9 Tips for Treating Hyperpigmentation on Your Knees, Straight From Dermatologists

Have you ever slipped into a pair of shorts for a workout and realized the skin on your knees is darker than the rest of your legs? It may appear patchy, or it could cover your entire knee area. This darker skin, also known as hyperpigmentation, is common and can have various causes, such as a rash, sun exposure, a medical condition, blue light, or even hormonal changes.1

Knee hyperpigmentation usually isn’t harmful, but many people still may want to get rid of it. With the help of expert advice from board-certified dermatologists Jennifer Baron, MD, and Azadeh Shirazi, MD, we’ve broken down everything you need to know about dark skin on your knees—from why it happens to how to treat it.

What Causes Dark Skin On the Knees?

People can develop dark skin on their knees for many reasons, Shirazi and Baron tell us. Some of the most common causes include friction, rubbing, pressure, a buildup of dead skin cells, sun exposure, genetics, eczema, or other skin conditions. Increased melanin production is a common cause of dark knees, particularly among people with darker skin tones, explains Shirazi.

Hyperpigmentation on the knees can also develop for less common reasons, the experts tell us, such as burns, medication or chemical reactions, inflammation, infection, or vitamin B12 or folate deficiencies.

How to Treat Hyperpigmented Knees

If you’re looking to treat dark skin on your knees, here’s what dermatologists recommend:

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Determine What’s Going On

To figure out the best and safest treatment for your specific situation, it’s important to take some time to determine what’s causing your darkening skin. Treatment varies depending on the cause, so this step is really important.

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Protect Your Skin

“If friction is the primary concern, then a good skin-lightening approach would be to protect the knees from trauma with physical barriers like clothing or knee pads,” Baron says. Avoiding friction and pressure on the knees is helpful because it reduces the buildup of skin cells and darkening of the skin, Shirazi explains.

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Use Alpha- or Beta-Hydroxy Acids

“When your skin is repeatedly damaged, even just from pressure or slight rubbing over a period of weeks or months, the epidermis will ramp up its barrier functions by overproducing and retaining its surface cells,” Baron says. “In this hyper-activated state, the melanin-producing cells are also sent into overdrive.”

For this type of darkened skin that’s been damaged and thickened over an extended period of time, alpha- or beta-hydroxy acids such as glycolic acid can help dissolve dead cells, Baron says. A strong retinol can then help return the skin’s cell turnover to a healthy, normal rate.

Shirazi recommends using a medicated spray like AziMD’s the ONE ($38) with glycolic and salicylic acid, which lightens hyperpigmentation and removes skin buildup.

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Moisturize

Keeping your skin well moisturized with rich skin emollients like lanolin and plant oils is a good way to treat dark skin on the knees that arises because of friction, Baron says. Additionally, moisturizing with an SPF cream helps protect the skin from producing more melanin, Shirazi says.

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Use Prescription-Strength Hydrocortisone

“A short course of prescription-strength cortisone ointment may occasionally be needed to break the cycle of damage and inflammation,” says Baron. “It should be noted that cortisone preparations can thin the skin, cause poor wound healing, and over-lighten the skin if they are not used with care.”

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Try a Tyrosinase Inhibitor

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

Shirazi says skincare products that contain tyrosinase inhibitors such as hydroquinone, azelaic acid, kojic acid, Arbutin, and vitamin C help lighten discoloration and pigmentation.

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Avoid Scrubbing

As counterintuitive as it may sound, scrubbing your knees isn’t a good idea. “The worst thing you can do to try to reverse skin darkening is to scrub it with a sand or metal file, pumice stone, or use an exfoliating product that contains any gritty material,” Baron says. “This would only add to the injury and force your skin to get thicker and darker.”

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Practice Caution With Whitening Creams

In some cases, using hydroquinone creams may not be a good idea, either. Hydroquinone is a chemical compound that reduces the activity of an enzyme that’s involved in the production of melanin pigment. Products containing hydroquinone are often used to lighten dark patches of skin, but there is a bit of debate over whether the compound carries harmful side effects. Cosmetics containing hydroquinone have been banned in the European Union for more than 20 years because of mercury contamination. However, in the United States, prescription skin-lightening products that contain hydroquinone are approved by the FDA.3

“Hydroquinone applied to the skin for more than two months continuously may lead to deposits of a dark material in the skin,” Baron says, adding that the risk can be eliminated by taking a two-week break for every two months of daily treatment. She suggests talking to a dermatologist who can direct you to a pharmacy or manufacturer with responsible standards in order to avoid products that may be contaminated with mercury.

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Skip the Hydrogen Peroxide

“Avoid hydrogen peroxide,” Shirazi says. “As a bleaching agent as it causes damage to skin cells and may end up causing inflammation, worsening hyperpigmentation.”

When to See a Doctor

In most cases, hyperpigmentation on the knees is harmless. But if you have any concerns about skin darkening, see a board-certified dermatologist. “There can be some significantly damaging diseases that are missed initially and show up as a spot or darkening of the skin,” Baron says. Even something like melasma—which isn’t life-threatening but can be difficult to treat—requires a dermatologist’s broad scope of knowledge and treatment options, Baron 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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