What Is Hyperpigmentation? Its Signs, Causes & Types

Do you feel hyper-aware of the dark spots on your face? Feeling they are holding your beauty back—and you are unable to get rid of them.

These discolored spots may draw unwanted attention wherever you go, and this could impact your self-esteem a bit. Meaning, you might not feel very confident in your appearance. This could be due to embarrassment or fear of judgement or frustration on why you can’t make these stubborn spots go away.

The dark spots are a type of skin condition called hyperpigmentation that can arise due to a number of factors, including prolonged exposure to Sun’s UV rays, hormonal changes, skin injuries, etc.

Melasma, too, is one of the skin hyperpigmentation types that appears on the skin as brown blotchy spots. A study states that melasma potentially affects “quality of life” and “self-confidence” as it occurs on the face frequently. It sometimes also is severe in nature and very difficult to go.

Before we get to the treatment methods, you should first develop a clear concept of “what is hyperpigmentation?” What are its major causes, its types and also prevention tips. 

In this blog, we’ll do exactly that. Let’s go.

What is Hyperpigmentation?

When excess melanin accumulates in some areas of the skin such that they appear darker than the surrounding skin, this condition is called hyperpigmentation. 

Also, melanin is a pigment that gives your skin its unique colour.

While hyperpigmentation is mostly harmless, it can sometimes signal internal health issues. 

Thinking along the lines of cosmetic appearance—yes, an individual with dark spots, especially on the face, can face mental distress and become too conscious about how he or she looks in a public setting.

That’s why if you come across skin discolorations on any of your body parts that’s significantly noticeable or are widespread—you should consult a dermatologist who can help you assess and treat them properly.

Some Natural Signs of Skin Hyperpigmentation

• Darkened Patches: If you find certain areas of your skin darker than their surrounding regions, this may be an initial indicator. These darkened patches can vary in size and appear anywhere on the body.

• Variation in Colour: The patches can appear brown, black, gray, red, or pink depending on the underlying cause and skin tone.

• Common Locations: Hyperpigmentation often occurs on areas that are frequently exposed to the sun, such as the face, neck, and hands. It can, however, develop on any body part. 

• Associated Conditions: Certain skin conditions like acne, eczema, or psoriasis—can lead to post-inflammatory hyperpigmentation, a type of hyperpigmentation where dark spots remain even after the initial lesion/wound/bruise/injury has healed.

What are the Causes of Hyperpigmentation of Skin?

I) Exposure to the Sun’s UV Rays

When you remain out in the sun for a prolonged time, the ultraviolet (UV) radiation from the sun stimulates the melanocytes present in your skin to produce more melanin as a defense mechanism. 

Chronic sun exposure can lead to hyperpigmented spots that return again and again, and these are commonly known as sunspots or solar lentigines.

II) Inflammation and Skin Injuries

Post-inflammatory hyperpigmentation (PIH) happens because of skin inflammation—resulting from skin conditions like acne, eczema, or skin trauma or injury. As the skin focuses on healing, it can trigger increased melanin production, leading to darkened areas.

III) Hormonal Changes

Another of hyperpigmentation causes include hormonal fluctuations, especially involving estrogen or progesterone. This clearly shows in conditions such as melasma, where dark patches develop on the face, often during pregnancy or with the use of oral contraceptives. 

IV) Exposure to Certain Medications or Chemicals

Medications that have been observed as a probable cause of pigmentation on face, neck, or other body parts, can include:

• Non-steroidal anti-inflammatory drugs (NSAIDs)

• Antimalarials

• Amiodarone

• Cytotoxic drugs

• Tetracyclines

• Heavy metals

• Psychotropic drugs

V) Medical Conditions

Undisclosed or latent health conditions can also be an elemental reason for hyperpigmentation. 

For example, Addison’s disease where one suffers from the insufficient functioning of adrenal glands. Now, such a condition may provoke the production of melanocyte-stimulating hormones. This results in generalized skin darkening. 

VI) Genetic Factors

Genetics play a fundamental role in determining your baseline skin colour and whether you’re and if so, how much, susceptible to pigmentation disorders. 

Individuals with a family history of conditions such as melasma may be prone to developing similar issues. 

So yes, there could be a genetic component to hyperpigmentation. 

VII) Ageing

As you grow older, the skin ages too. 

With time, the melanocyte distribution becomes less-controlled or less-uniform, leading  to hyperpigmented spots known as age spots or liver spots.

VIII) Stress

Extreme stress can elevate cortisol levels (a type of hormone released during stressful activities), which may stimulate melanin creation, causing darkened areas on the skin.

IX) Cosmetic Procedures

Treatments such as dermabrasion, laser therapies, and chemical peels can cause skin trauma—which results in post-inflammatory hyperpigmentation (PIH). This is especially true in individuals prone to pigmentation issues.

