or delayed with the correct usage of sunscreen and reduced time spent in the sun, some require the attention of a certified dermatologist to rule out the chances of skin cancer.

There are several treatments to choose from. While some require supervision from a trained expert, the rest can be done at home with over-the-counter (OTC) products. But before starting any cosmetic treatment, consult a board-certified dermatologist. A specialist is needed to determine the best course of action, as the treatments may vary. Some dark spots require oral medications, while others may require in-clinic and topical treatments.

Dr Agarwal suggests the following procedures depending on the condition and intensity of the dark spot.

-   Chemical peels

-   Q-switched laser

These treatments work well on recent and superficial to moderately deep spots.

For old, deep, dark spots that do not respond efficiently to regular options, the following are recommended:

-    Platelet-rich plasma

-   Exosomes

-   Skin boosters 

Often, underlying loss of skin tissue and fibrous scars may contribute to the persistence of overlying dark spots. In any case, one must always consult their doctor before choosing a cosmetic treatment

Treating dark spots requires time and patience, but a dedicated skincare regime helps. However, it is recommended to consult a certified dermatologist to get the correct diagnosis and solution. Dr Agarwal shares some valuable tips to help you choose the right option.

• Basics first: Use a good broad-spectrum sunscreen even when you're indoors.
• Check the ingredients: Recent studies have demonstrated that products containing azelaic acid, tranexamic acid, kojic acid, arbutin, niacinamide, soy and liquorice extracts have been effective.
• Vitamins are essential: Vitamin C and E are good antioxidants that help curb sun damage and should be included in your skincare regime to help reduce dark spots.
• Chemicals are our friends: Glycolic acid, lactic acid, and mandelic acid are chemical exfoliants that help minimise the accumulation of dead skin. However, they must be used sparingly and preferably after consulting your doctor.

There are various treatments to choose from. These can be oral and topical, but one thing common is that “dark spots take time and patience to resolve and may require multipronged care,” according to Dr Agarwal.

“There are no instant solutions. Remember, the darker the skin, the faster the dark spots develop and the longer it can take to resolve them. Prevent dark spots with a good skincare routine and sun protective measures,” she adds.

With so much information online, knowing what to do and not to do can get confusing. Dr Agarwal shares some tips to reduce dark spots:

1. No fairness creams: Avoid using fairness creams that contain steroids and mercury. They might offer immediate results but can cause severe damage to the skin.
2. Follow instructions: Always read the labels to check the ingredients and follow the usage instructions.
3. A patch test is important: Doing a patch test is a must before using a product to ensure you're not sensitive to it and prevent any adverse reactions.
4. Don’t self-medicate: Hydroquinone is effective against dark spots but has side effects, so using it without a dermatologist's prescription is not advisable.
5. Don’t exfoliate: Avoid physical exfoliation as it can worsen inflammation and, thereby, the dark spots.
6. When OTCs do not work: If your pigmentation does not improve or worsens with OTC treatment, please consult a dermatologist as that may be a sign of an underlying skin disease.

Dark spots can be frustrating, but they are treatable. The effectiveness of the treatment differs based on several aspects, such as the type of skin, intensity, spot age, and treatment method. Dr Agarwal iterates, “For Indian skin, we have to be gentle. It usually can take about 4 to 6 weeks to start seeing changes in spots with in-clinic procedural treatment. It can require about 3 to 5 months to see gratifying effects.”

The most common way is to avoid sun exposure and use a broad-spectrum sunblock indoors. Remember to reapply every few hours. Consult a certified dermat to rule out the chances of any underlying condition.

There can be various causes of dark spots, such as ageing, sun exposure, acne, vitamin deficiency, hormonal changes, and certain medications. Sun exposure is the common cause of dark spots, followed by acne.

Yes, but consult your dermatologist before starting any treatment. Recent studies have shown that OTC products containing components like azelaic acid, tranexamic acid, kojic acid, arbutin, niacinamide, soy, and liquorice extracts have produced results.

Typically, changes in spots begin to appear within 4–6 weeks, and it takes about 3–5 months to observe noticeable improvements.

You can try DIY packs with papaya, lemon, honey, gram flour, and banana to help reduce dark spots. Using yoghurt and aloe vera gel is also known to be beneficial. But make sure you do a patch test first and also continue using a good-quality sunscreen.