What Is Uneven Skin Tone and How to Treat It?

Dr. Janani Sree C M
July 11, 2025

Table of contents

TL;DR

Key Takeaways:

  • Uneven skin tone refers to areas of the skin that appear lighter or darker than the surrounding skin due to irregular melanin production.
  • Common causes include sun exposure, hormonal changes, acne scarring, environmental stressors, and certain medications.
  • Skin discolouration can present as hyperpigmentation (dark patches), hypopigmentation (light patches), redness, or other colour changes.
  • Sun damage is a leading cause, especially in India, and is preventable with daily sunscreen and protective measures.
  • Hormonal fluctuations and acne scarring are significant contributors, particularly in women and individuals with a history of inflammatory skin conditions.
  • Prevention strategies include consistent sun protection, gentle skincare, a healthy diet, and avoiding skin trauma.
  • Treatment options range from at-home remedies (vitamin C, niacinamide, retinoids, gentle exfoliants) to professional interventions (chemical peels, laser therapy, microneedling).
  • Consulting a qualified dermatologist is recommended for persistent or severe cases to ensure safe and effective management.

Uneven skin tone is a widespread dermatological issue characterised by areas of the skin that appear darker or lighter than the surrounding tissue, resulting in a visibly imbalanced complexion. 

Recent data highlight the magnitude of this concern in India. According to the Dermafique Indian Skin Health Report released in 2025, nearly 50% of Indian women experience pigmentation issues, with a striking 74% noticing these changes before the age of 30. 

This high prevalence is attributed to the unique characteristics of Indian skin, such as higher melanin content, which increases susceptibility to pigmentation disorders like melasma and post-inflammatory hyperpigmentation.

This article will explore the causes and types of uneven skin tone. It will also review evidence-based treatments and highlight how Velantis Dermatology uses the latest research for personalised care.

What Is Uneven Skin Tone?

Uneven skin tone is a clinical term describing the presence of areas on the skin that are either darker or lighter than the surrounding skin. This occurs due to irregularities in melanin production, the pigment responsible for the colour of skin, hair, and eyes. 

When melanin is produced in excess, it results in dark patches; conversely, insufficient melanin leads to lighter areas. These pigmentary changes can be localised or widespread, and may present as spots, patches, or diffuse discolouration.

Causes and Contributing Factors

The development of uneven skin tone is a multifactorial process. Common causes include:

  • Sun Exposure: Ultraviolet (UV) radiation is a primary driver of hyperpigmentation. Chronic sun exposure stimulates melanocytes to produce more melanin. This results in sunspots, freckles, and an uneven complexion, especially on areas frequently exposed to the sun, like the face, neck, and hands.
  • Hormonal Changes: Fluctuations in hormones, such as those occurring during pregnancy, the use of oral contraceptives, or certain medical conditions, can trigger melasma.
  • Post-Inflammatory Hyperpigmentation (PIH): Any skin injury or inflammation, such as acne, eczema, or trauma, can result in dark spots that persist after the injury or inflammation has healed. This is particularly common in individuals with medium to dark skin tones.
  • Genetic Factors: Some people are genetically predisposed to increased melanin production or pigmentary disorders, making them more susceptible to uneven skin tone.
  • Ageing: With age, the skin’s ability to regulate melanin production diminishes, often resulting in age spots and a mottled appearance.
  • Environmental and Lifestyle Factors: Pollution, exposure to chemicals, and even certain medications can contribute to oxidative stress and inflammation, exacerbating pigmentary changes.
  • Underlying Medical Conditions: Conditions such as vitiligo, Addison’s disease, or certain fungal infections can cause hypopigmentation or hyperpigmentation. In rare cases, skin discolouration can signal more serious health concerns, including skin cancers.

When to Seek Medical Advice?

While uneven skin tone is often benign and primarily a cosmetic concern, persistent or rapidly changing pigmentation, especially when accompanied by other symptoms, should prompt evaluation by a dermatologist. Early intervention is essential if skin cancer or systemic disease is suspected.

Having defined uneven skin tone, let’s explore the most common factors that contribute to its development in different individuals.

