ere we are using the term pigmentation to mean hyperpigmentation, which simply means pigment in excess.  Our skin produces a pigment called melanin. One very common cause of increase in pigment is increased exposure to sunlight (tanning).  After external injuries like scrapes and cuts or after insults to the skin like acne (pimples) and chickenpox, the amount of melanin at these sites tends to go up.  This is called as post-inflammatory hyperpigmentation.  Some types of fungal infections can also cause black patches on the skin.
Melasma Some people use the term pigmentation particularly to mean a localized kind of pigmentation occurring mainly on the cheeks and nose, more commonly seen in women.  This kind of pigmentation may start in pregnancy, occur in women who are on contraceptive pills or even occur spontaneously.  It is called melasma (chloasma if it is a result of pregnancy).  It may also be seen in men, especially in those with a lot of exposure to sunlight.
Increase in melanin may also occur due to hormonal irregularities as seen in Addison’s disease, insulin resistance, Cushing’s syndrome, etc.  Here it is usually localized (present in certain areas only) and may be associated with changes in skin texture.   In these cases, it is important to find the root cause and treat it along with treatments given to lighten the dark skin.
Dr Teja kulkarniDr Teja kulkarni
Acanthosis nigricans on the neck (there may be an underlying hormonal irregularity)
There are many treatments available to treat different kinds of pigmentation - depigmenting creams, chemical peels, microdermabrasion (skin polishing), some kinds of lasers, etc.  In order to maintain results obtained, one should protect one’s skin from sun exposure and the causes responsible for the pigmentation must be removed or kept in check as far as possible.
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