Skin pigmentation problems: Here’s our one-stop guide to the causes and treatments

Who doesn’t want a clear and glowing complexion? But the road to perfect skin isn’t always smooth—especially if you suffer from skin pigmentation issues.

There are no quick fixes to skin discolouration, and you can’t exactly wish the problem away. But here’s what you can do: monitor your skin, know your triggers, consult a dermatologist, and choose from a range of remedies and skincare options that actually work. Stick around for a deep dive into the causes of and possible treatments for all your skin pigmentation woes.

 

What is skin pigmentation?

The term ‘skin pigmentation’ refers to skin colour or tone. A natural pigment called melanin gives colour to your skin, as well as to your eyes and hair. Whether you are light-skinned or dark-skinned depends entirely on the amount of melanin being produced in the epidermis, which is the outermost layer of the skin.

Let’s look into the science behind it:

  • The epidermis contains special cells called melanocytes. They comprise around 5% to 10% of the skin cells in the basal layer of the epidermis. The job of these melanocytes is to produce the pigment melanin.
  • Helping the melanocytes to produce melanin are cellular organelles called melanosomes. These are mini-organs (‘organelles’) of the melanocytes. The number, size, and distribution of melanosomes throughout the skin lead to variations in skin colour.

The number of melanocytes does not vary significantly across individuals from different races. And this is regardless of whether they are light- or dark-skinned. What happens is that people with dark skin have more melanosomes and these are larger and more widely dispersed than in people with lighter complexions.

The pigment melanin can be of two types: eumelanin and pheomelanin.

  1. Eumelanin is brownish-black. It offers protection to the skin cells and DNA from the harmful ultraviolet (UV) rays of the sun. Thus, it functions as a safeguard against skin cancer.
  2. Pheomelanin is reddish-yellow. It offers no real protection against the harmful effects of UV rays. 

The combination of these two pigments gives skin its unique colour and tone. But the balance between the two is not permanent. It may fluctuate over the years owing to shifts in hormone levels, the effects of some genes, and various other factors.

 

Types of skin discolouration

From time to time, you may experience dark and light spots on your face and body or discoloured patches of skin. What’s triggering these? The cause could be a health issue, an injury, or hormonal changes. Whatever be the reason, discolouration will fall under one of the following three categories:

1. Hyperpigmentation: Do you have spots or patches that appear darker than your regular skin tone? If yes, then you are dealing with hyperpigmentation. What has happened is that the melanocytes in the area are producing too much melanin.

Birthmarks, age spots, and dark spots due to acne are examples of hyperpigmentation. Birth control pills, some antibiotics, and overexposure to the sun are some common triggers.

 

2. Hypopigmentation: Instead of dark spots, you end up with spots and patches that are lighter than the surrounding skin. The melanocytes in the affected area are not pulling their weight. They are producing abnormally low quantities of melanin, leading to hypopigmentation.

Consider a few examples: If your skin heals after a burn or blister, the recovering skin tends to look lighter. Hypopigmentation also occurs among people with inflammatory conditions such as eczema and psoriasis.

 

3. Depigmentation: Here, the skin loses all the pigment and becomes white. This is what happens to people with vitiligo. When the melanin disappears, smooth and white patches show up on the skin. 

 

 

A guide to skin pigmentation issues

Skin discolouration happens to us all, but the severity tends to vary. While a lucky few will notice only the occasional dark spots, some people regularly experience large discoloured patches, and still others struggle with pigmentation issues all over the body.

Although skin pigment discolouration is usually harmless, it could signal an underlying disease. So, it’s important to monitor your skin regularly and consult a medical professional if required. But first, let’s get the ball rolling and explore some common skin pigmentation problems.

  • Birthmarks: Abnormal skin colouration is common in newborn babies. In some cases, birthmarks appear a few weeks after birth. Although most birthmarks are benign, a few may pose health risks and should be examined by the paediatrician.

There are mainly two types of birthmarks: pigmented and vascular.

