Behnoush Zarrini, M.D
Understanding Skin Discoloration and Pigmentation
Our skin is not static — it evolves with every environmental exposure, hormonal change, and year of life. These shifts can alter your skin tone, creating areas that appear darker or lighter than your natural complexion. This phenomenon is known as skin discoloration, and it reflects a disruption in melanin regulation — the pigment system that defines skin color and protects against UV radiation.
UV-Induced Dyspigmentation and Photoaging
Chronic ultraviolet (UVA and UVB) exposure disrupts melanocyte regulation, leading to dyspigmentation—uneven skin tone that develops primarily in sun-exposed areas such as the face, neck, chest, and hands. This pigment irregularity is a hallmark of photoaging and reflects cumulative photodamage rather than intrinsic aging alone.
Skin Discoloration Between the Buttocks
Although the darker area between the buttocks is usually not a cause for concern, conditions such as irritation and inflammation can lead to hyperpigmentation. Skin trauma and irritation can lead to post-inflammatory hyperpigmentation, forming dark spots on or between the buttocks. The most common causes of such discolorations are:
- Folliculitis, an infection of hair follicles known as butt acne
- Friction caused by clothing or skin
- Irritation from skin treatments and procedures or products, such as some cleansers
What Is Skin Discoloration?
Skin discoloration refers to areas of the skin that differ in color from your natural tone. It may appear as dark patches, lighter areas, redness, or even gray-blue hues caused by shifts in melanin production — the pigment that determines skin, hair, and eye color.
When melanin levels increase, the skin darkens (hyperpigmentation). When they decrease, the skin lightens (hypopigmentation).
What Is Melanin?
Melanin is the pigment responsible for your skin, hair, and eye color. It’s produced by melanocytes — specialized cells that regulate how your body responds to sunlight and other stressors. When melanin becomes imbalanced through genetics, UV exposure, inflammation, or injury, the result is uneven tone or visible pigmentation contrast.
Modern Approaches to Pigmentation Correction
Advances in aesthetic medicine now allow discoloration to be addressed safely and precisely. Treatments may include light-based technologies, chemical resurfacing, or regenerative modalities that target pigment at its cellular source. These therapies work by dispersing excess melanin, improving clarity, and restoring uniform texture — all without compromising skin health.
The key lies in individualized evaluation: determining whether your pigmentation is superficial, hormonal, inflammatory, or vascular in nature. Proper diagnosis ensures your treatment is matched to the underlying cause rather than its appearance.
A Physician-Led Philosophy
At Beverly Wilshire Aesthetics, every pigmentation treatment plan is developed under physician supervision. Our approach balances clinical precision with an aesthetic philosophy of restoration — understanding that every shift in tone tells part of the skin’s story. Through advanced diagnostic insight and measured intervention, we guide the skin back to equilibrium — luminous, balanced, and unmistakably alive.
What Causes Skin Discoloration?
Several factors lead to skin discoloration. Here are just some of these factors: Sunburns, aging, hormonal changes, infections, burns, and skin pigmentation disorders. All of these cause your skin to look damaged, dull, and discolored.
Skin Discoloration from Sun
Sunburns and other burns damage the skin and often cause discolored skin patches.
Aging
Another determining factor for hyperpigmentation is age. As you age, you may notice more spots on the skin around the face, chest, and other areas. The risk of developing these spots is higher if you fail to apply sunscreen to these areas frequently and adequately enough.
Other Common causes include:
• Birthmarks (moles, Mongolian spots, port-wine stains, strawberry or salmon patches)
• Skin infections or rashes (rosacea, psoriasis, eczema)
• Hormonal changes or pregnancy (melasma)
• Autoimmune diseases such as lupus
• Certain medications or allergic reactions
• Skin cancer or genetic pigmentation disorders
Skin Pigment Discoloration Types
There Are Several Reasons That Can Lead To A Change In The Color Of Your Skin, Such As Pigment Disorders, Injuries, And A Variety Of Internal Or External Factors. Skin Pigmentation Can Happen Anywhere On The Skin, And Appear As Hyperpigmentation, Hypopigmentation, And Depigmentation.
