Hyperpigmentation: Causes, Treatments, and Medications That Affect Skin Tone

When your skin develops dark patches that don’t fade, you’re dealing with hyperpigmentation, a condition where excess melanin builds up in certain areas of the skin, creating uneven dark spots. Also known as skin discoloration, it’s not just a cosmetic issue—it can be a sign of something deeper, like a reaction to medication, sun damage, or an underlying health change. This isn’t the same as a sunburn that fades. These spots stick around, sometimes getting worse over time, and they show up on the face, hands, neck, or anywhere the skin is exposed or irritated.

Many people don’t realize that common drugs can trigger hyperpigmentation. For example, antibiotics, like tetracyclines and sulfonamides, can make skin extra sensitive to sunlight, leading to dark streaks or spots. Hormonal medications, including birth control pills and some hormone therapies, often cause melasma—a type of hyperpigmentation that forms symmetrical brown patches on the cheeks and forehead. Even some antidepressants, like certain SSRIs, have been linked to skin darkening in rare cases. If you notice new dark patches after starting a new pill, it’s not just "bad luck." It could be your medicine.

Topical treatments like hydroquinone, retinoids, and azelaic acid are common fixes, but they don’t work if the root cause isn’t addressed. If a drug is making your skin darken, stopping or switching it—under a doctor’s care—might be the only real solution. Sunscreen isn’t optional here. UV light makes every type of hyperpigmentation worse, and many of the medications that cause it also make your skin burn faster. You need broad-spectrum SPF 30+ every single day, even when it’s cloudy.

What you’ll find in the posts below are real stories and facts about how medications affect skin, from the side effects of acne drugs like isotretinoin to how heart meds like beta-blockers can trigger skin flares that look like pigmentation changes. There’s no fluff—just clear, practical info on what’s causing your dark spots, what to ask your doctor, and how to protect your skin while staying on the meds you need.