Skin Pigmentation Disorders

Skin pigmentation disorders are changes in skin colour from too much or too little melanin. Darker Indian skin tans easily, scars darkly, and is prone to post-inflammatory hyperpigmentation — the brown marks left after acne, insect bites, eczema, or any inflammation. These are cosmetic issues, not dangerous — but they cause real distress and drive a large, often dangerous, skin-lightening market.

Common types

• Hyperpigmentation (darker) — melasma (hormonal, face, pregnancy/pill-related), post-inflammatory marks from acne, eczema, friction areas (dark knees/elbows/underarms), periorbital dark circles.
• Hypopigmentation (lighter) — vitiligo (see separate page), pityriasis alba (pale scaly patches on children's cheeks), post-burn or post-inflammatory depigmentation, tinea versicolor.

Melasma — India's most common pigmentation concern

• Symmetrical brown patches on cheeks, forehead, upper lip, jawline.
• Triggered by pregnancy, hormonal contraceptives, sun exposure.
• Treatment is slow and requires daily sunscreen — this is non-negotiable. Without sun protection, no cream will work.
• Topical options: several evidence-based prescription creams (including combination formulations) — all under dermatologist supervision.
• Chemical peels and laser can help but can also worsen pigmentation in Indian skin in untrained hands.

The "fairness cream" problem

• Many over-the-counter skin-lightening creams in India are contaminated with mercury, high-potency steroids (clobetasol/betamethasone), or unregulated hydroquinone.
• Mercury causes kidney damage and neurological problems over time.
• Steroid creams thin the skin, cause acne, facial hair, rosacea-like rashes, permanent pigmentation, and dependency.
• If a cream gives "results in 7 days" — it is almost certainly a steroid cream. Stop and see a dermatologist to wean safely.
• Skin colour is not a disease. Permanent, dramatic lightening is neither achievable safely nor necessary.

Safer approach

• Daily broad-spectrum sunscreen — the single most effective pigmentation treatment.
• Treat the underlying cause — acne, eczema, friction, rubbing.
• Be patient — post-inflammatory marks fade slowly over months.
• Use dermatologist-guided creams; avoid online fairness kits.