Hyperpigmentation; Hypopigmentation; Skin - abnormally light or dark
Abnormally dark or light skin is skin that has turned darker or lighter than normal.
Normal skin contains cells called melanocytes. These cells produce melanin, the substance that gives skin its color.
Skin with too much melanin is called hyperpigmented skin.
Skin with too little melanin is called hypopigmented. Skin with no melanin at all is called depigmented.
Pale skin areas are due to too little melanin or underactive melanocytes. Darker areas of skin (or an area that tans more easily) occurs when you have more melanin or overactive melanocytes.
Bronzing of the skin may sometimes be mistaken for a suntan. This skin discoloration often develops slowly, starting at the elbows, knuckles, and knees and spreading from there. Bronzing may also be seen on the soles of the feet and the palms of the hands. The bronze color can range from light to dark (in fair-skinned people) with the degree of darkness due to the underlying cause.
Causes of hyperpigmentation include:
Causes of hypopigmentation include:
Over-the-counter and prescription creams are available for lightening the skin. Hydroquinone combined with tretinoin is an effective combination. If you use these creams, follow instructions carefully, and don't use one for more than 3 weeks at a time. Darker skin requires greater care when using these preparations. Cosmetics may also help mask a discoloration.
Avoid too much sun exposure. Always use sunscreen with an SPF of 30 or higher.
Abnormally dark skin may continue even after treatment.
Call your health care provider for an appointment if you have:
Your provider will perform a physical exam and ask about your symptoms, including:
Tests that may be done include:
Your provider may recommend creams, ointments, surgery, or phototherapy, depending on the type of skin condition you have. Bleaching creams can help lighten dark areas of skin.
Some skin color changes may return to normal without treatment.
Chang MW. Disorders of hyperpigmentation. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 67.
Passeron T, Ortonne JP. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 66.BACK TO TOP
Review Date: 4/16/2019
Reviewed By: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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