Beyond the Spectrum:
How Skin Color Shapes Hyperpigmentation

February 2025Donika Vata, MD, and Dr. Samujjala Deb, MD

The skin, our body's largest and most expressive organ, has a starring role far beyond protection; it actively communicates the state of our inner health, with every change resonating of what's happening beneath the surface. Among the many skin concerns people face, hyperpigmentation stands out for its widespread impact, affecting millions globally and disproportionately impacting individuals with darker skin tones. Conditions like post-inflammatory hyperpigmentation (PIH), melasma, and solar lentigines (age spots) aren't just cosmetic issues, they carry significant emotional and social burdens, often leading to feelings of self-consciousness and even social stigma.

What underlies the widespread prevalence of this condition, and why does it manifest in such varied forms?

Moreover, what should be the appropriate approach to address it?

When I discussed hyperpigmentation with Dr. Samujjala Deb, we were well aware of the struggles our patients faced. We saw firsthand that this condition goes beyond the surface, presenting as a persistent issue for many people.

Yet, despite its prevalence, hyperpigmentation remains surprisingly under-discussed, especially regarding the unique experiences of those with darker skin tones.

The conversation often stops at "dark spots," without addressing the distinct challenges that different ethnicities face.

But to understand why hyperpigmentation affects different skin tones so specifically, we need to start with the basics: melanin. This natural pigment, responsible for the shades of our skin, is more than just a color, it's a powerful protector.

Melanin shields our skin from harmful UV rays, but in individuals with darker skin, it also responds more strongly to injuries and inflammation. This heightened response is where hyperpigmentation begins.

This brings us to the Fitzpatrick scale, a system dermatologists use to classify skin types based on their melanin content and response to sunlight.

Ranging from Type I to Type VI, this scale helps explain why some skin tones are more prone to hyperpigmentation than others.

People with lighter skin tones, categorized as Types I through Type III, produce less melanin and tend to burn easily with sun exposure.

On the other end of the spectrum, Types IV through VI include individuals with more melanin, whose skin naturally tans or darkens under the sun but is also more reactive to injuries and inflammation.

This heightened response is what often leads to post- inflammatory hyperpigmentation (PIH), making dark spots more visible and longer-lasting.

Hyperpigmentation as a Medical Condition

Hyperpigmentation is a medical condition where patches of skin become darker than the surrounding area due to an excess of melanin production. This pigmentation change can be triggered by various factors, such as sun exposure, hormonal changes, and, significantly, skin trauma or inflammation.

Each of these factors pulls melanocytes, our skin's pigment-producing cells, into action, leaving traces that linger, especially on darker skin, where higher melanin levels intensify the imprint.

Demystifying the Underlying Causes

Sun Exposure: The Primary Trigger

The sun is a major source of UV radiation, which is split into two types: UVA and UVB. These rays are both capable of reaching your skin, but their impact differs depending on their penetration depth. UVB rays primarily affect the epidermis, the outermost layer of the skin, while UVA rays penetrate much deeper into the dermis, the inner layer of the skin.

When these rays strike the skin, they don't just tan you, they cause direct DNA damage in skin cells. Over time, this damage can lead to mutations in the DNA, increasing the risk of skin cancer. That's why the body needs to protect itself when exposed to UV radiation.

Activation of Melanocytes

In response to the damage caused by UV exposure, the skin activates melanocytes, the specialized cells responsible for producing melanin, the pigment that gives skin its color.

Melanin acts as the skin’s natural defense mechanism.
It absorbs and dissipates UV radiation, shielding the underlying cells from further DNA damage.

When UV rays hit your skin, they wake up the melanocytes. These little pigment-producing cells get to work, cranking out more melanin to protect you from UV damage. This melanin is packed into melanosomes, which travel to the skin's surface, creating a protective shield against the sun’s harmful rays.

Skin Response in Dark Skin

With more melanin already in place, dark skin ramps up production when exposed to UV rays. This results in darker, larger, and more persistent spots, think sunspots or age spots, that don’t fade as quickly. The skin’s extra melanin means the spots tend to stick around longer.