5 Common Causes of Uneven Skin Tone

Uneven skin tone often results from a combination of internal and external factors, especially in the Indian population. Sun exposure and hormonal fluctuations are key contributors, but post-inflammatory hyperpigmentation, environmental pollutants, and genetic factors also play significant roles. 

Key Causes of Uneven Skin Tone:

1. Sun Damage (Photoaging)

Sun exposure remains the leading cause of uneven skin tone in India, where intense ultraviolet (UV) radiation stimulates melanocytes to produce more melanin as a protective response. Prolonged exposure leads to the formation of sunspots, freckles, and age-related lentigines, all of which contribute to hyperpigmentation and an irregular complexion.

  • Why It Happens: UV rays activate melanocytes, causing localised overproduction of melanin. Over time, this results in persistent dark spots or generalised skin darkening, especially on sun-exposed areas like the face, neck, and hands.
  • Prevention and Treatment: Daily use of a broad-spectrum sunscreen with an SPF of at least 30 is critical, even on cloudy days. Treatments such as chemical peels, topical antioxidants (e.g., Vitamin C), and laser therapies (e.g., Q-switched lasers) can help reduce pigmentation and restore a more uniform skin tone.

2. Hormonal Changes

Hormonal fluctuations, particularly in women, are a significant cause of melasma, a chronic hyperpigmentation disorder characterised by symmetrical dark patches on the face. Melasma frequently occurs during pregnancy, with oral contraceptive use, or menopause, and is exacerbated by sun exposure.

  • Why It Happens: Hormones such as estrogen and progesterone stimulate melanocytes, increasing melanin synthesis in sun-exposed areas.
  • Prevention & Treatment: Consistent sun protection is essential to prevent worsening. Topical agents like hydroquinone, azelaic acid, and tretinoin are commonly prescribed. Advanced treatments include chemical peels and laser therapies such as fractional CO2 or intense pulsed light (IPL), administered under dermatological supervision.

3. Acne and Scarring

Post-inflammatory hyperpigmentation (PIH) is a frequent sequela of acne, especially in individuals with medium to dark skin tones, including many Indian patients. Inflammation from acne lesions triggers excess melanin production during the healing process, resulting in dark spots or patches that can persist long after acne resolves.

  • Why It Happens: Inflammatory mediators stimulate melanocytes, causing localised melanin overproduction in the affected areas.
  • Prevention & Treatment: Early and effective acne management using agents like benzoyl peroxide, salicylic acid, or topical retinoids reduces PIH risk. Established PIH can be treated with microneedling, chemical peels, and laser therapies, though results vary and require multiple sessions.

4. Environmental and Lifestyle Factors

Environmental pollutants, cigarette smoke, and lifestyle factors such as poor sleep and nutrition contribute to oxidative stress, damaging skin cells and exacerbating pigmentation irregularities. Pollution-induced free radicals accelerate skin ageing and uneven melanin distribution, leading to dullness and patchiness.

  • Why It Happens: Oxidative stress from environmental toxins damages melanocytes and keratinocytes, disrupting normal pigment regulation.
  • Prevention and Treatment: Incorporating antioxidants like Vitamin C and E into skincare, maintaining a balanced diet rich in vitamins, staying hydrated, and ensuring adequate sleep all support skin health. The use of pollution-protective skincare products and regular cleansing can help mitigate environmental damage.

5. Additional Considerations

Other less common causes include genetic predispositions, certain medications (e.g., antimalarials, chemotherapy agents), and underlying medical conditions such as vitiligo or fungal infections. Harsh skincare products and overexfoliation can also disrupt the skin barrier function, leading to pigmentary changes.

Note: If you notice sudden or persistent changes in skin colour, or if other symptoms accompany uneven skin tone, it is important to consult a board-certified dermatologist.

Common Types of Skin Discolouration

Skin discolouration encompasses a broad range of changes in the skin’s natural colour, reflecting underlying alterations in pigmentation, blood flow, or tissue composition. Clinically, skin discolouration is categorised based on the underlying mechanism and the appearance of the affected areas. 

The following table summarises the primary types of skin discolouration, their underlying mechanisms, common clinical examples, and important considerations for diagnosis and management.

