Causes of Joint Darkness in Skin of Color

hand on knee
Women of color often experience joint darkness. Photo: Fuse/Getty Images

Skin of color is prone to pigmentation problems.  Along with being easily affected by hyperpigmentation, another issue is a tendency towards developing darkened skin around the knees, elbows, knuckles and toe joints.

The darkness is due to the type of skin that is around the joints. The extra skin in this area (which slightly bunches up when joints are extended) is necessary to allow for movement of the joints, so you might see darkness in the elbows, knees, knuckles, toes, heels and anklebone.

  There is no permanent way to lighten these areas.  Because of this continual movement, the removal of some of the darkness in this area is only temporary.

Another thing that contributes to the darkening of the skin is the frequent friction and pressure placed on these areas.  Knocking on doors with our knuckles, wearing poorly fitting shoes that rub against our heels, or flip flops that make us grip our toes, plus kneeling and crawling on our knees, resting elbows on hard desks, and more, causes trauma to the skin leading to discoloration.  In addition, the body also responds to damage by thickening the skin in the area it perceives as being under attack.

We tend to consider this area of skin to be tougher and attempt to scrub away the roughness and darkness, only to make the condition worse.  Bumps, bruises and other trauma lead to hyperpigmentation in Asian, olive and dark skin tones in which the melanocytes (cells that give skin its color) are especially active.

Home remedies and over-the-counter products probably won’t work if the condition is severe or caused by genetics.   Also, if you have persistent discoloration that doesn’t respond to topical treatments, you should see a doctor to make sure the cause is normal skin darkening.  There are some medical conditions that cause dark joints from eczema to certain diseases.

Eczema (dermatitis) – The irritated and thickened skin can be darker than the surrounding skin.

Psoriasis is a chronic inflammatory skin condition characterized by red, scaly and thickened skin that often occurs on the elbows and knees.  When the condition clears up it can leave discoloration.

Rheumatoid arthritis and Raynaud’s syndrome can have signs of dark discoloration of the finger joints.

Scleroderma is a condition that causes scarring of the skin and joints.  The disease can affect skin pigmentation and cause dark spots and scarring of skin over the joints, leading to discoloration as well as difficulty in movement.

Acanthosis nigricans.  Though symptoms of acanthosis nigricans is growth of dark patches and thickened skin on folds of skin, such as the armpit, inside of the elbow, backs of the knees and neck, it can lead to dark patches of skin over such areas as the knuckles.  This condition develops as a sign of insulin resistance.  The excess insulin interferes with skin cells, leading to patches of excess skin growth and hyperpigmentation.

Dermatomyositis is an inflammatory muscle disease accompanied by skin rashes.  One sign and symptom of the disease is Gottron’s papules.  Abnormal pigmentation can develop over knuckles, knees, ankles and elbow joints.

  It’s often mistaken for psoriasis. 

Keratoderma is a condition that causes blisters and calluses, usually on the soles of the feet and palms.

Treatments for Skin Discolorations

Once medical and other factors have been ruled out, and natural and OTC lighteners have proved to be ineffective, a dermatologist might do microdermabrasion and chemical peels using beta hydroxy acids or salicylic acid peels to help speed up the performance of topical creams (such as retinoid) to lighten joints.  But caution has to be taken with microdermabrasion, chemical peels and chemical bleaching agents in skin of color to avoid even further damage.

For further information, be sure to read Hyperpigmentation Treatment for Skin of Color: Proceed With Caution.

During your daily skin care routine, massage an exfoliating cream, lotion or homemade scrub into the areas that need treatment five minutes before bathing or showering, to remove rough skin and dead skin cells.

  After bathing apply a moisturizer containing glycolic acid or alpha hydroxy acid to the areas.

To keep joints looking their best:

  • Gently cleanse the area.  Avoid vigorous scrubbing and the use of harsh or abrasive cleansers and exfoliating agents.
  • Exfoliate to remove dead skin cells that may accumulate in knuckles and other areas.
  • Always follow with a good moisturizer. 
  • Give special attention to the finger and toe joints when doing manicures and pedicures. 
  • Massage natural oils like coconut, olive, sesame and almond oil onto dark joints daily.
  • When using any skin lighteners, always remember to apply sunscreen on skin that will be exposed to sunlight.