    • Pigmented birthmarks include Mongolian spots which disappear by the time a child is four. Moles are also a type of pigmented birthmark. Mostly harmless, moles become concerning only if they start to grow or change colour.
    • Vascular birthmarks are caused by blood vessels. These are usually
      flat marks that are pink, purple, or red in colour. Macular stains take the form of mild red marks and are quite harmless. However, haemangiomas and port wine stains could pose health risks and will need to be checked out by a doctor.

 

  • Skin pigmentation disorders: Dark and light skin patches could be the symptoms of some melanin-related conditions. A few such conditions are described here:
    • Melasma: Pregnant women, as well as those taking birth control or postmenopausal oestrogen, are most susceptible to melasma. Although more common in women, the brown facial patches of melasma affect men as well. In some women, the patches go away on their own after pregnancy. 
    • Albinism: Some people produce too little melanin, which leads to hardly any colour in the skin, eyes, and hair. Albinism is a genetic disorder that is passed down by one or both parents to the child. 

There is no cure for albinism at present. Moreover, albinos are at high risk of sun damage and skin cancer because of their low melanin levels. To stay safe, they must use sunscreen generously for protection from the sun’s UV rays.

    • Vitiligo: Generally considered an autoimmune disorder, vitiligo manifests in smooth, white patches in specific areas or all over the body. Those with vitiligo often have pigmentation around the mouth and eyes. Some notice patches on the backs of their hands.
Here, pigment loss occurs when the immune cells attack the melanocytes. Some people may lose colour from their hair as well.

 

    • Post-inflammatory discolouration: Any kind of burn, injury, or other skin trauma could lead to temporary discolouration. Depending on the type of inflammatory damage, people may experience hyperpigmentation or hypopigmentation. The discolouration is generally not permanent, but it may take several months for the original shade to return.


 

Why is your skin discoloured?

Knowing the symptoms is one thing, but do you know what’s causing your skin pigmentation problems? When you identify whatever is going on behind the scenes, finding a treatment plan becomes that much easier.

  • Genetics: Did you know skin pigmentation is affected by more than 125 genes? Genetics plays a big role in melanin production. Our genes govern a number of things, including: 
    • how much eumelanin and pheomelanin are produced by the melanocytes,
    • the number, size, and functioning of the melanosomes, and
    • how your skin colour fluctuates over the years.
Pregnancy hormones: Hormonal fluctuations are a major culprit here.
The high levels of oestrogen and progesterone during pregnancy can stimulate the melanocytes to produce more melanin when exposed to sunlight. Some women develop skin pigmentation problems when they start taking birth control.
  • Medical treatment: Surgery, chemotherapy, and radiation therapy can all do a number on the skin. Many people notice discolouration after these medical procedures. Allergic reactions to certain medications and injections could also lead to bruised, red skin or hyperpigmented patches. The discolouration tends to normalise when the course of treatment ends.
  • Skin irritation and trauma: Any injury, rash, or other damage to the skin could also upset the melanin balance. Here are some situations where discoloured spots and patches may appear. 
    • Sunburn: Too much sun exposure could lead to sunburn. You might get reddish or pinkish pigmentation on the lips, earlobes, and scalp as a result. And that’s not the only pigmentation risk either! Excessive sun exposure also causes age spots, and inefficient sunscreen application could lead to an uneven tan.
    • Contact dermatitis: Allergies to everyday products like soap, cosmetics, or laundry detergent might leave you with a rash, a burning sensation, and redness.
    • Burn, blister, or infection: When skin cells around the compromised area heal, you may be left with scar tissue that looks different from your regular skin. Although most scars tend to improve on their own, the discolouration may take weeks or months to go away.
    • Acne: When acne lesions heal, they could leave behind signs of hyperpigmentation, such as redness or dark spots. Those with
      lighter-toned skin may also experience rosacea—a condition that is often confused with acne. People with rosacea experience red pigmentation all over the face (Discover 10 ways to lose acne-related redness.)
    • Health conditions: Some endocrine diseases, such as Addison’s disease, can manifest with skin discolouration as a symptom. People with insulin resistance may also be prone to developing skin cells that are darker than the surrounding skin.

     

     

    Home remedies for skin pigment discolouration

    If you have minor discolouration issues, some home remedies could kickstart your journey to more even-toned skin. Here are a few that put household products to good use.