Type of Discolouration
Description & Mechanism
Common Examples (India & Global)
Clinical Notes
Hyperpigmentation
Excess melanin production leads to darker patches or spots.
Melasma, post-inflammatory hyperpigmentation (PIH), sunspots, freckles, café-au-lait macules.
Often triggered by sun exposure, hormonal changes, acne, or skin injury. More prevalent in darker skin types.
Hypopigmentation
Reduced or absent melanin causes lighter patches or blotches.
Vitiligo, pityriasis alba, post-inflammatory hypopigmentation, albinism.
It may be genetic, autoimmune, or post-inflammatory. Vitiligo affects 0.5–2% of the Indian population.
Erythema (Red Discolouration)
Increased blood flow or inflammation causes redness.
Eczema, psoriasis, contact dermatitis, rosacea, and cellulitis.
May be acute or chronic; often associated with itching or swelling.
Vascular Discoloration
Abnormalities or changes in blood vessel function or oxygenation typically cause blood vessels to appear blue, purple, or red.
Hemangiomas, port-wine stains, bruises, cyanosis.
Cyanosis may indicate systemic illness (e.g., heart or lung disease).
Yellow/Orange Discolouration
Accumulation of pigments like bilirubin or carotene.
Jaundice (liver disease), carotenemia (resulting from dietary excess).
Jaundice requires urgent evaluation for underlying hepatic or hemolytic disorders.
Other Causes
Skin cancer, infections, rashes, and birthmarks can also cause localised discolouration.
Actinic keratosis, basal cell carcinoma, squamous cell carcinoma, fungal infections, and moles.
A dermatologist should evaluate new, rapidly changing, or symptomatic lesions.

Clinical Relevance

  • Pigmentary changes (hyper- and hypopigmentation) are the most common causes of skin discolouration in India, often related to sun exposure, post-inflammatory changes, or genetic predisposition.
  • Non-pigmentary discolouration (erythema, vascular, yellow/orange) may signal underlying systemic or dermatological disease and require further evaluation.
  • Skin cancer and certain infections can present as discoloured patches or nodules; any rapidly changing or symptomatic lesion should prompt medical review.

When to Seek Medical Advice?

While many forms of skin discolouration are benign and treatable, sudden onset, rapid progression, or association with other symptoms (such as pain, ulceration, or systemic illness) warrants prompt assessment by a board-certified dermatologist.

Among the many causes, sun damage is a particularly significant contributor to uneven skin tone, especially in populations that are frequently exposed to the sun.

At Velantis Dermatology, we prioritize clarity and clinical integrity in the treatment of pigmentation and melasma. Consult our MD dermatologists in Chennai for advanced, ethical care and long-term results.

The Role of Sun Damage in Uneven Skin Tone

Sun damage is a leading cause of uneven skin tone, particularly in regions with high UV exposure, such as India. Chronic sun exposure stimulates melanocytes, the pigment-producing cells in the skin, to increase melanin production, thereby protecting deeper tissues. This results in localized areas of increased pigmentation, manifesting as sunspots, freckles, or general skin darkening.

For individuals with medium to dark skin tones, which are common in the Indian population, this uneven pigmentation can be more pronounced and persistent. UV exposure also exacerbates pre-existing conditions, such as melasma and post-inflammatory hyperpigmentation (PIH). Over time, this photodamage contributes to photoaging, marked by uneven skin tone, fine lines, and textural changes.

Treatment Options for Sun-Induced Uneven Skin Tone

If sun damage has already led to uneven skin tone, several evidence-based treatment options are available. It is important to consult a board-certified dermatologist for an individualised treatment plan. Common treatments include:

  • Topical Agents: Prescription creams with hydroquinone, azelaic acid, kojic acid, or retinoids can lighten hyperpigmented areas by inhibiting melanin production or boosting skin turnover.
  • Chemical Peels: Superficial to medium-depth peels with glycolic acid, salicylic acid, or TCA exfoliate skin layers, reducing pigmentation and promoting an even complexion. Multiple sessions may be needed, with results varying by skin type.
  • Laser and Light-Based Therapies: Q-switched Nd: YAG lasers, fractional CO2 lasers, and IPL target deeper pigment, effectively treating sun-induced hyperpigmentation. These should be performed by experienced dermatologists, especially for darker skin types, to minimise post-inflammatory pigment changes.
  • Microneedling: This minimally invasive procedure can help improve uneven skin tone by stimulating collagen production and facilitating the penetration of topical depigmenting agents.

