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Not All Dark Spots Are the Same

No. Acne marks (PIH), melasma, sun spots and freckles, and a few other skin conditions can look alike but have different causes, so they need different care. Daily sunscreen and avoiding irritation help all of them; some spots should be checked by a doctor.

Written by the Oliareen editorial teamDermatologist review: pendingLast updated: 6 November 2026How we write

The three common types

  • **Acne marks (PIH):** flat brown to dark spots scattered where acne, picking or irritation happened. More common and longer-lasting in brown skin.
  • **Melasma:** brown patches on both cheeks, the forehead or upper lip, often fairly symmetrical. More common in women; sun, hormones, pregnancy and genes play a part.
  • **Sun spots and freckles:** small brown dots on the nose, cheeks and backs of the hands that increase with sun. Sun spots (solar lentigines) become more common with age.

Other things that can look like dark spots

  • Small raised dark bumps (DPN): small, soft, raised dark bumps on the cheeks and under the eyes; common in South Asian skin and harmless. Creams do not remove them; a doctor can take them off with a small procedure.
  • Dark velvety skin on the neck (acanthosis nigricans): not dirt and does not scrub off; it can be linked to insulin problems or weight, so it is worth a doctor's check.
  • Patches after unknown creams: creams with hidden steroids or mercury can also change skin colour.

Why the cause matters

Acne marks need the acne stopped first. Melasma needs protection from sun and visible light above all, and it tends to come back. Sun spots need sunscreen to stop new ones forming. Harsh scrubs or peels can worsen both melasma and PIH, so guessing wrong and using the wrong thing can make spots darker.

Common mistakes

  • Assuming every spot is a tan and reaching for “fairness” creams.
  • Rubbing lemon, scrubs or home bleach on melasma.
  • Sunscreen only on sunny days, not on cloudy days or by a window indoors.
  • Switching products every two weeks because nothing has changed yet.

What helps every type

  • Daily SPF 30+ with PA+++ or higher; with spots or melasma, consider a tinted (iron oxide) sunscreen.
  • Shade with an umbrella, cap, orna or hijab, together with sunscreen.
  • Avoid irritation: a gentle cleanser and one new ingredient at a time.
  • One spot-fading ingredient used steadily for 8 to 12 weeks, then judge.

A photo cannot settle it

Whether pigment sits near the surface or deeper cannot be told from a photo; doctors use special lights or a dermatoscope, and even these do not always agree. This page gives you a rough idea only; show new or changing spots to a dermatologist.

Questions people ask

Does melasma go away for good?

Melasma can usually be kept under control, but it can return with sun or hormone changes, so protection has to continue all year.

Can dark neck skin be scrubbed off?

No. Thick, velvety dark skin is not dirt; scrubbing only adds irritation and darkness. It can be linked to an internal cause, so see a doctor.

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Sources

  1. DermNet — Postinflammatory hyperpigmentation
  2. DermNet — Melasma
  3. DermNet — Solar lentigo
  4. DermNet — Dermatosis papulosa nigra
  5. DermNet — Acanthosis nigricans
  6. Davis EC, Callender VD. Postinflammatory hyperpigmentation in skin of color. J Clin Aesthet Dermatol 2010
  7. NHS — Moles (when to see a GP about a changing mole)