    • Apple cider vinegar: Thanks to its acetic acid content, apple cider vinegar is an effective chemical peel. When diluted in water and applied topically, it is said to lighten hyperpigmentation. There’s a bonus too: apple cider vinegar contains polyphenols that have antioxidant effects.
    • Milk and yoghurt: Both dairy products contain small amounts of lactic acid, which is an active ingredient in many chemical peels. These hyperpigmentation home remedies can be applied directly onto the affected skin, and then rinsed off after a few minutes. 
    • Red onion: Hyperpigmentation home remedies often call for skin-
      lightening agents like red onion. Look out for red onion or its scientific name Allium cepa when shopping for an over-the-counter (OTC) pigmentation cream. Alternatively, you could take the DIY approach: just grind the onion, place it in an empty tea bag, and hold it against the hyperpigmented skin. 
    • Green tea: An active ingredient called epigallocatechin-3-gallate (EGCG) is green tea’s superweapon against skin pigment imbalances. If you want to beat discolouration, you could use green tea in a few different ways: apply green tea extract, take EGCG tablets, or place a used green tea bag on the affected skin. (Did you know green tea is also an acne-fighter?)
    • Aloe vera: Topical application of aloe vera gel can reduce dark patches. That’s because aloe vera contains a depigmenting substance called aloin. Besides, aloe vera gel is non-toxic, soothing, and suitable for most skin types.
    • Vitamin C: Oranges, lemons, and papayas could support your battle against skin pigmentation issues. Vitamin C sourced through ascorbic acid and citric acid could lighten your dark patches—albeit to some extent. 

     

     

    How to remove pigmentation with in-clinic treatments

    Stubborn skin discolouration won’t respond to DIY treatments. If you think a more potent solution is needed, here’s a sampling of in-office treatments that a dermatologist might suggest. 

    • Chemical peels: This skin resurfacing method removes dead skin cells from the outer layer of the skin. With the upper layer gone, you are left with healthier-looking skin. Chemical peels containing alpha-hydroxy acids, glycolic acid, and trichloroacetic acid help reduce dark spots and other pigmentation imbalances.
    • Microdermabrasion: The skin specialist uses a handheld applicator with an abrasive surface to gently remove the outer skin cells in the targeted
      areas. Many users notice instant results with this procedure. However, the severity of the discolouration will matter. Some people may need to undergo multiple sessions to get the desired results.

     

    • Intense pulsed light (IPL) photofacials: Light of different wavelengths is used in IPL photofacials. The light penetrates the dermis—the second layer of the skin—without harming the epidermis. The melanocytes absorb the light energy, which is then converted to heat. The heat goes on to destroy the excess pigment. Each session takes about half an hour and people may require multiple sessions. (Some photofacials can also beat acne bacteria and tough scars.)
    • Laser resurfacing: Short, concentrated beams of light are directed at the discoloured skin. When it comes to pigmentation, laser treatment works very precisely. It tackles the pigmented cells one layer at a time, dealing first with the compromised cells of the epidermis before moving on to the dermis. The process stimulates the production of new and healthy skin cells, thereby improving skin tone and texture.
    • Mesotherapy: Solutions made up of multivitamins, enzymes, hormones, and plant extracts are injected into the skin. Very fine needles are used to transport the solution to the affected skin cells at different depths. At a sitting, you would receive a series of such injections. Each one would deposit a tiny amount of solution into the skin.
    • Microneedling: In this minimally invasive procedure, the dermatologist
      uses very fine needles to puncture the affected skin. As these intentional puncture wounds start to heal, so do the neighbouring discoloured skin cells. Microneedling works well across most skin types and skin tones but is better avoided by people who are prone to acne, scarring, or skin infections.

    Can the doctor help?

    Although most skin discolouration cases are benign, sometimes you have to play it safe and consult a dermatologist. Make an appointment if you see:

    • any new moles or discoloured sections of skin,
    • any changes in the appearance of existing moles, discoloured patches, or pigmentation demarcation lines, and
    • any lasting changes in your skin tone and colour.

