Lesions usually fade over a period of weeks to months and are not considered scars. Topical tretinoin lightens postinflammatory hyperpigmentation, such as that following resolution of acne, within four weeks. This agent can also lighten normal skin in black persons. It is commonly seen in women during pregnancy and after delivery. It may also be associated with the use of oral contraceptives and with the use of estrogens in postmenopausal women.
Lesions become less prominent when a sunscreen is used to minimize UV exposure.
Bleaching agents such as two to four percent hydroquinone in an opaque base may slowly improve the condition. Daily use of topical tretinoin may accelerate the response. Early lesions resemble exaggerated skin lines or dirt on the skin surface. Rare cases of generalized disease have occurred. Mucous membrane lesions and palmar and plantar keratoses are occasionally seen.