The Impact of Hyperpigmentation on the Lives of Patients

July 2025 | Volume 24 | Issue 7 | 668 | Copyright © July 2025


Published online June 30, 2025

doi:10.36849/JDD.8519

Jennifer Y. Wang BAa,b, Margaret Kabakova BSa,b, Raichel Philip BAa, Julia Stolyar BAa, Rebecca Berger-Gutierrez BAa, Jared Jagdeo MD MSa,b

aDepartment of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY

bDermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY

Abstract
Hyperpigmentation is a prevalent condition that disproportionately impacts individuals with skin of color, diminishing their quality of life and psychosocial well-being. There is a need to better understand the experiences, motivations, and expectations of patients seeking hyperpigmentation treatment. A cross-sectional survey was performed to analyze the perspectives and experiences of patients with hyperpigmentation. While over half (51.37%) of participants view their hyperpigmentation as “more bothersome than its initial cause,” there is a notable lack of routine dermatological care and sunscreen use. Of the respondents, 40.67% had never tried any treatments and among those who have, 34.67% were dissatisfied with the results. Expectations for treatment outcome timeframes varied, with 37.06% expecting results within 1 to 4 weeks. Of the participants, 52.67% reported being “not at all” or only “slightly” informed about current treatment options and only 16.32% feel “very” or “extremely” satisfied with current treatments. If their hyperpigmentation was successfully treated, 43.33% of respondents anticipated a very positive impact on their self-esteem. The current study highlights a critical need for improved patient education and tailored treatment approaches in hyperpigmentation practices. Enhancing patient knowledge about treatment options and setting realistic expectations may bridge the gap between patient experiences and treatment outcomes.

J Drugs Dermatol. 2025;24(7):668-674. doi:10.36849/JDD.8519

INTRODUCTION

Hyperpigmentation results from excessive deposition of melanin pigment in the epidermis and/or dermis layers following inflammation or injury.1 The term hyperpigmentation encompasses numerous conditions causing discoloration, pigmentation, and darkening of the skin including melasma, post-inflammatory hyperpigmentation (PIH), ephelides, and lentigines.1-3 Although a common skin condition prevalent among individuals across all demographics, hyperpigmentation disproportionately impacts individuals with skin of color in terms of both frequency and severity.4 The prevalence of PIH is as high as 9.99% in African American patients.4 Asian patients with darker skin also have a higher reported prevalence of PIH compared to Caucasian individuals.4

Hyperpigmentation is generally considered a benign condition, but it has a significant negative impact on patient quality of life and psychosocial well-being.5 One study found that among patients diagnosed with a pigmentary disorder, 47% felt self-conscious about their skin to some degree, 33% felt unattractive because of their skin, and 24% felt that their skin affected their daily activities.5 Another study found that 54% of patients express embarrassment due to their hyperpigmentation, with 22% experiencing a severe negative impact on their quality of life.6 Nearly half of those affected by hyperpigmentation report applying makeup daily to conceal it, spending an average of 20.8 minutes each day on this routine.7

The hyperpigmentation treatment market has an estimated value of $5.0 billion as of 2023, and is projected to reach $9.5 billion by 2031.8 With some patients being willing to allocate up to 13.3% of their monthly income to address their symptoms, the projected growth of this market underscores its impact on patients and highlights the importance of addressing hyperpigmentation.7

There is a need to better understand the motivations, expectations, and experiences of patients seeking hyperpigmentation treatment. The aim of this study is to explore patients’ perspectives on hyperpigmentation, including uncovering their treatment expectations, barriers to care, and satisfaction levels with current hyperpigmentation treatments. These insights can guide physicians to better align their practices with patients’ diverse expectations and challenges.

MATERIALS AND METHODS

This study is a single-center, observational, cross-sectional, in-person questionnaire-based survey distributed to participants with a history of hyperpigmentation at SUNY Downstate Health Sciences University in Brooklyn, New York. A hard-copy