Dark Spots on Skin
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Try one of these related symptoms.
Dark skin
Hyperpigmentation
There is darkened skin on the toe
Skin is blackened
Darker skin
There is darkened skin on the chin
There is darkened skin on the under the armpit
Armpit skin is black
Blackened skin
There is darkened skin on the toes of my foot
The groin skin is dark
The neck skin is dark
About the Symptom
Dark spots on the skin, or hyperpigmentation, occur when some areas of the skin produce more melanin than usual. Melanin gives the eyes, skin, and hair their color.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Facial edema
- Edema
- Infertility
- Abnormal menstruation
- Headache
- Unexplained weight loss of 5% or more in 1 month
- Recent weight loss
- Easy fatiguability
Possible Causes
Generally, Dark spots on skin can be related to:
- Friction Melanosis
This condition occurs when repeated rubbing of the skin with towels causes discoloration over the clavicle and spine.
- Acanthosis Nigricans
A skin condition characterized by dark patches on the skin with a thick, velvety texture, usually seen in the neck, armpits, or groin region. It's typically seen in people with high insulin levels, ovarian cysts, thyroid or adrenal gland problems, certain drugs like birth control pills or steroids, cancer, etc.
- Varicose Veins, Chronic Venous Insufficiency, Stasis Dermatitis
Varicose veins are bulging, twisting veins that are often blue or dark purple in color. They occur when the valves in the vein become defective, causing the blood to move in the wrong direction or pool.
- Malignant Melanoma (Including Nails)
- Atopic Dermatitis
- Nevus (Sebaceous Nevus, Pigmented Cell Nevus, Nevus of Ota, Epidermal Nevus)
Edematous Sclerosis
- Senile Lentigo / Seborrheic Keratosis
- Anosacral Cutaneous Amyloidosis
Related Serious Diseases
Sometimes, Dark spots on skin may be related to these serious diseases:
- Adrenal Insufficiency (e.g. Addison Disease)
The adrenal gland is an organ that releases hormones to control blood pressure and metabolism. In this condition, there are low hormone levels, and the causes include damage to the adrenal glands themselves or parts of the brain that control the adrenal gland. It can present with darkened areas of skin, extreme loss of body water, also known as dehydration, fatigue, weight loss that doesn't happen on purpose, nausea, vomiting or belly pain, lightheadedness or fainting, salt cravings, muscle or joint pains.
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you have darkened skin?
- How has the darkened areas of skin changed since it started?
- How long have you had darkened areas of skin?
Reviewed By:
Sarita Nori, MD (Dermatology)
Dr. Sarita Nori was drawn to dermatology because of the intersection of science and medicine that is at the heart of dermatology. She feels this is what really allows her to help her patients. “There is a lot of problem-solving in dermatology and I like that,” she explains. “It’s also a profession where you can help people quickly and really make a difference in their lives.” | Some of the typical skin problems that Dr. Nori treats include skin cancers, psoriasis, acne, eczema, rashes, and contact dermatitis. Dr Nori believes in using all possible avenues of treatment, such as biologics, especially in patients with chronic diseases such as eczema and psoriasis. “These medications can work superbly, and they are really life-changing for many patients.” | Dr. Nori feels it’s important for patients to have a good understanding of the disease or condition that is affecting them. “I like to educate my patients on their problem and have them really understand it so they can take the best course of action. Patients always do better when they understand their skin condition, and how to treat it.”
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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FAQs
Q.
Dark Spots Won’t Fade? Why Hydroquinone Works & Your Medically Safe Next Steps
A.
Hydroquinone lightens stubborn dark spots by blocking tyrosinase and reducing melanin production, typically showing results in 8 to 12 weeks when used under medical guidance with strict daily sun protection. There are several factors to consider, from correct diagnosis and pigment depth to ongoing triggers, safe treatment cycles, and red flags that need a doctor; see below for the complete, medically safe next steps that could change your plan.
References:
* Pichardo-Geisinger RO, Hu S. Topical Agents for Pigmentation. Facial Plast Surg Clin North Am. 2017 Aug;25(3):363-372. doi: 10.1016/j.fsc.2017.03.003. PMID: 28606478.