What Treatments Can and Cannot Do?

While these treatments can improve sun-induced uneven skin tone, complete resolution may not always be possible, especially for chronic or deep-seated pigmentation. Maintenance therapy, sun protection, and realistic expectations are essential. Some treatments, such as lasers, may not be suitable for all skin types and can sometimes worsen pigmentation if not properly selected and performed.

Beyond sun exposure, internal factors such as hormonal changes and acne scarring also play a significant role in the development of uneven skin tone.

Hormonal Influences and Acne Scarring on Skin Tone

Uneven skin tone can result from various internal factors, with hormonal imbalances and acne-related scarring being two significant contributors. Both conditions involve the production of excess melanin, which leads to darker patches on the skin.

Hormonal Influences

Hormonal changes, particularly during pregnancy, menopause, or while using oral contraceptive pills, can trigger a condition known as melasma. Melasma typically causes symmetrical brown or gray-brown patches on the face, often on the forehead, cheeks, and upper lip, which are exacerbated by sun exposure. 

The hormonal fluctuations associated with these stages can stimulate melanocytes to produce excess melanin in specific areas, resulting in uneven pigmentation.

Acne and Post-Inflammatory Hyperpigmentation (PIH)

Acne is another common cause of uneven skin tone, particularly due to the development of post-inflammatory hyperpigmentation (PIH). PIH occurs when the skin produces excess melanin in response to inflammation caused by acne lesions. 

This often leaves dark spots or patches once the acne heals, especially in individuals with darker skin tones. The presence of PIH can cause the skin to look uneven and discoloured, contributing to concerns of both texture and tone.

Treatment & Prevention

Effective treatment and prevention strategies can help address the underlying causes of uneven skin tone and pigmentation. Here are some of the most common options:

For Hormonal Influences

To effectively address pigmentation issues caused by hormonal changes like melasma, the following treatments are commonly used:

  • Topical Treatments: To address melasma, creams containing hydroquinone or retinoids can help lighten the dark patches. These work by reducing melanin production and promoting skin renewal.
  • Laser Therapy & IPL: When topical treatments aren’t enough, laser therapy and Intense Pulsed Light (IPL) treatments can be highly effective. These treatments target and break down excess pigment, helping restore even skin tone.

For Acne and PIH

To prevent and treat post-inflammatory hyperpigmentation (PIH) caused by acne, consider these options:

  • Acne Treatments: To prevent PIH, it is essential to treat acne early. Topical treatments like benzoyl peroxide, salicylic acid, and retinoids help to control breakouts and reduce inflammation.
  • Microneedling, Chemical Peels, and Laser Therapy: For existing PIH or scarring, microneedling and chemical peels can help by promoting collagen production and exfoliating the skin’s surface, which reduces the appearance of dark spots. 

By addressing both hormonal influences and acne scarring, you can enhance skin tone and texture, ultimately achieving a more even complexion.

While some causes may be unavoidable, several proven strategies can help prevent or mitigate uneven skin tone.

Prevention Strategies for Uneven Skin Tone

Preventing uneven skin tone is more effective and less complex than treating established pigmentary changes. A proactive approach, grounded in dermatological science, can significantly reduce the risk of developing hyperpigmentation, hypopigmentation, and other forms of skin discolouration. 

Below are key strategies supported by clinical research and expert consensus.

1. Consistent Sunscreen Application

Daily use of broad-spectrum sunscreen is the cornerstone of uneven skin tone prevention. 

  • Choose a sunscreen with at least SPF 30 and reapply every two hours when outdoors.
  • Sunscreen should be applied generously to all exposed areas, including the face, neck, and hands.
  • For those with a history of pigmentation disorders (e.g., melasma, post-inflammatory hyperpigmentation), diligent sun protection is especially critical.

2. Protective Clothing and Sun Avoidance

Beyond sunscreen, physical barriers are highly effective in reducing UV exposure.