    When you visit the doctor, let them know if you had any sunburns, injuries, or other lesions recently. Also, make sure to tell them if you have any underlying health conditions or are pregnant, as these may have a bearing on the diagnosis. Also, inform the doctor if you are taking hormonal therapy or any other medication.

    The dermatologist will examine your skin thoroughly before prescribing any pigmentation serum or face wash. They may also run some tests before providing a diagnosis and a treatment plan.

     

    Is acne to blame for your skin pigmentation issues?

    Some people get flat, dark spots where an acne lesion used to be. The pimple is gone but it has left behind an unpleasant reminder in its wake. Hyperpigmentation of this form is more common among people with darker skin tones. 

     

    Why does this happen?

    • When the acne lesion clears up and the skin starts to recover, sometimes the recovering skin cells will produce extra melanin.
    • Overproduction of melanin results in brown spots that are darker than the surrounding skin.
    • Exposure to the sun tends to aggravate the appearance of these post-acne spots.

    Acne-related hyperpigmentation tends to fade over time. But if the lesion was very deep-seated, you might notice bluish-grey marks that are permanent. In the latter case, your dermatologist may suggest a suitable in-office treatment. 

     

    Treating acne-related hyperpigmentation

    Most acne-related dark spots resolve themselves. But these spots could take anywhere from six months to a year to disappear completely. You could help them along with pigmentation home remedies involving everyday ingredients like apple cider vinegar, aloe vera, red onions, and green tea. (Here’s our one-stop guide to defeating dark spots naturally at home.)

    Meanwhile, channel the power of makeup if that’s up your alley. You could use concealer to cover up the spots until they go away completely. Just make sure to use non-acnegenic and non-comedogenic products. Why take the chance of aggravating your acne and landing up with more discolouration? 

    The safest bet in all such cases is to consult your dermatologist. They may suggest pigmentation face washes, cleansers, and serums that are better suited to your acne-prone skin and discolouration concerns. Typically, dermatologists suggest OTC and medicated pigmentation creams and other formulas that contain actives like 2% hydroquinone, azelaic acid, glycolic acid, retinoids, and Vitamin C. 

    What if your hyperpigmentation does not respond to topical treatment? Speak with your dermatologist about in-clinic options. Chemical peels, laser resurfacing, and IPL therapy are often effective against acne-related hyperpigmentation.

     

    Prevent acne, prevent skin pigmentation issues

    If your hyperpigmentation has its origins in acne, attack the problem at the root. Acne needs special care, so reaching for regular bath soap won’t do you any favours. What you need is a skincare routine that is personalized to your acne-prone skin. 

    Here is a four-step routine that will take just five minutes of your time every morning and night:

    1. Cleanse: Wash away the oil, grime, and dead skin cells that have been accumulating on your skin. But no harsh formulas, please! What you need is a gentle cleanser to deep-clean the pores without stripping away vital moisture. A creamy formula like Clearica Anti-Acne Cleanser will get the job done and keep pimples away.
    2. Tone: Restore the skin’s pH level post cleanse by applying toner with a cotton ball. Swipe all over freshly cleansed skin using quick, upward strokes. This step primes the skin for any serums and treatments that may be in store.
    3. Repair: Give your acne-prone skin an extra helping hand with Clearica Anti-Acne Cream. This powerful plant-based cream fights acne bacteria and infections, clears the pores, and minimises any redness and inflammation. It also leaves your skin feeling rejuvenated.
    4. Moisturise: Close out your skincare regimen with a moisturiser that contains enough SPF. Protection from UV rays is a key element in the fight against skin pigment imbalances. Sun exposure can darken your spots and patches, making them harder to fade. So, don’t skip this step.

     

    Bottom-line

    Whatever the reason for your skin pigmentation issues, monitor your complexion with care. Even once you start any pigmentation treatments, watch out for any side effects. Even the gentlest of treatments can irritate your skin and leave you at risk of fresh discolouration. You can never be too careful on the road to clear, even-toned, unblemished skin.

     

     

     

     

    Disclaimer: This page is for educational and informational purposes only. It is not intended as a recommendation or for diagnostic purposes. Please consult your dermatologist or doctor before acting on any of the information provided here.