Probably the most frustrating thing about hyperpigmentation is how long it takes to go away. This makes it hard to know if a treatment is failing or if it just hasn’t had enough time to work. There many reasons for this including the fact that hyperpigmentation is a complex condition that involves abnormal pigment distribution and prolonged inflammation. It has may different causes and response also depends on depth, location, type of hyperpigmentation and individual response. Because all these variables need addressing to fade hyperpigmentation, there is no instant solution and treatments require time. All this raises the question, how do you know whether your hyperpigmentation treatment isn’t working or whether it just needs more time? In this article we review how long hyperpigmentation treatments take to work and why does it take so long to go away.
How Long Does Hyperpigmentation Take to Go Away?
First of all the key to understanding how long it takes for treatment to work is to recognise that visible dark marks are due to pigment deposition from weeks, months or even years earlier. In our skin special pigment producing cells called melanocytes produce pigment all the time. However, in response to certain triggers like injury or inflammation, they produce excess pigment which deposits onto the skin. As the skin naturally exfoliates, some of this pigment gradually moves upward through the surface of the skin and falls off which naturally fades the hyperpigmentation. This process is however slow. Normal skin turnover takes approximately 6 weeks. For pigment that sits deeper in the skin, it can take much longer to clear and it may not full fade.
Unfortunately for ongoing, severe or deep hyperpigmentation, it is usually not possible for the skin to fully clear it by itself. This means that hyperpigmentation can linger for months or years particularly in skin of colour. In this case, active hyperpigmentation treatments are necessary to suppress excess melanin production and remove the hyperpigmented patches of skin. However, these treatments take time as they need to control melanoctye activity and enable exfoliation of the pigment deposits. For this reason, few people will see any progress before 6 weeks. It is also unrealistic to expect meaningful improvement in hyperpigmentation in less than 12 weeks. In fact, for many people it can take months to see significant results.
Does Type of Hyperpigmentation Affect Speed of Progress?
The type and depth of hyperpigmentation has a significant impact on how quickly it responds to treatment. Essentially the deeper your hyperpigmentation, the more slower it will fade if it does at all. The same goes for types of hyperpigmentation the main ones being:
- Post-inflammatory Hyperpigmentation (PIH): This form of hyperpigmentation usually occurs after acne, eczema, injury or irritation. Superficial PIH may begin to fade over a few months once inflammation is fully under control. Deeper PIH, particularly in darker skin tones, fades much more slowly and may persist for many months or years despite treatment.
- Sun-spots: Solar lentigines are caused by cumulative UV exposure. These lesions tend to respond more predictably and quickly than other forms of hyperpigmentation to treatment. However, progress is still gradual and highly dependent on strict ongoing sun protection as recurrence is common.
- Melasma: This hormonally influenced form of hyperpigmentation that is continuously stimulated by UV, heat and internal inflammation. It is typically the slowest to improve and often responds only partially to treatment. Melasma also almost always requires long-term maintenance to prevent relapse..
- Ochronosis: A rare but severe form of hyperpigmentation, ochronosis is most commonly associated with prolonged or inappropriate use of topical hydroquinone. Pigment is deposited deep within the skin and does not fade spontaneously. Improvement is limited, slow and often incomplete.
How Long Do Topical Hyperpigmentation Treatments Take to Work?
Topical hyperpigmentation treatments usually work by reducing melanin production, improving pigment distribution, or accelerating epidermal turnover. Often a combination of different ingredients is necessary to tackle hyperpigmentation from different angles. How long these treatments take to work varies from person to person and depend on type and depth of hyperpigmentation. Below are average response patterns of the most common topical hyperpigmentation treatments:
- Hydroquinone: This prescription only medicine is the gold standard for treating hyperpigmentation. It works by suppressing pigment production and with appropriate use, early lightening may begin after 4–6 weeks of treatment. However, more reliable improvement usually requires at least 12-18 weeks. Treatment courses are often limited in duration between 3-6 months of continuous use and so it may need cycling. It also requires maintenance as there is a risk of rebound hyperpigmentation when it is stopped abruptly.
