Doctronic

Understanding Skin Pigmentation: Causes, Conditions, and Treatments

Oghenefejiro Okifo | MD

Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on July 8th, 2023.

Key Takeaways

  • Melanocytes produce melanin in response to UV exposure, hormonal changes, and inflammation—when this process becomes irregular, it creates patches of hyperpigmentation (excess color) or hypopigmentation (reduced color).
  • Melasma affects 90% of pregnant women due to estrogen surges, creating symmetrical brown patches on the face that often fade within 6-12 months postpartum.
  • Hydroquinone 2-4% remains the gold standard for treating dark spots, typically showing results in 6-8 weeks when combined with tretinoin and a corticosteroid in triple-combination therapy.
  • Post-inflammatory hyperpigmentation occurs in up to 65% of people with darker skin tones following acne, cuts, or burns, and can persist for months to years without treatment.
  • Daily broad-spectrum SPF 30+ sunscreen prevents 80% of facial aging and pigmentation changes—reapplication every 2 hours is crucial for maintaining protection.

Skin pigmentation refers to the coloring of a person's skin. When healthy, skin color appears normal, but various factors can cause changes in pigmentation, resulting in skin that is darker (hyperpigmentation) or lighter (hypopigmentation) than usual. This article will help you understand the causes of pigmentation changes and the available treatment options.

Hyperpigmentation: When Skin Becomes Darker

Hyperpigmentation occurs when there is an increase in melanin, the substance responsible for skin color. Several factors can contribute to hyperpigmentation, including:

  • Pregnancy

  • Addison's disease (decreased adrenal gland function)

  • Sun exposure

  • Certain medications (antibiotics, antiarrhythmics, and antimalarial drugs)

Melasma: A Common Form of Hyperpigmentation

Melasma is a condition characterized by tan or brown patches, most commonly appearing on the face. While often called the "mask of pregnancy," as it frequently affects pregnant women, men can also develop melasma. Treatment options include:

  • Prescription creams (e.g., hydroquinone)

  • Sun protection (broad-brimmed hats, sunscreen with SPF 30 or higher)

  • Sunscreens containing zinc oxide or titanium dioxide to block UVA rays

People with darker skin are at a higher risk for melasma, which appears as dark brown or greyish brown patches. Consult with your doctor before attempting to treat the condition yourself.

Understanding Skin Pigmentation: Causes, Conditions, and Treatments

Hypopigmentation: When Skin Becomes Lighter

Hypopigmentation results from a reduction in melanin production. Some examples of hypopigmentation include:

Vitiligo

Vitiligo is an autoimmune disorder that causes smooth, white patches on the skin. While there is no cure, treatment options include:

  • Cosmetic cover-ups

  • Corticosteroid creams

  • Calcineurin inhibitors (Elidel cream, Protopic ointment)

  • Ultraviolet light treatments

  • Janus Kinase inhibitor ruxolitinib (Opzelura) for nonsegmental vitiligo in patients 12 years and older

Albinism

Albinism is a rare inherited disorder caused by the absence of an enzyme that produces melanin, resulting in a complete lack of pigmentation in skin, hair, and eyes. There is no cure, but people with albinism should use sunscreen at all times to prevent sun damage and skin cancer.

Pigmentation Loss Due to Skin Damage

Skin infections, blisters, burns, or other trauma can cause a loss of pigmentation in the affected area. While this type of pigment loss is often not permanent, re-pigmentation may take a long time. Cosmetics can be used to cover the area during the healing process.

In conclusion, changes in skin pigmentation can be caused by various factors, including hormonal changes, sun exposure, medications, and genetic conditions. If you notice any concerning changes in your skin color, consult with a healthcare professional to determine the underlying cause and appropriate treatment options.

For more information on skin pigmentation and related conditions, visit:

The Bottom Line

Most pigmentation disorders respond well to early intervention with topical treatments and strict sun protection, though results typically require 3-6 months of consistent use. The key is identifying the underlying cause—whether hormonal, inflammatory, or genetic—to choose the most effective treatment approach. If you're dealing with persistent dark spots or unusual pigmentation changes, Doctronic can help you understand your options and connect with appropriate care.

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