What is facial pigmentation?

Facial pigmentation also known as hyperpigmentation where “Hyper” means more, and “pigment” means color, simply means dark patches or spots on the skin, especially over the face. It happens when some parts of your skin make more melanin (the pigment that gives your skin its color).

What does it look like?

It can appear as:

• Light brown to dark brown patches

• Freckles or sunspots

• Uneven skin tone

• Sometimes grayish or bluish areas (especially in deeper skin tones)

The spots are sometimes called age spots, sun spots or liver spots.

What causes it?

There are many reasons! Some common causes include:

• Adrenal disorders: Conditions like Addison’s disease, where the body doesn’t produce enough cortisol hormone, can cause darkening of the skin.

• Genetics: Some families naturally have freckles or darker spots due to their genes.

• Hormonal changes: Pregnancy or puberty can trigger more melanin production, leading to dark patches.

• Skin injuries: Acne, cuts, burns, or other skin damage can cause dark spots after healing, known as postinflammatory hyperpigmentation.

• Medications: Some drugs, including birth control pills, can make skin more sensitive to light, causing dark spots.

• Melasma: A condition that causes large patches of dark skin, often related to hormonal changes.

• Vitamin deficiencies: Lack of vitamins like B12 and folic acid can contribute to pigmentation problems.

• Sun damage: Long-term sun exposure can cause spots called solar lentigines or sunspots.

• Thyroid disorders: Problems with the thyroid gland can also affect skin pigmentation.

Is it harmful?

Nope! Facial pigmentation is usually harmless, but it can be bothersome cosmetically. However, a new or changing dark spot could be a sign of an internal issue — so it's always good to check with a dermatologist.

Can it be treated?

Yes! While it takes time, facial pigmentation can fade or improve with the right steps. Treatment depends on what’s causing the dark patches. Your doctor may suggest:

• Lifestyle changes:

  Protect your skin from the sun – Stay in the shade, wear sunscreen, hats, and long sleeves.

  Stop certain medicines – If a medication is the cause, your doctor might switch it.

  Take vitamins – If you're low in vitamins like B12 or folic acid, supplements may help.

• Topical treatments (creams and ointments):

  These are applied directly to the skin and help lighten the dark spots. Consult your dermatologist for personalised treatment as required for your cause of pigmentation. Stay informed that none of these medications should be initiated or continued without the guidance of a licensed dermatologist as safety profile on case to case basis needs to be established.

  Azelaic acid – Helps reduce swelling and pigmentation.

  Corticosteroids – Anti-inflammatory creams that may reduce darkness.

  Glycolic acid – An alpha-hydroxy acid that gently removes the top layer of skin.

  Hydroquinone – A skin-lightening agent often used to fade dark patches.

  Kojic acid – Reduces how much melanin the skin makes.

  Salicylic acid – Helps exfoliate and brighten skin.

  Skin bleach – Used cautiously to lighten dark areas.

  Tretinoin – A vitamin A derivative that helps with cell turnover.

  Vitamin C and B3 (Niacinamide) – Brighten and even out skin tone.

• Other treatment options:

  If creams don’t work or if the pigmentation is deeper, your doctor may recommend:

  Chemical peels – Removes the top layer of skin to reveal clearer skin underneath.

  Cryotherapy – Freezes and removes the pigmented spots.

  Laser skin resurfacing – Uses focused light to remove or fade the pigmentation.

  Pigmented lesion laser – Targets and breaks down dark pigment without harming nearby skin.

Skincare Routine for Facial Pigmentation (Morning + Night)

Here's a simple skincare routine for managing facial pigmentation but under a proper diagnosis and guidance of your Dermatologist.

Goal: Fade dark spots, even out skin tone, and protect your skin from further damage.

Morning Routine

• Gentle Cleanser

  Use a mild, non-drying face wash
  Look for: “fragrance-free,” “soap-free,” “for sensitive skin”
  Avoid scrubs or harsh cleansers

• Brightening Serum (Optional but helpful)

  Apply a lightweight serum to help fade spots over time

• Moisturizer

  Use a lightweight moisturizer to keep skin healthy
  Look for: fragrance-free, non-comedogenic, hydrating moisturizer

• Sunscreen – MUST!

  This is the most important step — without sunscreen, spots won’t fade
  Look for: SPF 30 or higher, broad spectrum, PA+++ or more
  Reapply every 2–3 hours if outdoors
  Don’t skip, even on cloudy days

Night Routine

• Cleanser (again)

  Wash off dirt, sunscreen, and makeup with the same gentle cleanser

• Treatment Serum or Cream as directed by your Dermatologist

• Moisturizer

  Keeps skin calm and hydrated — especially important when using strong actives like retinol.

Quick Tips:

• Patch test any new product on a small area first

• Be patient: Pigmentation fades slowly — give products 6–12 weeks

• Stay consistent: Skipping sunscreen or treatments delays results

• Avoid DIYs like lemon juice or turmeric — they can irritate or burn

Facial Pigmentation: Myths vs. Facts

• Myth 1: Pigmentation only happens to people who don’t take care of their skin.
  Fact: Even people with great skincare habits can get pigmentation — it can be due to hormones, sun exposure, acne, or genetics.

• Myth 2: You can scrub pigmentation away.
  Fact: Scrubbing won’t help, and can even make things worse by irritating your skin. Pigmentation is deep in the skin, not just on the surface.

• Myth 3: Only fair-skinned people get pigmentation.
  Fact: People with all skin tones can get pigmentation — but deeper skin tones are often more prone to stubborn dark spots.

• Myth 4: Sunscreen is only for sunny days.
  Fact: UV rays are present even on cloudy or indoor days (through windows, phone/laptop light), so daily sunscreen is a must to prevent and control pigmentation.

• Myth 5: Natural remedies like lemon juice or toothpaste will lighten dark spots.
  Fact: These can actually burn or damage your skin. Not all “DIY hacks” are safe — some can make pigmentation worse.

• Myth 6: Once treated, pigmentation will never come back.
  Fact: It can come back with sun exposure or hormonal changes. That’s why maintenance (sunscreen, gentle care) is important even after it fades.

• Myth 7: All pigmentation is the same.
  Fact: There are different types and each needs specific care or treatment.
  They are as follows:    
  A. Melasma    
  B. Post-Inflammatory Hyperpigmentation (PIH)    
  C. Sunspots (also called age spots or liver spots)    
  D. Freckles    
  E. Pigmentation from medications or medical conditions

Bonus Tip: No matter the type, sun protection is key in preventing it from getting worse and helping treatment work better!

Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.