Signs, causes, treatments, home remedies

Eczema is a skin condition known for causing a range of uncomfortable symptoms, from dry and scaly patches to itchy rashes. A lesser-known symptom is dark spots, sometimes referred to as post-inflammatory hyperpigmentation.

“Any inflammatory process in the skin can lead to discoloration,” she explains Cybele FischmanMD, a board-certified dermatologist with Advanced dermatology PC. “In general, the darker your skin tone, the higher your risk of post-inflammatory hyperpigmentation.”

According to Fishman, these patches are always darker than your natural skin tone, but they can vary from light brown to deep purple.

If you have darker skin, you may also notice spots that are lighter than your natural skin tone Malini FowlerMD, a board-certified dermatologist Westlake Dermatology. This is called hypopigmentation.

Below, dermatologists share how to spot dark spots in eczema, why they appear, and what to do about them.

This type of hyperpigmentation can appear on any area of ​​skin affected by inflammation, Fishman says, but especially in areas exposed to the sun. These patches, which often appear after an eczema flare-up has subsided, may not go away for several months.

Common characteristics of eczema patches are:

  • Color ranging from ash gray to dark brown or deep purple depending on your natural skin tone
  • Dryness, flaking and itching on the discolored areas
  • Ringworming or skin that becomes leathery from frequent scratching and rubbing
  • other general signs of eczema, including skin swelling, blistering, oozing and crusting

However, keep in mind that not everyone with eczema has all of these symptoms, including hyperpigmentation.

Learn more about eczema and how to recognize it.

Eczema causes an inflammatory response in the body. This triggers the release of protein cells called cytokines, which stimulate the cells responsible for producing melanin, explains Michele GreenMD, a board-certified cosmetic dermatologist.

Melanin is a type of pigment that affects your skin color. When melanin production increases, the pigment can transfer to the top layer of skin, causing discoloration.

Not everyone who has eczema will notice these spots. Because people with darker skin naturally have more melanin, they’re more prone to hyperpigmentation, says Green.

Green also points out that sun exposure can trigger or worsen hyperpigmentation because the sun’s UVA rays can cause cells to produce more melanin.

Even scratching the skin can result in darker spots.

The longer an eczema-related discoloration goes untreated, the darker the discoloration can become, Fowler explains.

Usually, dark spots from eczema eventually go away on their own. Still, you may not want to wait months for them to fade.

Your treatment options include:

Prescription Treatment

The most common professional treatment for this type of hyperpigmentation involves topical prescriptions of hydroquinone and tretinoin, Fowler says.

Hydroquinone, a lightening agent, whitens your skin by reducing cells that produce skin pigment. You will generally use it once or twice a day for 3 to 6 months. If you don’t notice results after about 3 months, your dermatologist will likely recommend a different approach.

With an older one Study 2013 of people with melasma, a type of hyperpigmentation associated with hormonal changes, participants used a treatment regimen that included 4 percent hydroquinone and 0.025 percent tretinoin. At the end of the 12-week study, 17 out of 20 participants were satisfied with the effectiveness of the treatment.

However, hydroquinone can make hyperpigmentation worse if you have darker skin. Your dermatologist can provide more guidance on the best treatment approach for your skin care needs.

tretinoin

Tretinoin is a naturally occurring form of vitamin A, or retinoic acid. This topical medication increases the rate at which skin cells are renewed. In other words, it causes old cells to die off more quickly, allowing newer, healthier ones to replace them.

according to a Review 2022Tretinoin appears to help reduce eczema-related discoloration over about 12 weeks, including in Hispanic and Black participants with medium to dark skin.

Studies suggest that hydroquinone and tretinoin may work more effectively when used together.

Keep in mind that hydroquinone and tretinoin can sometimes cause irritation or trigger eczema flare-ups, which can worsen hyperpigmentation. A dermatologist may prescribe a topical steroid alongside these medications to reduce potential irritation.

Laser therapy and chemical peels

Laser therapy and chemical peels can also have benefits, but they do have one higher risk Side effects, including irritation.

Laser ablative procedures remove layers of skin, while laser non-ablative procedures can help tighten skin and promote collagen growth.

Your dermatologist can help you determine the best type of laser therapy for your skin type.

Chemical peels, like glycolic acid peels, remove the top layer of skin, which can help get rid of hyperpigmentation spots. You can have this procedure performed at a dermatologist’s office or by a licensed esthetician at a spa.

research about using chemical peels for hyperpigmentation has found mixed results.

Chemical peels seem to be most effective when used with topical prescription medications like tretinoin and hydroquinone. According to Fowler, if you have sensitive skin prone to irritation, gentler lactic and mandelic acid peels may be a better option.

All of these treatments can increase your sensitivity to the sun, so it’s important to wear sunscreen daily during use.

If you’re looking to treat eczema discoloration at home or are looking for gentler alternatives to prescription treatment, you have a few options.

Fishman suggests considering skincare products with herbal ingredients, which are known to promote lightening by slowing melanin production. This includes ingredients such as:

She points out that you will likely need to use these products for at least 3 months to see results.

Another skincare brightening ingredient that may help lighten hyperpigmentation? Vitamin C.

According to Green, vitamin C may have benefits because it:

  • has anti-inflammatory properties
  • helps reduce the production of melanin
  • has antioxidant properties that help neutralize free radicals caused by sun exposure

Vitamin B-3, which you may know as niacinamide, can also help prevent darker areas of pigment from rising to the top layer of skin where they are visible.

Green also emphasizes the importance of using a moisturizer that repairs the skin’s natural protective barrier, which can promote healing and minimize discoloration. She recommends trying one with ingredients known to help lock in moisture and repair skin, including:

Experts agree that sun protection is key to preventing post-inflammatory hyperpigmentation. Green recommends applying sunscreen with at least SPF 50 daily and reapplying every 90 minutes.

You should also avoid scratching or picking at areas of hyperpigmentation, says Fowler. The trauma this causes stimulates the melanocytes to produce more melanin, resulting in more dark spots.

Additionally, chronic scratching can lead to ringworm or scarring, Green explains. Instead, to ease the itch, she suggests:

  • Soak in a lukewarm oatmeal bath for 15 minutes and pat skin dry
  • Use a rich moisturizer, especially after bathing
  • Applying a cool, wet washcloth to the affected area

Find more home remedies for eczema.

Post-inflammatory hyperpigmentation can happen to anyone, regardless of other eczema symptoms or skin tone. While these patches usually fade on their own after an eczema flare-up has ended, it can take several months.

If you notice these patches developing, a good next step is to contact a dermatologist for more information on your treatment options. Know that relief is possible even if you’re living with severe eczema.

To stave off eczema-related hyperpigmentation, or at least prevent it from getting worse, use sunscreen daily and avoid scratching as much as possible.


Rebecca Strong is a Boston-based freelance writer specializing in health and wellness, fitness, nutrition, lifestyle and beauty. Her work has also appeared in Insider, Bustle, StyleCaster, Eat This Not That, AskMen and Elite Daily.

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