Pigmentation on Indian skin: tan, melasma, dark marks and why each needs a different answer

Pigmentation is the single most common reason Indians see a dermatologist, and the category where the most money is wasted - largely because four different problems get treated with the same cream.

Skin with more melanin protects itself better against burning and responds to almost any insult by producing more pigment. Inflammation of any kind - a spot, a shave, a scratch, a badly chosen laser - leaves a brown mark that can take months to fade.

Telling them apart

Melasma is the one that punishes aggressive treatment. Harsh peels, strong lasers and irritating actives can worsen it, because the inflammation they cause triggers more pigment. Slow and gentle wins; a practitioner who treats Indian skin regularly matters more here than the machine they own.

What actually helps

• Sunscreen, every day, at the right dose, with a high PA rating. Nothing else on this list works without it.
• Tinted sunscreen with iron oxides, which adds protection against visible light - specifically useful for melasma.
• Niacinamide at 4 to 5 per cent, which slows pigment transfer into skin cells.
• Azelaic acid, effective and well tolerated on brown skin.
• Vitamin C in the morning, which addresses tone and adds antioxidant protection.
• Retinoids at night, which improve turnover so marks clear faster.
• Alpha arbutin, kojic acid and tranexamic acid in cosmetic formulations, all with reasonable support.
• Treating the cause: the acne, the shaving irritation, the eczema. Marks keep re-forming while the inflammation continues.

Heat is a genuine trigger

Melasma responds to heat and to visible light, not only to UV. That makes Indian summers, kitchen work over a stove, long commutes and outdoor jobs genuinely harder to manage - and it explains why some people see their pigmentation worsen through summer despite diligent sunscreen.

The practical responses are unglamorous: shade, a wide-brimmed cap, a car sun film, breaks from the stove, and accepting that management in May will not look like management in December.

Prescription and procedures

Hydroquinone remains effective and is prescription-led in India for good reason - long unsupervised use carries real risks, including paradoxical darkening. Combination creams pairing it with a retinoid and a mild steroid are a recognised short-course regimen, and specifically not something to buy over the counter and use indefinitely.

Oral tranexamic acid has evidence in melasma and is a prescription decision, not a cosmetic one. Chemical peels and lasers can work well on Indian skin in experienced hands, and cause new pigmentation in inexperienced ones. Ask what settings and what experience with your skin type, and treat a cheap offer as a warning rather than a bargain.

Expectations, set honestly

• Post-inflammatory marks: visible improvement in two to three months with sun protection and an active.
• Melasma: managed over months, prone to seasonal relapse, rarely permanently gone.
• Tan: fades over weeks once exposure stops.
• Under-eye darkness: often structural, and frequently unchanged by any cream.
• Nothing in this category changes your natural skin colour, and any product promising that is either ineffective or illegal.