Skin Response in Light Skin

Light skin doesn’t produce as much melanin, so when exposed to the sun, the response is milder. Freckles or lighter sunspots appear, but they’re usually smaller and fade faster. Light skin is also more likely to burn because it lacks the melanin needed for protection, leaving it more vulnerable to UV damage.

Post-Inflammatory Hyperpigmentation (PIH)

Post-inflammatory hyperpigmentation (PIH) is a skin condition that leaves you with lingering dark spots after skin injury or inflammation. It's a natural reaction, but it’s more pronounced in people with darker skin tones, where any trauma or irritation can spark an overproduction of melanin, leading to darker, more persistent marks.

PIH usually follows any type of skin trauma, like acne, eczema, cuts, burns, or even insect bites. When the skin gets irritated or injured, the body kicks into repair mode. The inflammatory process begins, triggering the immune system to send healing agents to the affected area.

Melanocyte Stimulation in Response to Inflammation

Now, during this healing phase, signals are sent to melanocytes. The task?

Produce more melanin to shield the damaged skin from further harm and help with recovery. It’s the skin’s natural defense mechanism.

The difference in skin type comes in when we look at how much melanin is produced in response to inflammation. In dark skin, the melanocytes are far more active. This means a higher baseline level of melanin, so the skin is already primed to produce more pigment. The increased melanin produced during inflammation gets concentrated in the affected area, creating those dark marks you see.

Excess Melanin Accumulation in Affected Areas

The excess pigment tends to accumulate in large patches or dark spots, often remaining visible long after the skin has healed. These spots are deeper, darker, and more persistent, they might take months or even years to fade completely.

Meanwhile, in light skin, the melanin production is less intense. The response is more subdued, and you’ll see smaller, lighter spots that usually fade faster. These marks don’t linger as long as in dark skin, and the process of fading is much quicker, typically taking a few weeks to a couple of months depending on how severe the inflammation was.

Hormonal Changes (Melasma)

Understanding How Hormonal Changes Cause Melasma and Hyperpigmentation

Melasma is often referred to as "the mask of pregnancy" when it appears during pregnancy, it’s a sign of hormonal change. Typically appearing as symmetrical patches of darkened skin, melasma commonly affects the face, particularly the cheeks, forehead, nose, and upper lip.

But the story doesn’t end there, this condition is more pronounced in individuals with darker skin tones, where melanin production is naturally higher.

Why Hormonal Changes Cause Melasma?

The elevated levels of estrogen and progesterone during times of hormonal fluctuation trigger melanocytes to overproduce melanin, resulting in the darker patches characteristic of melasma.

These hormones essentially “turn on” the melanocytes to an extent that’s disproportionate to the actual need for pigmentation protection, leading to hyperpigmentation.

At the heart of this process are estrogen and progesterone. These hormones don’t just circulate in your bloodstream; they actively bind to receptors on melanocytes, turning them on and causing them to produce more melanin.

These receptors are most concentrated in places like the face, which explains why melasma often targets those areas.

Why Melasma Is More Intense in Dark Skin?

In darker skin tones, the melanocytes are more active, producing larger quantities of melanin. This makes melasma much more intense, deeper and darker than in lighter skin tones.

The more melanin your skin produces, the harder it is to fade the hyperpigmentation. The pigmentation accumulates in the skin’s layers, making melasma difficult to treat and often more persistent over time.

Type I
Type I
Type I
Bar 6
Type I
Type II
Type II
Bar 5
Type II
Type III
Type III
Bar 4
Type III
Type IV
Type IV
Bar 3
Type IV
Type V
Type V
Bar 2
Type V
Type VI
Type VI
Bar 1
Type VI

UVB

UVA

Type I
EpiDermisDErmisHypodermis
Type I
Type I
Type VI
Type VI
Type I
Type VI
Type I
Type I
Type VI
Type VI
Type I
Type I
Type VI
Type VI

Estrogen

estrogen-arrow

Progesterone

progesterone-arrow
4-6 Weeks
Type I
Type I
3-12 Months
Type VI
Type VI

Experiences and Approaches

If you’re here hoping for a quick fix for your hyperpigmentation, sorry to disappoint you, but we won’t be offering any treatments or remedies. You might be wondering why, well, take a look at the stories of Amira, Jared, and others, and you’ll see how each person’s skin and body are distinct. That’s why their approach to hyperpigmentation should be, too.

