9 Tips for Treating Hyperpigmentation on Your Knees, Straight from a Dermatologist

Have you ever slipped on your shorts while working out and noticed that the skin on your knees is darker than the rest of your legs? It may look patchy or cover the entire knee area. This darkening of the skin (also known as hyperpigmentation) is common and can have a variety of causes, such as: rashes, sun exposure, illness, blue light, or even hormonal changes. 1

Hyperpigmentation on the knees is usually harmless, but many people still want to get rid of it. With expert advice from board-certified dermatologists Jennifer Baron, MD, and Azadeh Shirazi, MD, we break down everything you need to know about dark skin on your knees—from causes to treatments.

What causes dark skin on your knees?

Shirazi and Baron tell us that people can develop dark skin on their knees for a variety of reasons. The most common causes include friction, chafing, pressure, dead skin cell buildup, sun exposure, genetics, eczema, or other skin conditions. Shirazi explains that increased melanin production is a common cause of dark knees, especially in people with darker skin tones.

Hyperpigmentation on your knees can also be caused by less common causes, such as burns, reactions to medications or chemicals, inflammation, infection, and vitamin B12 or folic acid deficiencies, experts say.

How to Treat Hyperpigmentation on Your Knees

If you want to treat dark skin on your knees, dermatologists recommend the following:

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Determine What’s Going On

In order to find the best, safest treatment for your specific situation, it’s important to take some time to figure out what’s causing your skin to darken. Treatments vary depending on the cause, so this step is important.

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Protect Your Skin

“If friction is the main issue, a good way to lighten your skin is to protect your knees from trauma using a physical barrier like clothing or knee pads,” Barron says. Avoiding friction and pressure on your knees is helpful because it reduces the buildup of skin cells and darkening of the skin, explains Shirazi.

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Use an Alpha or Beta Hydroxy Acid

“When your skin is repeatedly damaged over weeks or months, even with just pressure or minor friction, the epidermis works to strengthen its barrier function by overproducing and retaining its surface cells,” Barron says. “In this overactive state, melanin-producing cells also go into overdrive.”

For this type of dark skin that’s been damaged and thickened for a long time, alpha or beta hydroxy acids, such as glycolic acid, can help dissolve dead cells, Baron says. Powerful retinol can help restore skin cell turnover to healthy, normal levels.

Shirazi recommends using a medicated spray, such as AziMD’s ONE ($38), which contains glycolic and salicylic acids to lighten pigmentation and remove skin buildup.

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Moisturizer

Keeping your skin hydrated with rich skin emollients like lanolin and plant oils is a good way to treat darkened knees from friction, Baron says. Additionally, moisturizing with sunscreen can help prevent your skin from producing more melanin, Shirazi says.

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Using prescription hydrocortisone

“Sometimes, a short-term application of a prescription cortisone ointment may be necessary to break the cycle of damage and inflammation,” Baron says. “It should be noted that cortisone preparations can thin the skin, cause poor wound healing, and over-lighten the skin if used carelessly.”

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Try a tyrosinase inhibitor

Tyrosinase is an enzyme that plays an important role in the production of melanin, which gives skin its color. Some skin care products contain tyrosinase inhibitors to treat and prevent hyperpigmentation and even skin tone. 2

Skin care products containing tyrosinase inhibitors (such as hydroquinone, azelaic acid, kojic acid, arbutin, and vitamin C) can help lighten discoloration and pigmentation, says Shirazi.

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Avoid scrubbing

As counterintuitive as it sounds, scrubbing your knees is not a good idea. “The worst way to reverse skin darkening is to scrub with sand, metal files or pumice stones, or use exfoliants that contain granular materials,” says Barron. “It just makes the injury worse and forces your skin to grow thicker and darker.”

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Be careful with whitening creams

In some cases, using hydroquinone creams may not be a good idea, either. Hydroquinone is a compound that reduces the activity of an enzyme involved in melanin production. Products containing hydroquinone are often used to lighten dark areas of the skin, but there is some controversy over whether the compound has harmful side effects. Cosmetics containing hydroquinone have been banned in the European Union for more than 20 years due to mercury contamination. In the United States, however, prescription whitening products containing hydroquinone are FDA-approved. 3

“Using hydroquinone on the skin continuously for more than two months can cause dark deposits to form on the skin,” Barron says, adding that this risk can be eliminated by using a daily treatment every two months and taking a two-week break. She recommends talking to a dermatologist, who can refer you to a pharmacy or manufacturer with responsible standards to avoid products that may be contaminated with mercury.

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Avoid hydrogen peroxide

“Avoid hydrogen peroxide,” says Shiraz. “As a bleaching agent, it damages skin cells and eventually causes inflammation, which can exacerbate hyperpigmentation.”