  • Wear wide-brimmed hats, UV-protective sunglasses, and clothing that covers arms and legs.
  • Limit outdoor activities during peak UV hours (10 AM to 4 PM).
  • Seek shade whenever possible to further minimise direct sun exposure.

3. Gentle and Consistent Skincare Routine

A well-structured skincare regimen helps maintain skin barrier function and reduces the risk of uneven skin tone.

  • Use a gentle cleanser to remove impurities without stripping natural oils.
  • Incorporate mild exfoliants (e.g., polyhydroxy acids, lactic acid) 1–2 times per week to promote cell turnover and prevent the buildup of pigmented cells.
  • Avoid harsh scrubs or aggressive exfoliation, which can trigger inflammation and worsen pigmentation, especially in sensitive or darker skin types.

4. Topical Antioxidants and Brightening Agents

Certain topical ingredients are clinically proven to inhibit melanin formation and reduce oxidative stress.

  • Niacinamide and vitamin C are effective in reducing pigmentation and improving overall skin tone.
  • Other agents, such as azelaic acid or liquorice extract, may be recommended by dermatologists for individuals prone to hyperpigmentation.
  • Prescription-strength products (e.g., hydroquinone, retinoids) should only be used under medical supervision.

5. Hydration and Nutrition

Maintaining adequate hydration and a nutrient-rich diet supports skin health and resilience.

  • Drink sufficient water daily to keep the skin hydrated.
  • Consume a balanced diet rich in antioxidants, vitamins (especially C and E), and minerals to combat oxidative stress and promote even skin tone.
  • Limit processed foods and refined sugars, which can exacerbate inflammation and skin problems.

6. Avoiding Skin Trauma and Picking

Physical trauma, such as picking at acne or scratching, can lead to post-inflammatory hyperpigmentation, particularly in individuals with medium to dark skin.

  • Practice gentle skincare and avoid manipulating blemishes or lesions.
  • Seek prompt dermatological treatment for acne or other inflammatory skin conditions to minimise the risk of pigmentation changes.

7. Consistent Dermatological Assessment

If you notice persistent or worsening uneven skin tone, consult a board-certified dermatologist, such as for a thorough evaluation and personalised prevention plan. Early intervention can prevent minor discolouration from progressing into more stubborn pigmentary disorders.

While these strategies can significantly reduce the risk of developing uneven skin tone, genetics, hormonal factors, and certain medical conditions may still contribute to pigmentation changes despite best efforts. 

Treatment Options for Uneven Skin Tone: At-Home and Professional Approaches

Effectively managing uneven skin tone requires a combination of consistent at-home care and, when needed, professional dermatological treatments. Understanding the strengths and limitations of each approach can help patients make informed decisions and set realistic expectations.

At-Home Treatment Options

Many individuals with mild to moderate uneven skin tone benefit from evidence-based home care strategies. These can be particularly useful for early intervention, maintenance, or as adjuncts to professional treatments.

Key Ingredients and Their Clinical Roles:

  • Vitamin C: A potent antioxidant, vitamin C (ascorbic acid) inhibits melanin synthesis and helps protect against UV-induced oxidative stress. Regular use of vitamin C serums can reduce the appearance of dark spots and promote a more uniform skin tone. It is best applied in the morning under sunscreen.
  • Niacinamide: A form of vitamin B3, niacinamide has anti-inflammatory and pigment-inhibiting properties. It helps fade hyperpigmentation, improves barrier function, and is well-tolerated by most skin types.
  • Retinoids: Retinoids (such as retinol and tretinoin) accelerate cell turnover, helping to shed pigmented cells and stimulate new collagen production. They are effective for post-inflammatory hyperpigmentation and sun-induced discolouration, but can cause irritation in sensitive skin and should be used with sun protection.
  • AHA/BHA Exfoliants: Alpha hydroxy acids (like glycolic and lactic acid) and beta hydroxy acids (like salicylic acid) exfoliate the upper skin layers, improving texture and fading superficial pigmentation over time. Overuse can cause irritation, so moderation is key.
  • Natural Remedies: Ingredients such as aloe vera, turmeric, honey, lemon juice, and green tea have anti-inflammatory and antioxidant properties that may help reduce pigmentation and soothe the skin. 