Diagnosis may involve:
• Blood tests
• Wood’s lamp examination
• Skin biopsy
Hyperpigmentation
Hyperpigmentation, In Which Patches Of Skin Become Darker, Is Quite Common And Usually Harmless. The Darkening Of The Skin Occurs Due To An Unusually High Amount Of Melanin In The Skin.
Hyperpigmentation Can Be Caused By:
- Birthmarks;
- Age Spots;
- Acne Scars;
- Pregnancy (During Which Melasma Or Tan, Brown, Or Gray Patches Can Appear On The Face);
- Addison’s Disease (A Rare Disorder That Causes The Decreased Function Of The Adrenal Gland And Appearance Of Dark Patches On The Skin);
- Certain Drugs, Such As Antibiotics And Birth Control Pills; And
- Sun Exposure.
Hypopigmentation
Hypopigmentation Causes The Skin To Appear Lighter Because Of An Abnormally Low Amount Of Melanin.
Reasons For Hypopigmentation Include:
- Past Skin Injuries Because Of Burns, Blisters, Ulcers, Chemical Exposure, Or Infection;
- Inflammatory Skin Conditions Such As Psoriasis Or Eczema (Atopic Dermatitis); And
- Rare Genetic Conditions Like Albinism, Which Is Caused By The Lack Of A Melanin-Producing Enzyme.
Depigmentation
This Condition Causes The Skin To Lose Pigments And Become White. One Of The Common Causes Of Depigmentation Is Vitiligo.
Skin Pigmentation Disorders
Melasma
Melasma Is Identified By Tan Or Brown Patches That Appear On Different Parts Of The Body, Like The Forehead, Upper Lip, Nose, And Chin. Melasma Is Often Called The “Pregnancy Mask;” However, In Rare Cases, Men Can Also Develop It. Women Who Are Consuming Pregnancy Prevention Medication Or Postmenopausal Medication Can Develop Melasma. Sunlight Can Make This Condition Worse.
Vitiligo
Vitiligo Is An Autoimmune Disease In Which The Body’s Immune System Attacks The Pigment Cells. This Disease Causes White Patches Around The Mouth, Eyes, Or Back Of The Hand.
Other Skin Pigmentation Disorders Include:
- Solar Lentigines;
- Freckles;
- Café-Au-Lait Macules;
- Pityriasis Alba;
- Tinea Versicolor;
- Postinflammatory Hypopigmentation;
- Albinism;
Hormonal Changes and Allergies
Hormonal changes can lead to skin discoloration on the face. Allergic reactions, too, may result in discoloration of skin and appear as raised patches, bumps, or rashes.
Skin Infections
Infections cause discolored patches of skin on different parts of your body. Infected cuts and scrapes can also change the texture and color of the skin.
Where Does Skin Discoloration Develop?
Skin discoloration can happen in any part of your body; however, the most common areas are the neck, hands, stomach, buttocks, and around the mouth.
Discoloration on the Neck
Any fluctuations in the melanin levels of the neck skin will lead to discoloration, which is commonly caused by one or more of these factors:
- Excessive Sun Exposure
- Hemochromatosis, or Iron overload
- Certain medications
- Aging
Skin Discoloration of Hands
The skin on the hands is usually taken for granted. People often take it hard on their face, applying a bunch of products to do everything to their skin, but when it comes to their hands, they forget them. However, our hands are also exposed to the sun, and if you don’t protect the delicate skin of your hands, it could lead to dryness, dark spots, and discoloration. There are, of course, other reasons for skin discoloration of the hands, for example:
- Injuries or burn marks might cause hyperpigmentation
- Allergic reactions to medications might cause dark spots on the hands
- Pills that contain estrogen and antiepileptic drugs can cause hyperpigmentation
- Eczema and Lichen Planus can cause discoloration on the hands
- Aging
Skin Discoloration on the Stomach
The thin and sensitive skin on the stomach is subject to discoloration too. It occurs as a result of a medical condition; however, the most common causes of discoloration on the abdomen are:
- Sun exposure
- Personal hygiene
- Diet
Skin Discoloration Around the Mouth
The skin around the mouth is prone to discoloration. Here are just some of the causes:
- Melasma
- Medications such as hormone replacement and chemotherapy drugs
- Sun exposure
- Trauma to the skin
- Vitamin deficiencies
Evidence-Based Treatment Approaches
Addressing Pigmentation Effectively Requires Identifying The Underlying Cause And Choosing Treatments Tailored To The Skin’s Biology:
Topical Brightening Agents — Dermatologist-Prescribed Formulations Containing Hydroquinone Alternatives, Azelaic Acid, Or Niacinamide To Regulate Melanin Synthesis.
