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Abnormally dark or light skin

Show Alternative Names
Hyperpigmentation
Hypopigmentation
Skin - abnormally light or dark

Abnormally dark or light skin is skin that has turned darker or lighter than normal.

Considerations

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

Causes of hyperpigmentation include:

  • Skin inflammation (post-inflammatory hyperpigmentation)
  • Use of certain medicines (such as minocycline, certain cancer chemotherapies, and birth control pills)
  • Hormone system diseases such as Addison disease
  • Hemochromatosis (iron overload)
  • Sun exposure
  • Pregnancy (melasma, or mask of pregnancy)
  • Certain birthmarks
  • A skin condition called acanthosis nigricans

Causes of hypopigmentation include:

  • Skin inflammation (post-inflammatory hypopigmentation)
  • Certain fungal infections (such as tinea versicolor)
  • Pityriasis alba
  • Vitiligo
  • Certain medicines
  • A skin condition called idiopathic guttate hypomelanosis in sun exposed areas such as the arms
  • Certain birthmarks

Home Care

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 skin discoloration.

Avoid too much sun exposure. Always use sunscreen with an SPF of 30 or higher.

Abnormally dark skin may continue even after treatment.

When to Contact a Medical Professional

Contact your health care provider for an appointment if you have:

  • Skin discoloration that causes significant concern.
  • Persistent, unexplained darkening or lightening of the skin.
  • Any skin sore or lesion that changes shape, size, or color. It may be a sign of skin cancer.

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask about your symptoms, including:

  • When did the discoloration develop?
  • Did it develop suddenly?
  • Is it getting worse? How fast?
  • Has it spread to other parts of the body?
  • What medicines do you take?
  • Has anyone else in your family had a similar problem?
  • How often are you in the sun? Do you use a sun lamp or go to tanning salons?
  • What is your diet like?
  • What other symptoms do you have? For example, are there any rashes or skin lesions?

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.

Review Date: 6/3/2025

Reviewed By

Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Bolognia J, McMichael A. Infections, pigmentation disorders, regional dermatology, and distinctive lesions in black skin. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 408.

Seneschal J, Passeron T, Torrelo A, Ortonne J-P. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 66.

Weston GK, Chang MW. Disorders of hyperpigmentation. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 67.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Images
Vitiligo - drug induced - Illustration Thumbnail

Vitiligo - drug induced

The white spots on this person's face have resulted from drug-induced vitiligo. Loss of melanin, the primary skin pigment, occasionally occurs as a result of medicines, as is the case with this individual. The typical vitiligo lesion is flat and depigmented, but maintains the normal skin texture.

Illustration

Vitiligo on the face - Illustration Thumbnail

Vitiligo on the face

This is a picture of vitiligo on the face. Complete loss of melanin, the primary skin pigment, occurs for unknown reasons. The resulting lesions are white in comparison to the surrounding skin. Vitiligo may occur in the same areas on both sides of the face -- symmetrically -- or it may be patchy -- asymmetrical. The typical vitiligo lesion is flat (macular) and depigmented, but maintains the normal skin texture. The dark areas around the eyes are this person's normal skin color.

Illustration

Incontinentia pigmenti on the leg - Illustration Thumbnail

Incontinentia pigmenti on the leg

Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.

Illustration

Incontinentia pigmenti on the leg - Illustration Thumbnail

Incontinentia pigmenti on the leg

Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.

Illustration

Hyperpigmentation 2 - Illustration Thumbnail

Hyperpigmentation 2

Hyperpigmentation refers to skin that has turned darker than normal where the change that has occurred is unrelated to sun exposure. Cells called melanocytes located in the skin, produce melanin. Melanin gives the skin its color. In certain conditions melanocytes can become abnormal and cause an excessive amount of darkening in the color of the skin.

Illustration

Post-inflammatory hyperpigmentation - calf - Illustration Thumbnail

Post-inflammatory hyperpigmentation - calf

Hyperpigmented concentric rings over the tibia are secondary to prior inflammation. Residual hemosiderin from broken down red blood cells in macrophages, left behind after inflammation pigments the skin.

Illustration

Hyperpigmentation w/malignancy - Illustration Thumbnail

Hyperpigmentation w/malignancy

Generalized hyperpigmentation, in addition to localized areas of even deeper pigmentation is sometimes found in patients with malignancy. Etiology of these pigmentary changes is varied.

Illustration

Post-inflammatory hyperpigmentation 2 - Illustration Thumbnail

Post-inflammatory hyperpigmentation 2

Post-inflammatory hyperpigmentation is seen here in a mottled pattern, over the posterior shoulder. Hemosiderin, left behind by degraded RBC's, creates the discoloration.

Illustration

 
 
Vitiligo - drug induced - Illustration Thumbnail

Vitiligo - drug induced

The white spots on this person's face have resulted from drug-induced vitiligo. Loss of melanin, the primary skin pigment, occasionally occurs as a result of medicines, as is the case with this individual. The typical vitiligo lesion is flat and depigmented, but maintains the normal skin texture.

Illustration

Vitiligo on the face - Illustration Thumbnail

Vitiligo on the face

This is a picture of vitiligo on the face. Complete loss of melanin, the primary skin pigment, occurs for unknown reasons. The resulting lesions are white in comparison to the surrounding skin. Vitiligo may occur in the same areas on both sides of the face -- symmetrically -- or it may be patchy -- asymmetrical. The typical vitiligo lesion is flat (macular) and depigmented, but maintains the normal skin texture. The dark areas around the eyes are this person's normal skin color.

Illustration

Incontinentia pigmenti on the leg - Illustration Thumbnail

Incontinentia pigmenti on the leg

Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.

Illustration

Incontinentia pigmenti on the leg - Illustration Thumbnail

Incontinentia pigmenti on the leg

Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.

Illustration

Hyperpigmentation 2 - Illustration Thumbnail

Hyperpigmentation 2

Hyperpigmentation refers to skin that has turned darker than normal where the change that has occurred is unrelated to sun exposure. Cells called melanocytes located in the skin, produce melanin. Melanin gives the skin its color. In certain conditions melanocytes can become abnormal and cause an excessive amount of darkening in the color of the skin.

Illustration

Post-inflammatory hyperpigmentation - calf - Illustration Thumbnail

Post-inflammatory hyperpigmentation - calf

Hyperpigmented concentric rings over the tibia are secondary to prior inflammation. Residual hemosiderin from broken down red blood cells in macrophages, left behind after inflammation pigments the skin.

Illustration

Hyperpigmentation w/malignancy - Illustration Thumbnail

Hyperpigmentation w/malignancy

Generalized hyperpigmentation, in addition to localized areas of even deeper pigmentation is sometimes found in patients with malignancy. Etiology of these pigmentary changes is varied.

Illustration

Post-inflammatory hyperpigmentation 2 - Illustration Thumbnail

Post-inflammatory hyperpigmentation 2

Post-inflammatory hyperpigmentation is seen here in a mottled pattern, over the posterior shoulder. Hemosiderin, left behind by degraded RBC's, creates the discoloration.

Illustration

 
 
 
 
 
 

 

 
 
 
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