How to reduce dark elbows and knees?

Darkening can follow repeated kneeling, leaning, dryness or an earlier rash. Thick surface skin can make the area look duller, while inflammation can leave pigment that persists after symptoms fade. The right plan depends on whether the skin is simply dry, actively inflamed, thickened or affected by another dermatological condition. Treating the trigger helps prevent a cycle of irritation and new pigment.

Start with a gentle cleanser and a bland moisturiser applied regularly, including after bathing. Replace rough exfoliation with soft washing, and reduce contact with hard surfaces. Apply sunscreen to exposed elbows and knees. If pigment remains, a dermatologist may assess you for a topical retinoid or chemical peel, taking into account sensitivity, current inflammation and your skin tone. Follow one treatment plan at a time so a reaction can be recognised.

Get medical advice when darkening is new and fast-moving, affects other folds, or is accompanied by thickening, itch, scale, pain, cracking, bleeding or ulcers. A product that causes marked redness, swelling or blistering should be stopped. Review is also worthwhile when careful moisturising and trigger control do not improve roughness or when the diagnosis is uncertain.

What pattern do you see on examination? Should I treat dryness, inflammation or pigment first? Which active treatment is suitable, and what reaction should make me stop it?