Hyperpigmentation — the overproduction of melanin resulting in darker patches — is the most common skin concern in Indian dermatology practice. It encompasses melasma, post-inflammatory hyperpigmentation (PIH), sun-induced pigmentation, and age spots. A clinically effective pigmentation routine addresses multiple steps in the melanin production pathway simultaneously — relying on a single ingredient consistently underdelivers.

Step 1 — The Non-Negotiable Foundation

No depigmentation routine works without daily broad-spectrum sunscreen — SPF 50, PA++++. UV exposure is the primary driver of melanin production. Every other step in this routine is undermined by inadequate sun protection. This is not a suggestion; it is the pharmacological prerequisite for everything else.

Step 2 — Tyrosinase Inhibition (Morning or Evening)

Tyrosinase is the enzyme that drives melanin synthesis. Inhibiting it is the mechanism behind most depigmenting actives. The most effective and well-tolerated options for Indian skin: tranexamic acid (oral or topical — excellent evidence, very well-tolerated), azelaic acid (9-20% — anti-inflammatory and depigmenting), kojic acid, and alpha-arbutin. Vitamin C in the morning adds antioxidant protection alongside mild tyrosinase inhibition. Combining 2-3 of these produces better outcomes than relying on one.

Step 3 — Cell Turnover (Evening)

Accelerating cell turnover removes pigmented cells from the skin surface faster, speeding visible improvement. Retinoids are the gold standard — tretinoin for faster results, retinol for sensitive skin. AHAs (particularly mandelic acid for darker skin tones) provide chemical exfoliation that removes pigmented surface cells. Use retinoids and AHAs on separate evenings if sensitivity is a concern.

Step 4 — In-Clinic Treatments for Established Pigmentation

For entrenched, deep, or extensive pigmentation, topical maintenance alone is slow. Monthly chemical peels, Q-switched laser, or Cosmelan/Dermamelan protocol accelerate clearance and allow the maintenance routine to preserve the results. The combination of clinical treatment and rigorous home maintenance consistently outperforms either approach alone.

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— Dr. Nishita Ranka | Consultant Dermatologist | Dr. Nishita’s Clinic for Skin, Hair & Aesthetics, Hyderabad