Different Types of Pigmentation in Skin

I) Melasma

We just mentioned it earlier. So, what is it all about?

Melasma mostly presents itself as symmetrical, blotchy facial pigmentation, brown in colour. Also known as chloasma, it largely affects women, and especially during pregnancy or while taking oral contraceptives.

It occurs on the cheeks, forehead, nose, and upper lip. Sun exposure can worsen the situation, therefore, it is important to have UV protection in your daily routine to effectively manage skin pigmentation.

II) Post-Inflammatory Hyperpigmentation (PIH)

We already discussed how skin injury or inflammation can activate the body’s immune response (or healing mechanism) to produce more melanin in the skin. This causes darkened patches at the site of the original injury. This phenomenon is also common in the case of post-acne hyperpigmentation, where the affected area (the original site of acne) darkens, leaving a stubborn mark even when the lesion heals.

Now, PIH can affect individuals of all skin types. Still, it is more prevalent in those with darker skin types.

III) Solar Lentigines

They’re commonly referred to as the age spots or liver spots. How do they look? Small, darkened patches that appear on areas exposed to sun, like the face, hands, shoulders, and arms.

Hyperpigmentation reason here? Well, the usual suspect—UV rays of the sun. 

Persistent exposure to them leads to localized proliferation of melanocytes, meaning—these melanin-producing cells rapidly multiply in number and are confined to a specific region (that is, out in the sun) within the body.

These age spots are more common in people over the age of 40, but can occur in young people too if they spend significant time in the sun.

IV) Freckles (Ephelides)

Freckles are small, flat spots—brownish in colour—typically found on skin often exposed to the sun. 

They, too, result from an overproduction of melanin and are far more easily noticeable during summer months.

Genetic component plays a crucial role in their development. It is found that people with fair skin and red or blonde hair are more vulnerable to this condition than others.

V) Café-au-Lait Macules

These flat spots can intrude and show up on any part of the body; they can range from light-brown to dark-brown in skin discoloration and are usually benign in nature.

According to research, Café-au-Lait Macules can have a correlation with genetic conditions, like neurofibromatosis type 1.

Let’s take a closer look at other Types of Pigmentation in Skin

I) Lichen Planus Pigmentosus (LPP)

• A rare condition which causes brownish-black or purple gray skin pigmentation.

• Usually in the form of oval or round macules (or patches), sometimes accompanied with mild itching (also called pruritus).

• Affects the face, neck, arms, and trunk.

• The reason for pigmentation is not known, but possible factors include—sunlight, mustard oil, amla oil, tight clothing, hair dyes, cosmetic agents like Kum Kum, Hepatitis C virus, etc.

II) Erythema Dyschromicum Perstans

• Experts also call it ashy dermatosis. It manifests as flat, slate-gray coloured patches (at a later stage) that can vary in size.

• You may find them on the trunk, upper arms, and thighs.

• Asymptomatic in nature, meaning—people don’t experience any discomfort or pain from the lesions or pigmentation patches.

• Again, the exact cause is unclear. But it may be associated with genetic factors, specific medications, exposure to chemicals.

III) Riehl Melanosis

• Researchers believe that this skin condition results from a Type-IV hypersensitivity reaction.

• This could be triggered by contact allergens such as personal fragrances, textiles, and cosmetics.

• One may find brown-gray pigmented patches on the face, neck, and upper chest.

• Now, the patches can appear in two patterns. Either, they are reticulated (meaning, forming a net-like or lace-like pattern on the skin). Or, they are diffused (meaning, widespread uniform skin discoloration lacking clear boundaries).

IV) Poikiloderma of Civatte

• A skin condition that leads to reddish-brown patches on the neck, upper chest, and cheeks.

• Also known as sun aging; there could be other symptoms like—visible small blood vessels (spider veins) and thinning of the skin.

• Excessive exposure to the sun’s UV radiation, normal aging, genetic factors, and hormonal changes are common causes of pigmentation in this case.

V) Fixed Drug Eruption

• It is a skin reaction that happens when a patient takes a specific drug. 

• A rash appears in the same area on the body, each time the drug is taken.

• Symptoms also include patches—oval-shaped and red in colour; some even have bullae (that are large blisters filled with clear fluid).

• Certain medications like antibiotics, NSAIDs, acetaminophen, barbiturates, and anticonvulsants may cause such skin reactions.

• The first step in treatment is to identify and discontinue the drug causing it.

The Bottom Line

Hyperpigmentation are the darkened patches that form on skin due to excess production of melanin, which can arise from prolonged exposure to sun UV’s rays, certain medications, contact allergens, skin injury or trauma, etc.

Understanding the causes of hyperpigmentation and identifying which type has affected you—is very important for starting your hyperpigmentation treatment right. 

We recommend consulting a board-certified dermatologist for accurate diagnosis and effective management of your hyperpigmentation condition.