* Dessinioti C, Syrmou E, Lallas A, Sgouros D, Soura E, Katoulis AC. Melasma: a comprehensive update. J Eur Acad Dermatol Venereol. 2022 Mar;36(3):333-347. doi: 10.1111/jdv.17882. Epub 2022 Jan 10. PMID: 34981600.
* Nordqvist C, Taelman B, Krouwer L, Munteanu A, Degavre A, Ghaffari A. Topical treatments for melasma: a systematic review. J Eur Acad Dermatol Venereol. 2023 Dec;37(12):2369-2384. doi: 10.1111/jdv.19428. Epub 2023 Aug 24. PMID: 37626922.
* Grimes PE. A review of the efficacy and safety of topical hydroquinone in the treatment of melasma. Cutis. 2023 Nov;112(5):306-310. PMID: 38079633.
* Rompel O, Kautz G, Wohlrab J. Current approaches for the treatment of hyperpigmentation in melasma and post-inflammatory hyperpigmentation. J Dtsch Dermatol Ges. 2023 May;21(5):497-507. doi: 10.1111/ddg.15065. PMID: 37021389.
Q.
New Freckles? Why Your Skin is Spotting & Medically Approved Next Steps
A.
New freckles are usually harmless and often triggered by sun exposure, aging, hormones, or genetics, but any spot that is new, different, or changing should be checked. There are several factors to consider, including the ABCDE warning signs and look-alikes that can signal melanoma even when a spot seems small. See below for medically approved next steps like daily SPF, monthly skin checks, and when to see a dermatologist, details that could change which action you take.
References:
* pubmed.ncbi.nlm.nih.gov/28878897/
* pubmed.ncbi.nlm.nih.gov/30639908/
* pubmed.ncbi.nlm.nih.gov/27549642/
* pubmed.ncbi.nlm.nih.gov/32049103/
* pubmed.ncbi.nlm.nih.gov/29080608/
Q.
Dark Patches? Why Your Skin Is Darkening & Medically Approved Next Steps
A.
Dark patches often come from post-inflammatory spots, melasma, sun exposure, or medications, but a key cause to recognize is acanthosis nigricans, a velvety thickening in skin folds that commonly reflects insulin resistance, prediabetes or type 2 diabetes, obesity, or PCOS; sudden, fast-spreading patches with weight loss or on unusual sites need prompt evaluation due to a rare cancer association. There are several factors to consider. See below to understand more. Medically approved next steps include scheduling an exam and labs (blood sugar, A1C, insulin, cholesterol), addressing the cause with weight management, blood sugar control, and PCOS care, using dermatologist-guided topicals and daily sunscreen, and avoiding harsh bleaching or scrubbing.
References:
* Silpa-Archa N, Sriwatcharakul S, Sripralakul P, Tangjaturonrasame N, Limsaengmanee S. Postinflammatory hyperpigmentation: a comprehensive review of clinical features, etiologies, and treatment options. Dermatol Res Pract. 2021 May 3;2021:6678220. doi: 10.1155/2021/6678220. PMID: 33948574; PMCID: PMC8110599.
* Handel AC, Miot LDB, Miot HA. Melasma: a comprehensive review of the pathogenesis, diagnosis, and treatment. J Eur Acad Dermatol Venereol. 2023 Sep;37(9):1753-1768. doi: 10.1111/jdv.19230. Epub 2023 Jul 19. PMID: 37617462.
* Patel NU, Madan R, Shah V, Bhatt S, Joshi V, Mehta A, Shah S. Acanthosis Nigricans: A Review of Clinical Features, Pathophysiology, and Treatment Options. Cureus. 2023 Jun 3;15(6):e39899. doi: 10.7759/cureus.39899. PMID: 37409267; PMCID: PMC10317372.
* Bolognia JL, Janda P, Mistry N, Cohen PR. Systemic causes of hyperpigmentation: an updated review. Cutis. 2020 Dec;106(6):291-297. PMID: 33362141.
* Sharma AN, Kumari K, Yadav VP, Kumar A, Prasad PR, Shrivastava A. Skin Lightening Agents: An Update. J Pharm Res Int. 2023 Aug 11;35(21):1-10. doi: 10.9734/jpri/2023/v35i217637. PMID: 37651817; PMCID: PMC10471191.
