4 Frustrating Skin Disorders That Cause Uneven Skin Tone and How to Treat Them

Dealing with skin disorders can be frustrating and anxiety-provoking for just about anyone. It is a lot harder to hide a rash or uneven skin tone on the face than it is to hide other medical conditions like high cholesterol. These skin disorders, that we are going to discuss, can have both a negative social and psychological impact on patients.

This article is going to address 4 of the more common skin disorders that cause skin pigmentation changes that I see and treat among my patients. Some are easier to treat than others but they all have one thing in common… they will worsen with sun exposure.

If you want to save yourself reading the remainder of the article, the main takeaway is to wear sunscreen. However, if you want to know what causes each condition, and what else you can do about it then keep reading. I promise by the end of this article you will have a better understanding of what each skin condition is and the common ways medical providers treat each of them.

4 Common Skin Disorders That Cause Uneven Skin Tone

Melasma

Sometimes called the “mask of pregnancy”, melasma is fairly common amongst pregnant people. It can also come about when taking other hormonal-related medications such as birth control.

The most important thing with melasma is to… protect yourself from the sun, yup you guessed it. I always recommend wearing mineral-based sunscreens with at least 30 SPF and to reapply every two hours. Mineral-based sunscreens include zinc oxide or titanium dioxide as the main ingredients and in my opinion are the best ones to use. My personal favorite is Elta MD UV Clear especially for those with sensitive skin.

Melasma can be treated with hydroquinone which is a lightening cream. The one downside is you can’t use it while you are pregnant and I also don’t recommend using it while breastfeeding.

In some stubborn cases, people with melasma also have to treat with cosmetic procedures such as chemical peels or lasers to take care of the pigmentation changes once and for all.

To reiterate, the most important thing is sun protection to hopefully prevent this from occurring. Think wide-brimmed hats, large polarized sunglasses, and sunscreen. Lots and lots of sunscreen.

Vitiligo

Vitiligo is an autoimmune disorder that causes LOSS of pigment in the skin. Depigmentation of the skin to be exact. Autoimmune conditions typically run in families but not always. One famous example of someone who had vitiligo is Michael Jackson.

Vitiligo is more apparent in people of color. However, people with skin types I and II can also experience vitiligo, it just may appear as uneven skin tone. It will typically become more apparent in the summertime when the rest of the skin tans around the areas affected.

Again, It is important to protect yourself from the sun. The goal when treating vitiligo is to cause the skin to pigment in areas that have lost their pigmentation. This is generally done with the help of topical medications. A recently FDA-approved medication that I have found to be extremely helpful is Opzelura.

Opzelura is a prescription medication that used to only be approved for atopic dermatitis (eczema), but has finally also been approved for vitiligo. It works best in hair-bearing areas which means areas like the fingertips may be difficult to treat. (Finger tips are unfortunately a common area affected).

When in doubt ask your dermatology medical provider for a diagnosis on your skin condition and what treatment option is best for you and your skin.

Tinea Versicolor

This skin condition is thankfully a little easier to treat than the other two aformentioned diagnoses. Tinea versicolor is a fungal infection of the skin that typically leaves both light and dark spots on your body (hence the name versicolor). Sometimes it is more hyperpigmented (dark) spots and other times it is more hypopigmented (light) spots.

Tinea versicolor likes to arise and worsen in warm moist environments and is typically first noticed in the summertime due to uneven tanning of the skin. Other patient populations that are at a higher likelihood of developing tinea versicolor are those that sweat a lot. For example, I commonly see this skin disorder in people that frequent the gym or people that frequent swimming pools.

The key to treating tinea versicolor is to use a good antifungal treatment. Fortunately, this is something you may be able to treat at home. You can use an anti-dandruff shampoo for example Nizarol which is Ketoconazole 1%. You simply wash it in affected areas 2-3 times per week in the shower. I recommend leaving it on for 5-10 minutes before rinsing it off.

Another over-the-counter treatment available is topical clotrimazole which can be found marketed as an athlete’s foot cream. You can use it twice daily for 6 weeks and more often than not it should clear the rash. If after 6 weeks of consistent use, it is still present then it’s time to go see a dermatology medical provider.

Post-Inflammatory Hyperpigmentation (PIH)

PIH is difficult because the first step is to treat the underlying condition. What I mean by this is PIH can be caused by a large variety of skin disorders. For example, I commonly see PIH with someone who has cystic acne. PIH is the dark spots that are left behind after a bad acne flare. Similarly, with rashes that were very inflamed, you can experience PIH once the rash has gone away.

While we can treat PIH with lightening creams and sunscreen, if the underlying condition is not properly treated then PIH can linger indefinitely.

It is important to note that while a lot of people develop post-inflammatory HYPERpigmentation it is also possible to experience post-inflammatory HYPOpigmentation, which I am sure you can guess, is when the skin is lighter after an inflammatory skin condition occurs.

My biggest tip for anyone who thinks they are experiencing PIH (besides using sun protection) is to try your best not to pick, scratch, or rub your skin. This is EXTREMELY important and can definitely make the PIH worse.

Conclusion

There you have it. These are the 4 most common skin disorders that cause uneven skin tone, that I treat in my clinic. There are many other ones out there so when in doubt it is best to get a clear diagnosis before you attempt to treat your condition.

Sun protection consisting of avoiding the sun, sun-protective clothing, and sunscreen is going to be your best friend if you are experiencing a skin disorder that causes pigmentation change.

I hope this information is able to help someone out there, as I know these conditions can sometimes be mentally straining! Comment below with any questions you may have, or if there is another topic you are interested in learning about.

*Disclaimer: Opinions expressed are solely my own and do not express the views or opinions of my employer. Information on this website is for education and entertainment purposes only. Content is my opinion. It is not substituted for your own doctor’s medical care or advice. One should not make any health or medical-related decisions based in whole or in part on any content on this site. Content is not intended to replace the services of a licensed, trained health professional. Content may not apply to you as an individual. Although I will update my website with current information, this website is not a definitive guide to dermatology.