She said that it’s common for people of color to come to her practice seeking lightening treatments for the elbows, knees, and underarms in particular, because they think the deeper hue is not natural—most of the time, it is, though. “I talk to them about the fact that it is normal,” Dr. Elbuluk added. “There’s no need to try to lighten it because this is normal, healthy skin.”
So why are some parts of your skin darker than others?
Certain areas like the elbows and knees are often darker simply because the skin is thicker, according to Dr. Elbuluk. Even if these spots start out approximately the same color as the nearby skin, repeated physical trauma or friction can cause the skin to thicken, producing darker patches, also known as hyperpigmentation. For example, “darkening of knees and elbows can be due to chronic frictional rubbing from kneeling, crawling, and sliding elbow on a desk,” Julia Tzu, MD, a New York-based board-certified dermatologist, told Allure.
Everyday activities like shaving or exfoliating are also potential culprits. The skin can become irritated from shaving, too much exfoliation, or simply trying a new product, especially deodorant, Dr. Elbuluk noted. “If you’re someone prone to ingrown hairs, you can get hyperpigmentation from that repeated inflammation,” she added.
Here’s when you should talk to your doctor about hyperpigmentation.
A common DIY remedy for dark spots is aggressively scrubbing that area—like what my relatives were advising I do with the back of my neck. In general, however, over-exfoliating the skin in an effort to make it lighter is counterproductive if you’re looking to limit any potential inflammation. “This happens [when people] try to scrub the skin too hard, thinking that that will help, or use too many exfoliating products at the same time,” Dr. Elbuluk explained. The skin can become irritated because its protective barrier is damaged; then, that inflammation becomes hyperpigmentation. Areas with thinner skin, like the underarms, are more sensitive and vulnerable to inflammation.
However, there are some instances when these areas are darker due to an underlying health issue like insulin resistance or an endocrine disorder, Dr. Tzu explained. Identifying when those sections of the skin are darker because of an internal disorder may require you to rethink what’s considered “normal” for your complexion. Naturally, the body has multiple tones and hues, but if you’ve recently noticed some sort of new, drastic change, then Dr. Elbuluk suggested visiting a board-certified dermatologist or your primary care doctor to determine the cause. And when you do, she stressed that you should feel empowered to ask the doctor plenty of questions: what’s normal and what’s not for your skin, if you do or don’t need to use certain treatments, and anything else that comes to mind.
She also noted that people of color can understandably be hesitant about visiting a dermatologist. There are several potential reasons for that, including high medical costs, lack of access to dermatologists that understand how to diagnose and treat darker skin, and general distrust of the medical field. As with any condition, these factors can make it more tempting to look to other places for help. “People rely heavily on not just who they know, but now social media, as well, and other sources,” Dr. Elbuluk shared. “There is some good information there, but there’s also a lot of misinformation.”
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