One of the most common issues at the dermat office is hyperpigmentation. So what is hyperpigmentation? It is a skin disorder where parts of your skin get discoloured (generally gets a darker tone). Although it is not a major health issue, it can be alarming and create some mental stress, making people more sensitive about their skin. Let us understand about this disorder in detail, its symptoms, causes and treatment. Stick till the end to completely get a hang of hyperpigmentation.
In hyperpigmentation condition, the skin colour gets discoloured to a darker tone. It can happen anywhere at the skin, but mostly found at the skin which is directly exposed to sun (face, neck, legs, hands, etc.). The colour depends on your skin complexation. It can get grey, brown, tanned, pink or in some cases, even purple. Hyperpigmentation often is misinterpreted with sun tan, but this condition lasts longer than a sun tan. Oftentimes, hyperpigmentation is a sign of an underlying disease or condition that might require further evaluation.
Hyperpigmentation happens due to excess melanin in the skin. Most hyperpigmentation types are harmless, but understanding each type helps treating it with ease and evaluating if there is an underlying condition. Here are the different types of hyperpigmentation:
Brown or gray-brown patches are seen on the face in Melasma. It is mainly seen in pregnant women. Generally, it is triggered due to hormones or sun exposure.
These are flat in shape and have brown spots that develop on sun-exposed areas like the face, hands, and arms. They are typically seen in grown adults, due to years of sun exposure and damage to skin due to harmful UV rays.
Acne, eczema, or cuts cause PIH, generally after the skin injury/inflammation. The skin heals with darkened spots that can stay for weeks or months.
These are dark, red-velvety type patches on the body. They generally occur at places where the body folds, like neck, armpits, elbows, behind knees, etc. Obesity, insulin resistance and hormonal changes are the major culprits here.
A vertical dark line that appears on the abdomen during pregnancy.
Pigmentation in the mouth or lips caused by tobacco use.
A genetic condition marked by dark spots on the lips, mouth, and fingers, often alongside intestinal polyps.
Certain drugs (e.g., antimalarials, chemotherapy) can cause diffuse or localised darkening of the skin.
The most obvious symptom of hyperpigmentation is the change in the colour of the skin. This can be seen at different parts of the body, which indicate a different type of hyperpigmentation. Here are the major symptoms or tells of hyperpigmentation:
This is the most common sign of hyperpigmentation, and generally found on parts of the face like cheeks, chin, nose, on parts of hands like arms, elbow, armpits.
The discolouration may range from light brown to deep black or even greyish, depending on skin tone, depth of pigment, and any underlying cause.
In some types, such as melasma, the dark patches appear in a mirror-image pattern on both sides of the face, giving it a symmetrical appearance.
Some pigmentation goes away over time (e.g., post-inflammatory marks), while others, like melasma or sunspots, may persist or worsen without treatment or protection from triggers.
Hyperpigmentation occurs when the body produces excess amounts of melanin (the hormone that gives colour to the skin). But, understanding why this happens and what are the risk factors for hyperpigmentation helps in the treatment, prevention and evaluation of any underlying conditions. Here’s is a detailed breakdown of the causes of hyperpigmentation:
While identifying if you have hyperpigmentation is easy, understanding which type of hyperpigmentation is a professional's work. A dermatologist (the skin doctor) will generally perform a series of clinical evaluation and use diagnostic tools to identify which type of hyperpigmentation it is. Here’s how the type of hyperpigmentation can be identified:
The affected skin is examined to assess the pattern, colour, and distribution of pigmentation. This visual inspection often provides strong clues about the type of hyperpigmentation.
A special ultraviolet light helps determine how deep is the pigmentation. In this it is determined whether the pigmentation is on the surface (epidermal) or deeper in the skin (dermal). This helps in deciding the best treatment approach.
If the diagnosis is uncertain or if there's suspicion of a more serious condition, a small skin sample may be taken and analysed in a lab.
The doctor will discuss any past skin issues, hormonal changes, medications, sun exposure, and family history to understand possible triggers or underlying causes.
Depending on the severity of hyperpigmentation, treatments can be done, that include routine skincare, medical treatments, etc. Here are the proper treatments that will help you reduce/prevent hyperpigmentation:
Hyperpigmentation at an early stage or for mild cases can be treated at home using home remedies. However, if the issue still persists or worsens, consult a dermatologist at the earliest. Here are some desi jugaads for hyperpigmentation:
Soothes and lightens skin
Reduces dark spots and inflammation
Antioxidants that help tone down pigmentation
Use cautiously to avoid irritation
Natural brightener; best mixed with yoghurt or honey
Lemon juice (diluted), potato juice, milk or yoghurt (lactic acid)
It is better to prevent a disease than to treat it. And, it is easier to prevent hyperpigmentation than to treat it. Here are a few tips to help you avoid getting discoloured skin:
Hyperpigmentation is more of a cosmetic disease, and is more common than you think. It can be easily prevented, and identified. However, if you do get hyperpigmentation, try to identify which type of hyperpigmentation it is, and then treat it accordingly. Contact a dermatologist for best diagnosis and treatment options. Health insurance does not typically cover hyperpigmentation unless it's a symptom of an underlying disease, so ensure you take care of your skin.
Ans: Minor hyperpigmentation can go away on its own with time, but if the issue persists ensure to visit a dermatologist.
Ans: Hyperpigmentation itself is not cancerous. However, sudden changes can indicate certain underlying issues, which might need evaluation by a professional.
Ans: Effects start in 4-8 weeks, but the complete process might take 6 or more months.
Ans: Yes, home remedies are effective for mild hyperpigmentation
Ans: A combination of treatments works best for melasma—usually including topical agents (like hydroquinone or tranexamic acid), strict sun protection, and sometimes chemical peels or low-intensity lasers, under professional supervision.
Ans: Certain antimalarials, chemotherapy agents, tetracycline antibiotics, amiodarone, and nonsteroidal anti-inflammatory drugs (NSAIDs) can cause hyperpigmentation.