When to see a doctor

In most cases, hyperpigmentation on your knees is harmless. But if you’re concerned about darkening of your skin, see a board-certified dermatologist. “Some conditions can cause significant damage that goes unnoticed initially and manifests as patches or darkening of the skin,” Barron says.Even a condition like melasma—which isn’t life-threatening, but can be difficult to treat—requires a dermatologist’s extensive knowledge and treatment options, Barron explains.

DQH Can I use salicylic acid first and then vitamin C? It’s easy to create a skincare routine, but knowing how to use it is another thing entirely. In most cases, if you’re not getting the desired skin results, it could be due to the layering of conflicting ingredients. So, is it possible that salicylic acid and vitamin C are such ingredients? Or are these active ingredients the duo that’s been missing from your skincare routine? If you want answers, stick around because today we are going to explain the benefits of salicylic acid and vitamin C and how they can be used in your daily life. What are the benefits of salicylic acid for skin? Salicylic acid is one of the most commonly used beta hydroxy acids and is favored by many people with oily, acne-prone skin. This acid is derived from willow bark, and unlike its water-soluble relatives (called alpha-hydroxy acids), salicylic acid is oil-soluble, which means it can penetrate deeper into the lower layers of the skin. Once it reaches the lower layers, it can help unclog pores of excess sebum, dirt, bacteria, debris, and impurities. This results in clearer skin tones and greater definition. Not only does salicylic acid benefit the underlying layers, but the outer surface of the skin benefits as well. When applied to the skin, salicylic acid removes the buildup of dead skin cells. This is accomplished by breaking the bonds that hold dead cells to the surface. Over time, this can cause the complexion to look dull and prone to acne, blackheads, and other blemishes. If you’d like to learn more about salicylic acid and how it can improve your skin, check out this dedicated blog post from a beauty insider. What are the benefits of vitamin C for skin? Vitamin C is considered one of the most powerful antioxidants, which means it is very effective at fighting free radicals and preventing them from causing further skin damage. Examples of free radicals include pollution, central heating, UV rays and harsh climate. They attack proteins, fats and cell membranes as soon as they come into contact with the skin, causing signs of premature aging such as fine lines and wrinkles as well as hyperpigmentation, flaky patches of skin and loss of elasticity. Many people usually prefer to use vitamin C in their morning routine as this ingredient gives the complexion a radiant glow. You’ll also find that vitamin C can target areas of hyperpigmentation, plumping the skin and reducing the appearance of fine lines and wrinkles. The thing about vitamin C is that there are a lot of outdated studies going back to the 1950s that describe vitamin C as an unstable skin component. Thanks to improvements in modern technology, this is no longer the case as all products now contain a stable form of vitamin C. Visit The Beauty Insider to learn more about vitamin C. So please check out our blog post. Can I use salicylic acid first and then vitamin C? Yes, you absolutely can. In fact, it’s thought that using salicylic acid before using vitamin C ensures it penetrates faster and works faster. This is an efficient way to utilize two power sources, and the reason has to do with pH. For example, the skin’s natural pH is about 4.7, making it slightly acidic. Salicylic acid and vitamin C are also both acidic, and you’ll find that vitamin C is absorbed quickly into the skin. Therefore, using salicylic acid beforehand can increase the acidity of the skin and allow vitamin C to penetrate into the skin faster. While this is considered an effective way to combine two powerful ingredients, you need to be aware of your skin type and how it reacts to certain active ingredients. Even people with perfect, normal skin can experience skin sensitivity and irritation. Therefore, always consult a doctor or dermatologist before using any new products on your skin. It’s also important to follow skin application rules. In this case, you need to use the product correctly to ensure you get the best results for your skin. If you’re not sure what I mean, the basic rule for skin is to start with the thinnest consistency and work your way up to the thickest consistency. This prevents a barrier from forming on the surface, preventing other active ingredients from penetrating the skin. Can I use salicylic acid at night and vitamin C in the morning? Yes, absolutely, this is considered the most effective way to get returns without any adverse side effects. This is because there is enough time between applications to ensure that the skin’s pH levels return to balance. You’ll also find that Vitamin C is rich in antioxidants and is perfect for use in the morning to ensure your skin is protected and looking its healthiest. Due to the small size of salicylic acid molecules, it is an acid that is able to reach the deepest parts of the skin. While this is effective at keeping skin clear, it also increases the risk of irritation and photosensitivity. Therefore, many people prefer to use powerful BHAs in their evening routine without exposure to UV rays, pollution, or harsh weather. Warning: If you avoid using sunscreen every day, none of these ingredients will do what your skin needs. The combination of chemical peels and powerful ingredients increases the risk of further damage to the skin’s surface. Use SPF 50 every day to keep your skin protected and your lipid barrier healthy, even on cloudy days, keeping your skin in top condition.

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