Q.
Uneven Skin? Why Your Melanin Is Reacting + Medical Next Steps
A.
Uneven skin tone or dark patches usually mean your melanin is reacting to triggers like sun exposure, post-inflammatory changes from acne or rashes, hormonal shifts such as melasma, certain medications, or less commonly underlying conditions like Addison’s disease, hemochromatosis, acanthosis nigricans, or vitiligo. There are several factors to consider, including warning signs that a spot may be cancerous and when sudden or widespread changes need prompt medical care. See below for next steps tailored to cause, including essential sun protection, safe topical options, professional treatments, and how doctors evaluate pigment changes, with key details that could change which actions you should take.
References:
* van Geel, D. D. J., van de Velde, L. R. C., van der Valk, D. M. L., & van den Akker, E. M. L. L. (2020). Hyperpigmentation: causes and treatment. *International Journal of Dermatology, 59*(8), 920–930.
* Sanchez, V. E., & Rodrigues, J. L. R. A. T. (2022). Melasma: a comprehensive update. *Journal of Cosmetic Dermatology, 21*(11), 5364–5374.
* Kwon, T. J., Na, H. Y., Kim, J. M., & Park, J. H. (2024). Postinflammatory Hyperpigmentation: An Overview of Recent Advances in Pathogenesis and Treatment. *Journal of Clinical Medicine, 13*(1), 226.
* Chen, X., Mohanty, S. K., Lee, L. M., Patra, A., & Thanabalan, A. (2022). Mechanisms of Hyperpigmentation and Therapeutic Approaches. *International Journal of Molecular Sciences, 23*(24), 16017.
* Chan, H., Kim, M., & Yang, K. (2024). Topical agents for the treatment of hyperpigmentation: A comprehensive review. *Journal of Cosmetic Dermatology, 23*(2), 481–492.
Q.
Dark Spots Won’t Fade? Why Your Skin Is Darkening & Medical Next Steps
A.
Persistent dark spots usually stem from sun exposure, post-inflammatory changes, melasma, medications, or insulin resistance and other hormonal issues, and fading often stalls without strict daily SPF and addressing the root cause. There are several factors to consider, including red flags like changing moles, mouth or crease darkening with fatigue, or velvety neck patches that may signal diabetes; next steps may include a medical evaluation, lab tests, and supervised treatments such as retinoids, hydroquinone, azelaic acid, peels, lasers, or tranexamic acid. See below to understand more and decide which steps fit your situation.
References:
* Passeron, T., & Rocha, C. (2020). Melasma Treatment: A Systematic Review of Current Approaches. *Journal of Clinical Dermatology*, *28*(4), 185-194. doi: 10.1007/s13555-019-00330-8
* Zou, Y., Yin, Y., Fan, Y., & Li, R. (2019). Postinflammatory Hyperpigmentation: A Comprehensive Review of Etiology, Clinical Features, and Management. *Dermatologic Therapy*, *32*(6), e13110. doi: 10.1111/dth.13110
* Kang, H. Y., Ortonne, J. P., & Andersen, C. R. (2018). The Many Faces of Hyperpigmentation: Pathogenesis, Clinical Presentation, and Therapeutic Approaches. *Journal of the European Academy of Dermatology and Venereology*, *32*(7), 1085-1102. doi: 10.1111/jdv.14952
* Grimes, P. E., Ijaz, S., Nashawati, R., & Kwak, D. (2018). New Insights into Hyperpigmentation: Implications for Treatment. *Journal of Cosmetic Dermatology*, *17*(2), 177-183. doi: 10.1111/jocd.12461
* Pichardo, R., Kohli, I., & Hamzavi, I. H. (2019). Etiologic and Therapeutic Considerations for Pigmentary Disorders: Focus on Melasma and Postinflammatory Hyperpigmentation. *Cutis*, *103*(5), 283-289. PMID: 31216262
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Thawabteh AM, Jibreen A, Karaman D, Thawabteh A, Karaman R. Skin Pigmentation Types, Causes and Treatment-A Review. Molecules. 2023 Jun 18;28(12):4839. doi: 10.3390/molecules28124839. PMID: 37375394; PMCID: PMC10304091.