Pigmentation Disorders – Why Live With Dark Spots When You Can Treat Them Safely?
Many of my patients come to me feeling confused, embarrassed, or tired of trying creams that don’t work. Uneven skin tone can quietly affect confidence and social comfort. In my clinical experience, pigmentation is common, treatable, and often misunderstood. This guide will give you clear, ethical, and safe direction.
What exactly are pigmentation disorders?
Pigmentation disorders occur when excess or reduced melanin causes dark or light patches on the skin. Most are harmless and treatable with the right approach.
Melanin is the natural pigment that gives skin its colour
Overproduction causes dark patches (hyperpigmentation)
Underproduction leads to light or white patches
Seen across all ages and skin types
Proper diagnosis is essential before treatment
Dr. Milan Doshi’s Tip:
In my OPD, many patients assume all dark spots are the same. Identifying the type of pigmentation decides the success of treatment.
What are the most common types of pigmentation disorders?
Age spots, melasma, post-inflammatory hyperpigmentation, vitiligo, and albinism are the most commonly seen pigmentation conditions.
i. Age spots:
Brown or black spots on sun-exposed areas
Common after prolonged sun exposure or aging
ii. Melasma:
Large dark patches on face
Triggered by hormones, pregnancy, or pills
iii. Post-inflammatory hyperpigmentation (PIH):
Dark marks after acne, eczema, or injury
More common in Indian skin types
iv. Vitiligo:
Autoimmune loss of pigment
White patches around eyes, mouth, hands
v. Albinism:
Genetic absence of melanin
A lifelong condition
Dr. Milan Doshi’s Tip:
Not all pigmentation should be treated cosmetically. Some conditions need medical supervision only.
What causes hyperpigmentation in the skin?
Sun exposure, hormones, inflammation, medications, and certain medical conditions can trigger excess melanin production.
Long-term sun exposure
Acne or skin inflammation
Hormonal changes (pregnancy, PCOS)
Certain medicines
Medical conditions like Addison’s disease
Dr. Milan Doshi’s Tip:
Treating pigmentation without correcting the cause leads to recurrence. Diagnosis always comes first.
Do home remedies really help in treating hyperpigmentation?
Home remedies may mildly improve pigmentation but cannot treat moderate or deep pigmentation reliably.
Aloe vera (aloesin reduces melanin activity)
Licorice extract (anti-inflammatory effect)
Green tea (antioxidant support)
Milk and buttermilk (lactic acid exfoliation)
Tomato paste (photoprotection support)
Note: Always patch-test before use.
Dr. Milan Doshi’s Tip:
In my experience, home remedies help only as support, not as standalone treatment for visible pigmentation.
Which medical creams are used to treat hyperpigmentation?
Prescription creams reduce melanin production and improve skin turnover when used correctly under supervision.
Azelaic acid
Niacinamide
Retinoids
Kojic acid
Vitamin C
Mandelic acid
Short-term supervised hydroquinone use
Dr. Milan Doshi’s Tip:
Unsupervised use of bleaching creams is one of the biggest causes of worsening pigmentation I see in Mumbai clinics.
Which cosmetic procedures are effective for pigmentation removal?
Advanced procedures can safely lighten pigmentation when tailored to skin type and depth of pigment.
Chemical peels: Controlled exfoliation for surface pigmentation
Laser therapy: Targets deeper pigment precisely
IPL: Useful in select light skin cases
Microdermabrasion: Mild pigmentation and skin refresh
Often, a combination approach gives best results.
Dr. Milan Doshi’s Tip:
Technology alone doesn’t decide outcomes. Correct settings and experience matter more than the machine.
Can pigmentation come back after treatment?
Yes, pigmentation can recur if triggers like sun exposure or hormones are not controlled.
Maintenance skincare is essential
Sunscreen is non-negotiable
Hormonal evaluation may be required
Follow-up treatments may be advised
Is pigmentation treatment safe for Indian skin?
Yes, when performed by an experienced doctor using skin-type–specific protocols.
Indian skin needs gentle, graded treatment
Over-aggressive lasers can worsen pigmentation
Safety depends on expertise, not trends
How long does pigmentation treatment take to show results?
Visible improvement usually begins in 3–6 weeks, with gradual enhancement over months.
Depends on depth and type
Consistency is key
Quick fixes often backfire
Conclusion – Final Words from Dr. Milan Doshi
Pigmentation disorders are common, manageable, and nothing to be embarrassed about. In my clinical experience, the best results come from early diagnosis, realistic expectations, and ethical treatment planning. You don’t have to live with uneven skin tone—safe, evidence-based solutions exist.
If pigmentation is affecting your confidence, a personalised evaluation is the first step toward clarity and healthier skin.
