What causes elbows and knees to darken? Skincare tips on dealing with hyperpigmentation

Uneven skin tone on your elbows and knees is more common than you think. Here’s why it happens – and effective ways to care for it.

Read a summary of this article on FAST.
Get bite-sized news via a new
cards interface. Give it a try.
Click here to return to FAST Tap here to return to FAST

With the return of Y2K fashion in full swing – think low-rise jeans, crop tops and micro-minis – showing more skin is back in style. Suddenly, dark elbows and patchy knees feel a lot more noticeable when your 2000s pop princess-inspired outfit requires showing off your limbs.

First and foremost: Darker elbows and knees are completely natural. The skin in these areas is naturally thicker, often drier, and takes on more friction than the rest of our bodies. For people with more melanin-rich skin, this darkening is a normal variation – not something that needs “fixing”.

However, if this is something you’d like to address – whether for aesthetic preference, comfort or simply as an act of self-care – here’s how to show your elbows and knees some TLC.

WHY DO ELBOWS AND KNEES GET DARKER?

Elbows and knees do a lot of heavy lifting – literally. These joints are constantly in motion and often come into contact with rough or hard surfaces. Whether you're leaning on your desk, kneeling during workouts, or crawling around after a toddler, this repeated friction and pressure can lead to skin thickening, dryness, and ultimately, hyperpigmentation.

Hyperpigmentation can happen when your skin responds to minor trauma or irritation by producing excess melanin, the pigment responsible for skin colour. Over time, this can cause those areas to appear darker than the surrounding skin. People with deeper skin tones may notice this more, as their skin naturally produces more melanin and is more prone to post-inflammatory darkening.

Neglect plays a role in the darkening too. Elbows and knees are often skipped in our skincare routines, leading to a buildup of dead skin cells, dryness and dullness that makes discolouration more visible.

In some cases, darker patches may also be caused by underlying medical factors like hormonal imbalances like Addison’s disease, inflammation, certain medications, a vitamin B12 deficiency or allergic reactions.

If you notice sudden darkening, changes in texture, rashes, or fatigue alongside pigmentation, it’s a good idea to consult a healthcare professional.

HOW TO BRIGHTEN HYPERPIGMENTED SKIN

Unlike throwback fashion, good skin habits never go out of style. If you’re looking to brighten your elbows and knees, the key is consistency, gentleness and patience. These spots didn’t darken overnight, so they won’t even out that quickly either. Here’s how to care for your darkened elbows and knees:

1. EXFOLIATE GENTLY

While scrubbing rough elbows and knees with grainy body scrubs or loofahs may feel satisfying in the moment, it can actually do more harm than good. Over-exfoliation causes micro tears, irritation, and inflammation – all of which can trigger even more pigmentation in these already-sensitive areas.

Instead, opt for chemical exfoliants with alpha hydroxy acids (AHAs) like lactic acid and glycolic acid, or beta hydroxy acids (BHAs), such as salicylic acid. These actives work by gently dissolving dead skin cells and promoting even texture over time. Use them two to three times a week, and always follow up with a moisturiser and SPF.

2. HYDRATION IS KEY

Dry, dull skin can make discolouration look more pronounced. Without proper hydration, your skin barrier becomes compromised, which can make it more prone to irritation from actives and environmental aggressors.

Use rich moisturisers containing ceramides, shea butter, or urea to help soften rough patches and improve barrier function. Applying body lotion on damp skin (post-shower) can help to lock in hydration more effectively.

For extra dry or thickened skin, consider body slugging – the K-beauty trick of applying an occlusive like petroleum jelly or a thick balm over your moisturiser to trap in hydration overnight.

3. INTRODUCE BRIGHTENING INGREDIENTS SLOWLY

Once your skin is properly exfoliated and moisturised, it’s time to bring in brightening products to reduce the appearance of excess pigmentation. Look for ingredients like niacinamide, vitamin C, azelaic acid and liquorice root extract, which are known for their brightening and anti-inflammatory properties.

While you can use facial products on your body (no need to toss that serum that didn’t work for your face), targeted body sticks containing these ingredients allow for more targeted application, making it easier to apply on small or curved areas without wasting product.

If you’re already using a brightening body lotion, you can layer a concentrated serum underneath to boost results.

Start slow, especially if you’re new to actives, then build up to daily use if your skin tolerates it well. For areas like elbows and knees, applying brightening products once a day in the evening is often enough.

4. DON'T FORGET SUNSCREEN

Yes, even on your knees and elbows. Sun exposure is a major trigger for pigmentation, especially when using exfoliating acids or brightening actives. A broad-spectrum SPF 30 or higher is non-negotiable if you’re serious about fading dark spots.

5. CONSIDER PRESCRIPTION OPTIONS IF YOU'RE NOT SEEING RESULTS

If you’ve been diligently exfoliating, hydrating and using brightening ingredients but still aren’t seeing much improvement, don’t be discouraged – some types of pigmentation run deeper and may require professional intervention.

A dermatologist can assess the underlying cause and customise a treatment plan tailored to your skin type and needs. They may recommend prescription-strength topical treatments such as:

• Tretinoin (a powerful form of retinoid): Known for increasing cell turnover and encouraging collagen production, tretinoin helps fade hyperpigmentation over time while smoothing rough or thickened skin. It can also improve overall skin texture and tone.
• Hydroquinone: Known as one of the most effective ingredients for treating pigmentation, hydroquinone works by inhibiting melanin production. It’s typically used short-term under medical supervision to avoid side effects like irritation or rebound pigmentation.
• Topical corticosteroids (eg hydrocortisone): These can reduce inflammation and are often prescribed in combination with other brightening agents to calm irritated or reactive skin.
• Custom compounded creams: Dermatologists may also prescribe tailor-made formulas that combine ingredients like retinoids, hydroquinone, azelaic acid and kojic acid in a single product for a synergistic effect.

If your pigmentation is linked to hormonal imbalances or inflammatory skin conditions, your doctor might explore oral treatments as well. These may include hormonal medications, oral anti-inflammatories or nutritional supplements.

6. EXPLORE LASER AND IN-CLINIC TREATMENTS

If topical treatments don’t yield results or you’re looking for a more targeted approach, you may want to explore laser or in-clinic procedures. These are best suited for persistent hyperpigmentation and are especially helpful if you’ve already ruled out underlying medical causes.

Some common options include:

• Q-switched Nd:YAG lasers: These are often used for treating melasma or post-inflammatory pigmentation and can help break down excess melanin in the skin. Multiple sessions may be required, spaced several weeks apart.
• Fractional lasers or IPL (Intense Pulsed Light): These resurfacing treatments can help improve both pigmentation and skin texture. While effective, they may not be suitable for all skin tones, especially deeper complexions, due to the risk of post-treatment pigmentation.
• Chemical peels: In-clinic peels with higher concentrations of glycolic, salicylic, or trichloroacetic acid (TCA) can exfoliate and brighten the area more deeply than at-home versions. These can be helpful when your pigmentation is combined with rough, bumpy texture.