Facial hyperpigmentation disorders (FHD) are common in dermatology, particularly in people with skin of color (SOC). They include melasma, post-inflammatory hyperpigmentation, and less frequent conditions such as exogenous ochronosis, lichen planus pigmentosus, Riehl’s melanosis, acanthosis nigricans, seborrheic melanosis, pigmentary demarcation lines, drug-induced pigmentation, and nevus of Ota, among others. These conditions may significantly affect quality of life. They can present similar clinical and dermoscopic features, making diagnosis challenging. A thorough medical history, physical examination, and careful dermoscopic evaluation are essential to achieve an accurate diagnosis. In this article, we present a narrative review of the clinical and dermoscopic characteristics of FHD in SOC and provide diagnostic clues for the early diagnosis of these conditions.
