Skin Discolouration

Overview

Skin discolouration is a change in the skin’s normal colour — patches that are lighter, darker, red, or altered in tone. It is a sign with many causes, ranging from harmless and treatable (such as a fungal infection or healed inflammation) to markers of an underlying medical condition. The pattern, location, and accompanying features guide the assessment. This page gives the overview; specific patterns such as darkening of the skin folds and diabetic-related changes have their own pages.

Common causes

• Post-inflammatory change — skin darkens or lightens after a rash, injury or acne heals.
• Fungal infection — pityriasis versicolor causes flaky discoloured patches (see Fungal Skin Infection).
• Sun exposure and sun damage — freckling, age spots, uneven tone.
• Hormonal pigmentation — melasma, common on the face.
• Darkening of skin folds — acanthosis nigricans, a marker of insulin resistance (see Acanthosis Nigricans, Darkening of Skin).
• Vitiligo — loss of pigment causing lighter patches.
• Medicine-related pigmentation.

Evaluation

Evaluation examines the pattern and distribution of the discolouration and asks about onset, sun exposure, medicines, and any underlying conditions. A skin scraping may be sent when a fungal cause is suspected. Blood sugar and HbA1c are checked when acanthosis nigricans is present. See Abnormal Test Results and Diabetes & Metabolic Health.

Management overview

Management treats the cause: antifungals for pityriasis versicolor, sun protection and topical measures for pigmentation, addressing insulin resistance for acanthosis nigricans, and specific dermatology care for vitiligo or stubborn pigmentation. Dr. Nayak identifies the cause and refers to a dermatologist when specialised treatment is needed.

Warning signs — seek prompt care

• A new, changing, or irregularly pigmented mole or spot — needs assessment to rule out serious skin lesions.
• Sudden widespread pigmentation change with weight loss or feeling unwell — needs evaluation.
• Discolouration with dark velvety thickening in the skin folds — check for diabetes.

How we help

Dr. Nayak identifies the cause of skin discolouration, begins appropriate treatment, and checks for underlying conditions such as diabetes — referring to a dermatologist when needed. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Darkening of Skin
• Acanthosis Nigricans
• Fungal Skin Infection
• Acne
• Diabetes & Metabolic Health