How to get rid of dark spots on your face

Dark spots on the face have many causes, and the right fix depends on the cause. This guide gives the order that the American Academy of Dermatology (AAD) recommends: find the cause, protect the skin from light, and then add one ingredient that fades spots. It also covers what a dermatologist can do when home care is too slow. For the science behind each step, see Skinli's guide to hyperpigmentation.

Step 1: find out what causes your spots

The AAD says getting rid of dark spots begins with finding out why they appear. If you can eliminate the cause, many spots clear on their own, and you can stop new ones from forming.

These are the common causes of dark spots on the face, with a clue for each one:

Cause	Clue	First step
A healed pimple	Flat spot where a pimple was	Treat the acne. See dark marks after pimples
Years of sun	Flat brown spots on the face, hands and shoulders, often after age 50	Sun protection. See sun spots
Hormones, sun and genes	Brown or gray-brown patches on both cheeks, forehead or upper lip	See melasma
An irritating product	New spots after starting a product that stings	Switch to gentle, fragrance-free products
A cut, burn or insect bite	Spot where the skin was hurt	Let it heal and avoid injuring it again
A medicine	Spots that started after a new medicine	Ask the doctor who prescribed it

MedlinePlus lists more causes of darker skin, including certain medicines such as minocycline and birth control pills, pregnancy, sun, and hormone conditions such as Addison disease. The skin discoloration page covers these, and lighter patches too. If you think a medicine causes your spots, the AAD says to keep taking it and ask the prescribing doctor whether skin discoloration is a known side effect. Stopping a medicine on your own could make you sick.

For product irritation, the AAD suggests gentler products, often labeled "for sensitive skin" or "fragrance-free." Once the skin is no longer irritated, new spots tend to stop appearing.

Step 2: protect your face from light

The AAD says effective treatment for dark spots begins with sunscreen. It recommends a tinted sunscreen with iron oxide. Iron oxide protects against visible light, the ordinary light we see, which the AAD names as a cause of dark spots. It is listed among the inactive ingredients on the label.

The AAD also asks that the sunscreen offer:

• SPF 30 or higher
• Broad-spectrum protection, which covers both types of ultraviolet rays
• Water resistance
• A non-comedogenic formula, made so it does not clog pores, if your skin is oily
• A shade that blends with your skin tone

Put it on before going outside, on every part of your skin that clothing will not cover. Reapply every two hours outdoors and after swimming or sweating. The AAD also suggests a wide-brimmed hat and less time outside between 10 a.m. and 2 p.m., when the sun is strongest. It says up to 80% of the sun's harmful UV rays can pass through clouds, so cloudy days count too.

Sunscreen is the step that makes everything else work. Without it, sun keeps making new color while a fading cream tries to remove the old color.

Step 3: add one ingredient that fades spots

Once the cause is under control and sunscreen is a habit, the AAD says a product that fades dark spots tends to work better. It lists five ingredients you can buy without a prescription. It says they can fade existing spots and, in some cases, slow the making of melanin, the pigment behind the spots.

Ingredient	Good to know	Skinli guide
Azelaic acid	Also treats acne, so it suits acne marks	Azelaic acid for dark spots
A retinoid (retinol, adapalene gel, tretinoin, tazarotene)	Adapalene 0.1% is sold without a prescription. Tretinoin needs one	Retinol and tretinoin for dark spots
Vitamin C	Breaks down in light and air, so storage matters	Vitamin C for dark spots
Glycolic acid	On the AAD list of ingredients that fade spots	Not covered in this hub
Kojic acid	On the AAD list of ingredients that fade spots	Not covered in this hub

Niacinamide is missing from the AAD's list, though studies have tested it. The niacinamide page explains what those studies found.

How to start a new product safely

• One product at a time. If your skin reacts, you will know which product caused it.
• Patch test first. Try it on a small area for several days. The guide on how to patch test a new skincare product gives the steps.
• Stop anything that burns or stings. The AAD says so directly, because irritation can make new dark spots.
• Check the strength. The AAD says labels for retinol products sold without a prescription do not have to state the percentage, so start with the mildest product you can find.

If you still get pimples

When acne is still active, the acne treatment can help with both problems. The AAD says a retinoid applied to the skin clears pores and can help lighten dark spots after acne clears, and that azelaic acid treats both acne and the dark spots it leaves. Picking one of these two means one product works on both problems, which keeps the routine short and lowers the chance of irritation.

Adapalene 0.1% gel is a retinoid sold without a prescription. The guide on how to start adapalene covers a slow start, and the complete acne skincare routine shows where it fits. The AAD says acne treatment takes at least 6 to 8 weeks before you see fewer breakouts, and the marks fade after that.

Products to avoid

Some products sold to fade dark spots can harm you.

• Hydroquinone bought over the counter. The FDA says no skin lightening product is legally sold over the counter in the US. It has received reports of rashes, facial swelling and ochronosis, a skin discoloration that may be permanent, from hydroquinone products.
• Imported creams with hidden ingredients. The FDA has found high levels of mercury in some skin lightening creams. Mercury absorbed through the skin can damage the kidneys and nerves. The AAD adds that researchers have found steroids or mercury missing from product labels, and suggests buying products made in the United States or recommended by a dermatologist.
• Liquid bleach. The AAD says it is harmful and should never go on your skin.

What a dermatologist can do

If home care does not give the result you want, the AAD says a dermatologist can help. Some spots need a prescription-strength treatment, and a dermatologist can safely combine treatments.

Option	What it is	What the sources say
Prescription cream	Stronger retinoids, or hydroquinone creams	The FDA says Tri-Luma, a prescription cream with hydroquinone, is approved for short-term treatment of melasma
Laser treatment	Light energy aimed at the spot	One or two sessions can treat age spots quickly. It can cause crusting or temporary darkening
Cryosurgery	Freezing the spot	Common for age spots. It may leave a blister, redness or swelling for a short time
Chemical peel	A chemical solution put on the skin	Effective for age spots on the hands. It heals faster than freezing
Microdermabrasion	Smoothing away the top layer of skin	The AAD says studies show it works for age spots, best when combined with a chemical peel

On darker skin, the AAD warns that even at-home versions of peels, microdermabrasion and laser can cause permanent dark marks and light spots. Choose a dermatologist who treats skin of color often.

Check the spot before you treat it

Not every dark spot is harmless. The AAD says what looks like an age spot could be skin cancer, and fading a skin cancer with a cream can give it time to grow and spread. It recommends a skin exam by a board-certified dermatologist before treating age spots.

See a doctor soon for any spot that is new and unlike your other spots, that changes in size, shape or color, or that itches or bleeds. The page on when a dark spot needs a doctor explains the warning signs.

A simple routine for a face with dark spots

A plain routine is easier to keep, and steady use matters more than the number of products.

Morning: a gentle cleanser, the fading ingredient if it is one you use in the morning, a light moisturizer, and tinted sunscreen SPF 30 or higher.

Night: a gentle cleanser, your acne treatment or retinoid if you use one, and moisturizer.

Skinli's 12-week acne plan follows this shape. The acne gels go on at night. When the photo shows flat marks, an azelaic acid 10% cream goes on in the morning from week 5, before sunscreen. For how long each type of spot takes to fade, read how long dark marks take to fade.