Chemical Peels for Hyperpigmentation – Medical-grade chemical peels remove dull, pigmented surface cells and trigger new collagen formation within the dermis. When performed under physician supervision, they safely refine uneven tone and improve texture. Learn more about our chemical peels ›
Advanced Photorejuvenation And Fractional Resurfacing — Physician-Supervised Technologies That Target Melanin Clusters Safely For Gradual, Even Correction.
Our Lumecca IPL treatment uses precise wavelengths of light to selectively target red and brown pigments. Because the surrounding tissue remains untouched, it can treat age spots, sun damage, spider veins and more across face, neck, hands, legs and back. Most clients see visible improvement in 1–3 sessions; deeper pigment may require up to 4–6.
Daily Photoprotection — Broad-Spectrum SPF 30+ Sunscreen Remains The Most Essential Preventive Measure Against Both Discoloration And Premature Aging.
All Treatment Protocols At Beverly Wilshire Aesthetics Are Overseen By Board-Certified Medical Professionals To Ensure Safety, Efficacy, And Long-Term Pigment Stability.
Lumecca IPL for Hyperpigmentation
Precision Light, Targeted Clarity
Lumecca™ IPL (Intense Pulsed Light) uses selective photothermolysis — wavelengths of light absorbed by melanin and hemoglobin to break apart unwanted pigment while preserving surrounding tissue. In one session, it addresses sun damage, freckles, age spots, and vascular redness with surgical accuracy.
How It Works
Each pulse of light in the 500–600 nm spectrum targets brown and red chromophores within the skin. The pigment absorbs the energy, fragments, and is naturally cleared by the body over the following days. The surrounding skin remains intact — a controlled renewal from within.
Clinical Course
Most patients see visible clarity after one to three sessions, spaced three to four weeks apart. More complex or mixed pigmentation may require a series of up to six for complete uniformity. Lumecca also stimulates dermal collagen, refining texture and tone beyond pigmentation alone.
Safety & Tolerance
Lumecca is a non-ablative, non-fractional therapy with minimal downtime. Temporary warmth, mild redness, or light flaking can appear for 24–48 hours. Pigmented spots darken briefly before fading, revealing smoother, more even skin within two weeks.
Expanded Treatment Spectrum
Lumecca effectively treats:
• Age spots and sun damage (brown or red pigmentation)
• Vascular lesions such as rosacea and spider veins
• Freckles, port-wine stains, and diffuse redness
It can be safely performed on the face, neck, décolletage, hands, and body — anywhere photodamage or uneven tone appears.
Microneedling for Hyperpigmentation
Microneedling complements IPL by activating the skin’s regenerative cycle. The controlled micro-injury process triggers collagen and melanocyte recalibration, reducing hyperpigmented patches and improving texture. This method is ideal for post-inflammatory pigmentation or darker skin tones where light-based energy must be used conservatively.
Aftercare & Results
After treatment, the skin may feel warm or appear flushed for a short period. Keep the area hydrated, protected from direct sun, and avoid exfoliation until the skin returns to baseline. By the third week, the complexion appears clearer, smoother, and more luminous.