However, these remedies should be used with caution, always patch-test and avoid harsh or undiluted applications, especially with lemon juice, which can cause irritation or photosensitivity.

Professional Treatment Options

For persistent, severe, or resistant cases of uneven skin tone, professional dermatological interventions offer more targeted and often faster results.

Standard Clinical Procedures include:

  • Chemical Peels: Peels with glycolic acid, TCA, or salicylic acid exfoliate deeper skin layers, reducing pigmentation and improving tone. Multiple sessions may be necessary, with risks of irritation or post-inflammatory hyperpigmentation, particularly in individuals with darker skin types.
  • Laser Treatments: Fractional CO2 lasers, Q-switched lasers, and IPL target melanin deposits, breaking down pigmentation and stimulating skin renewal. Expert assessment is required to minimise the risks of burns or rebound pigmentation.
  • Microneedling: Fine needles create micro-injuries, stimulating collagen and enhancing the absorption of pigmentation-targeting serums, improving skin texture and tone.

Professional treatments can yield significant improvements in uneven skin tone, but they are not without risks. Side effects may include temporary redness, swelling, or changes in skin pigmentation. Maintenance and strict sun protection are essential to preserve results.

For effective treatments of acne, scarring, or dark circles, Velantis Dermatology offers personalised medical-grade care. Book a consultation today to experience trusted, patient-centred dermatology.

Conclusion

Uneven skin tone is a treatable dermatological concern influenced by sun exposure, hormonal changes, acne, and environmental stressors. Prevention through sun protection and consistent skincare is key, but professional treatments, such as laser therapy, chemical peels, and microneedling, can offer significant improvements for persistent cases.

At Velantis Dermatology, we are committed to delivering safe, evidence-based solutions tailored to each patient’s unique needs. Founded by Dr. Janani (MD Dermatologist), our clinic is designed as an institutional, brand-first practice, ensuring ethical care and long-term trust for the Chennai community.

If you’re seeking a qualified dermatologist near Medavakkam or want expert guidance for pigmentation issues, our team is here to help. We offer comprehensive consultations and advanced treatments for acne, pigmentation, and other skin concerns, always with a focus on medical integrity and patient well-being. Request a callback here!

Ready to restore your skin’s even tone? Book a consultation with our expert dermatologists at Velantis Dermatology today to receive personalized care and treatment options tailored to your skin's needs.

FAQs

Q1. Can certain foods or supplements help improve uneven skin tone?
A1. While a balanced diet rich in antioxidants, vitamins (such as C and E), and minerals can support overall skin health, no specific food or supplement alone can cure uneven skin tone. However, maintaining good nutrition may help the skin recover from damage and support the effectiveness of topical or professional treatments.

Q2. Is uneven skin tone more common in certain age groups or genders?
A2.
Although uneven skin tone can affect anyone, it is more frequently reported in women, especially during periods of hormonal change such as pregnancy or menopause. The prevalence may increase with age due to cumulative sun exposure and slower skin regeneration.

Q3. Can stress or lack of sleep worsen uneven skin tone?
A3. Yes, chronic stress and inadequate sleep can impair the skin’s natural repair mechanisms, increase inflammation, and potentially worsen pigmentation issues or delay recovery from existing discolouration.

Q4. Are there any medications that can cause or worsen uneven skin tone?
A4. Some medications, like certain antibiotics, antimalarials, chemotherapy agents, and hormone therapies, may increase sensitivity to sunlight or directly affect melanin production, potentially leading to new or worsening pigmentation changes.

Q5. How long does it typically take to see results from treatments for uneven skin tone?
A5. The timeline for visible improvement depends on the underlying cause, the type of treatment, and individual skin characteristics. Topical treatments may take several weeks to months, while professional procedures like chemical peels or lasers may show results more quickly but often require multiple sessions.

Q6. Can uneven skin tone return after successful treatment?
A6. Yes, recurrence is possible, especially if underlying triggers such as sun exposure or hormonal fluctuations are not managed. Ongoing sun protection and maintenance of skincare are crucial to prevent relapse.

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