- Retinoids: Over the counter retinoids and prescription forms like tretinoin can help fade hyperpigmentation by increasing cell turnover to move pigment more superficially and disperse melanin more evenly. Visible improvement is modest and gradual. Superficial pigmentation may start to improve from 6–8 weeks with majority of benefit after 3–6 months.
- Azelaic acid: This gentle exfoliant reduces pigment production and inflammation. As such, it is useful for conditions like PIH and melasma. Improvement is usually subtle at first. However noticeable changes can emerge after 12 weeks if using at adequate strengths regularly alongside other hyperpigmentation treatments.
- Tranexamic acid: Whether topical or oral, tranexamic acid works by interfering with melanocyte signalling. It is mainly helpful as an adjunct to melasma treatment. Response is slow and cumulative, with improvement often appearing from 8–16 weeks onwards.
Can Professional Skin Treatments Fade Hyperpigmentation Faster?
A common misconception is that in office treatments like chemical peels, IPL and lasers act quickly and permanently. The truth is that they require multiple courses usually spaced 4-6 weeks apart and there is no guarantee of outcomes. Furthermore, these treatments work mainly by accelerating exfoliation and breaking up existing pigment to resurface the skin and remove dark patches. However, they do not permanently suppress melanocyte activity. To improve your chances of success, it is usually best to use topical hyperpigmentation treatments in between sessions. Whilst it depends on treatment and hyperpigmentation depth or type, on average, people undergoing a course of multiple professional skin treatments can expect:
- Early brightness or texture changes within 14 days
- Subtle pigment reduction over after 12 weeks or the first 2-3 treatments
- Cumulative improvement after 3–6 treatments (can be much more for deeper or more severe hyperpigmentation)
- Relapse is high if there is no maintenance with topical skin treatments and strict sun protection
Why is Hyperpigmentation Not Improving?
As a general rule, you should give any topical treatment at least 12 weeks before deciding whether it requires any adjustment or changes. In terms of in-clinic skin treatments this should be the recommended course of sessions your provider recommends. If despite all this, you are not seeing much progress then it may be that:
- The treatment requires longer for your case
- Application or dosage/strength needs adjusting
- Ongoing inflammation or sun exposure is perpetuating hyperpigmentation
- The treatment is not sufficient by itself for your type of hyperpigmentation
None of these automatically mean the treatment itself is ineffective. The next steps may mean adjusting the treatment or adding something else in. Of course it may also mean stopping the treatment entirely depending on how your skin responded and tolerated it.
Why Does Hyperpigmentation Progress Plateau?
Even if the hyperpigmentation eventually responds well to tretament, ut is not uniusual for prkfress ti plateau. This usually occutrs after 8–12 weeks of starting to see progress and can occur at any stage of treatment. Usually people notice a severe slowing down or stalling of results. The reason for this is not because the tretament has stopped working which is what most people fear. Usually, progress plateaus because:
- There’s been such significant improvment from teh baseline that new gains are less noticeable
- Excess pigment production has stopped but deposited pigment has not yet fully cleared
- Superficial hyperpigmentation has cleared but deeper deposits are not being addressed by the treatment
If hyperpigmentation progress stalls, its important not to panic or make any drastic changes. The fact that your skin had responded to the treatment means it is effective. However, you may need an adjustment of strength or frequency, addition of other treatments, transition to the next stage or just more time! If you are receiving medical treatment, the first thing to do is connect with your clinician who will advise on the nest next move for you.
Most effective hyperpigmentation treatments take months to go away which does mean playing a long game. Faster improvement does not necessarily mean better long-term control and slower progress does not mean failure. How long it does take for hyperpigmentation to go away depends on a number of factors including types, depth and your own biology. Understanding this can help set more expectations and prevent unnecessary switching or over-treatment.
At City Skin Clinic, we believe that skincare is personal and should always pivot around your needs. Our doctors offer custom topical skin treatments for hyperpigmentation using ingredients like tretinoin, azelaic acid, tranexamic acid and niacinamide where appropriate. If you are interested in a personalised skincare treatment please use our online skin consultation form or book a video consultation. Start your treatment journey today and take your first step towards great skin.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.