The Beverly Wilshire Aesthetics Standard
At Beverly Wilshire Aesthetics, every pigmentation treatment is MD-directed and customized to your skin’s unique tone and tolerance. Whether through Lumecca IPL, microneedling, or regenerative therapies such as PRP and Exosomes, our goal is simple: a complexion that reflects radiance, symmetry, and Skin Supremacy™.
FAQ for Skin Pigmentation Disorders and Discoloration
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What is Hyperpigmentation?
Hyperpigmentation is a medical term used to describe patches of skin that become darker than the surrounding area. This occurs when the body produces an excess of melanin, the natural pigment that gives our skin, hair, and eyes their color. While usually harmless, these dark spots can appear as small freckles, larger "age spots," or even widespread patches.
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What is a Hyperpigmentation Treatment?
A hyperpigmentation treatment refers to any professional procedure or topical product designed to fade dark spots and even out skin tone. These treatments typically work by:
- Shedding existing pigment: Exfoliating the top layers of skin where pigment is trapped.
- Slowing production: Inhibiting the enzymes that trigger melanin production.
- Breaking up pigment: Using light or heat energy to shatter melanin clusters so the body can naturally flush them out.
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Is Hyperpigmentation Permanent?
In most cases, no, it is not permanent. However, its "stubbornness" depends on the cause.
- Post-inflammatory hyperpigmentation (PIH): (e.g., marks from a healed pimple) often fades on its own over time or with simple treatments.
- Sun damage: Usually responds very well to laser and light therapies.
- Melasma: This is often chronic and hormonal; while it can be significantly faded, it often requires ongoing maintenance as it can "flare up" with sun exposure or hormonal shifts.
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Why is My Butthole Brown?
It is entirely normal and common for the skin in the perianal and genital areas to be darker than the rest of the body. This is primarily due to:
- High Melanocyte Density: These areas naturally have a higher concentration of pigment-producing cells.
- Hormones: These areas are highly sensitive to hormonal changes (puberty, pregnancy, aging), which often increase pigmentation.
- Friction: Constant movement, tight clothing, or even walking causes friction, which can lead to "protective" skin darkening over time.
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Is an IPL Treatment Safe for All Skin Types?
Historically, Intense Pulsed Light (IPL) was only safe for light to medium skin (Fitzpatrick types I–III). Because IPL targets pigment, it can struggle to distinguish between a "dark spot" and the natural melanin in darker skin, potentially causing burns or scarring.
However, modern technology is changing this. While traditional IPL is still risky for very dark skin, advanced practitioners can sometimes use specific settings or newer devices. Generally, those with deep skin tones (Fitzpatrick V–VI) are often better candidates for treatments like Nd:YAG lasers or chemical peels.
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Is Lumecca IPL More Effective Than Others?
Lumecca is widely considered one of the most powerful and effective IPL treatments available today.
- Higher Peak Power: It delivers up to 3x more energy in the "optimal" range compared to standard IPL.
- Efficiency: Because it is more powerful, it often achieves in 1–2 sessions what traditional IPL takes 4–5 sessions to accomplish.
- Vascular & Pigment: It is exceptionally good at treating both red (vascular) and brown (pigment) issues simultaneously.
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How Long Does it Take to See Results After Lumecca?
1–2 Days: Pigmented spots will actually turn darker (often looking like "coffee grounds"). This is a sign the treatment worked.
1 Week: These dark spots will flake off naturally.
2 Weeks: For vascular issues (redness/veins), you will see the skin begin to clear.
Optimal Results: Most patients see their most "radiant" results about 2–4 weeks after their final session.
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What Causes Skin Discoloration?
Several factors can trigger the overproduction of melanin:
- Sun Exposure: The #1 cause. UV rays trigger melanin as a defense mechanism (a tan is actually a sign of skin damage).
- Inflammation & Injury: Acne, eczema, or cuts can leave dark marks behind as the skin heals.
- Hormonal Changes: Pregnancy or birth control can cause "the mask of pregnancy" (melasma).
- Medical Conditions/Medications: Certain internal diseases or photosensitizing drugs can lead to darkening.
