Question 1

What is pigmentation?

Accepted Answer

Pigmentation changes describe alterations in the normal distribution or intensity of skin colour, resulting from increased or decreased melanin production, haemosiderin deposition, or structural changes to skin vasculature. Hyperpigmentation (darkening) occurs in sun-exposed areas, post-inflammatory responses, melasma, Addison's disease (diffuse darkening), and drug reactions. Hypopigmentation (lightening) occurs in post-inflammatory depigmentation after healed eczema or psoriasis, and as complete pigment loss in vitiligo.

Question 2

What do people commonly experience with pigmentation?

Accepted Answer

Dark patches or spots appearing on the face, neck, or hands
Uneven skin tone that has developed gradually
Lightening or loss of colour in patches of skin
Pigmentation that worsens after sun exposure
Skin colour changes following acne, injury, or inflammation

Question 3

What lifestyle changes can help with pigmentation?

Accepted Answer

Daily SPF 30+ sun protection is essential to prevent worsening of most pigmentation conditions and improve outcomes from treatment. Avoiding direct sun during peak hours reduces melanin stimulation. Topical vitamin C and niacinamide have evidence for brightening and pigmentation reduction. Addressing hormonal drivers where relevant.

Question 4

What integrative approaches support pigmentation?

Accepted Answer

Pigmentation disorders include melasma, post-inflammatory hyperpigmentation, vitiligo, and conditions linked to Addison's disease or other systemic diseases. Sun protection is the single most evidence-supported intervention. Azelaic acid, kojic acid, and niacinamide have clinical evidence for hyperpigmentation reduction. Vitiligo has specific treatment protocols including narrowband UVB and topical immunomodulators.

Question 5

When should I seek professional support for pigmentation?

Accepted Answer

Pigmentation changes in a mole — asymmetry, border changes, colour variation, diameter increase — require urgent dermatological assessment. New or rapidly changing pigmentation without clear cause. Post-inflammatory hyperpigmentation not responding to basic care. Widespread pigmentation loss (possible vitiligo assessment needed).

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