Earlier, we explored the science behind hyperpigmentation, how it develops, why it behaves differently in various skin tones, and how melanin plays a role. But understanding hyperpigmentation goes beyond just skin color.
What’s equally important is the individual’s background, their health, environment, personal history and genetics.

These factors strongly influence not just how hyperpigmentation manifests, but how it can be addressed.
By the end of this article, we’ll see that no two journeys with hyperpigmentation are the same and why an individualized approach matters.

Let’s meet the others!

Why Do These Stories Matter and Why Approaches Often Miss the Mark?

Hyperpigmentation isn’t just a reflection of skin biology, it’s shaped by systemic health, environment, and lived experiences. Yet, the approaches often taken to address it fail to recognize this complexity.

Why?

For starters, there’s a tendency to oversimplify. Generalized advice dominates the internet, offering quick-fix solutions or universal routines that don’t consider the nuances of an individual’s skin.

For example, while the science of melanin tells us why darker skin is more reactive to inflammation, it doesn’t mean every individual with darker skin experiences hyperpigmentation in the same way. Their health history, daily habits, and even the environments they navigate all have a role.

This oversimplification leaves many feeling stuck and forced to experiment with advice that wasn’t even crafted with them in mind.

A study by Forrester found that 77% of consumers have chosen, recommended, or were willing to pay more for a brand that offered an individualized customer experience. This highlights how critical and how much needed individualized insights are for addressing skin concerns.

Without this access people are left trying to fit into approaches designed for “everyone,” which often means “no one.”

And then there’s the cultural layer. Hyperpigmentation carries emotional and social weight, particularly in communities where even minor skin concerns can become stigmatized. But these challenges aren’t often discussed in the broader narrative about skin health, leaving those who experience them feeling unseen.

So, what’s missing?

It’s not more products or surface-level advice,it’s understanding. An approach rooted in the individual: their skin, their health, their medical background. The same hyperpigmentation that appears as a post-acne spot on one person might result from hormonal shifts in another.

An individualistic perspective acknowledges these distinctions, starting with the question, “What’s behind your skin story?”

Science tells us that skin is dynamic, constantly adapting to internal and external changes. An individualistic approach mirrors that dynamism. It doesn’t just categorize by skin type or condition, it considers how every factor, your environment, your health, and your habits, intersect to shape your skin.

Shifting the focus from standardization to singularity, we begin to address the root causes of hyperpigmentation in a way that aligns with each person’s unique biology and life. It’s not about chasing one solution, it’s actually about building an approach that evolves with the individual.

Conclusion

This brings us back to the heart of the matter: no two skin journeys are the same.

Skin is dynamic, it adapts, reacts, and reflects the body's inner workings. The same condition can manifest differently in two individuals, depending on their skin type, health history, and environment. This is why an individualistic approach is essential when addressing hyperpigmentation.

An individualized path doesn't rely on quick fixes or generic advice. Instead, it involves understanding the unique factors influencing a person's skin, both internal and external. It's about asking the right questions, examining health patterns, and considering how lifestyle, environment, and biology intersect to shape skin health.

The key is not to chase trends or follow what works for someone else but to embrace a process rooted in science and understanding. This approach mirrors how experts analyze data, starting with questions, gathering insights, and crafting strategies based on evidence.

Hyperpigmentation isn't just about dark spots, that is actually the tip of the iceberg in most of the cases. We have to focus on the bigger picture so then we can move beyond superficial solutions to uncover what truly works, step by step, for each one of you.



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