Hyperpigmentation often drives dermatology visits for patients with skin of color as an uneven skin tone can be distressing for patients. In fact, in cases where hyperpigmentation is a sequelae of an inflammatory skin condition, the hyperpigmentation can be more concerning for patients than the skin condition that caused it. Globally and in the U.S., this distress can lead patients to self-treat with skin lightening products, some of which may contain harmful ingredients, such as mercury, high-potency corticosteroids, and unregulated hydroquinone. Yet there’s little data on public interest in hyperpigmentation – and how interest has changed over time and across regions — that could inform public education and efforts to address gaps in care.
The authors of an original article published in the July Journal of Drugs in Dermatology used Google Trends data to determine public interest both in the U.S. and globally. I interviewed Nada Elbuluk, MD, MSc, FAAD, founder and director of the USC Skin of Color and Pigmentary Disorders Program at Keck Medicine of USC, and member of the JDD’s editorial board.
What motivated you to investigate public interest in hyperpigmentation?
Hyperpigmentation is one of the most common reasons patients seek dermatologic care,
particularly among individuals with skin of color. Despite how prevalent these conditions are and the significant impact they can have on quality of life, we know surprisingly little about how public interest has changed over time. We wanted to utilize Google Trends to better understand how people are seeking information about hyperpigmentation and whether online search behavior could provide insights into consumer needs, awareness, and potential gaps in education.
Why are pigmentary disorders still underrepresented in large-scale epidemiologic studies despite their high prevalence worldwide?
Historically, pigmentary disorders have not received the same level of research attention as many skin diseases including inflammatory, infectious, and neoplastic ones. In addition, these conditions encompass a broad spectrum of disorders, making large-scale epidemiologic studies more challenging. Yet recent global survey data suggests that pigmentary disorders affect nearly half of adults worldwide, highlighting a disconnect between their true burden and the amount of research devoted to them. Increasing the study of pigmentary disorders in scientific research including epidemiologic studies is essential to addressing our patients’ concerns optimally and through an evidence-based manner.
Your research points out that the global skin-lightening industry is expected to be worth more than $24 billion in 2027. How does the lack of epidemiological research impact consumers and the products they use for self-treatment?
When high-quality research and accessible education are limited, many consumers turn to over-the-counter products, social media, or online advice to manage hyperpigmentation on their own. While some products can be helpful, others may be ineffective or even harmful, particularly if they contain unregulated ingredients or are used inappropriately. Our findings suggest there is tremendous public interest in hyperpigmentation, underscoring the need for evidence-based education and safe, effective treatment options that are informed by rigorous research.
Your research analyzed Google Trends data to determine public interest over time and across regions. What were your findings, and which do you think are most notable?
The biggest takeaway was that public interest in hyperpigmentation has steadily increased over the past two decades, both in the United States and globally. We also observed seasonal trends—for example, searches for “brown spots” consistently peaked during the summer months, likely reflecting increased sun exposure and heightened awareness of pigmentation changes. Another notable finding was the geographic variation in search interest, with countries such as Ghana, Nigeria, and Mauritius consistently ranking highly across several search terms, suggesting substantial global interest in pigmentary disorders. Finally, we observed a striking spike in searches for “hyperpigmentation” in early 2025, which may reflect growing public awareness and interest in treatment options.
How should this data inform dermatology clinicians’ approach, and in what areas is further research needed?
Our findings remind clinicians that hyperpigmentation is not simply a cosmetic concern—it is a condition that many patients are actively seeking information about and that can have a significant impact on quality of life. Many of these conditions are also immune mediated and propagated by inflammation, which must be addressed to effectively treat. Dermatologists have an opportunity to proactively educate patients about prevention, photoprotection, prognosis, and safe therapeutic options. From a research perspective, we need more basic science and translational research, greater inclusion of diverse patient populations, and continued investigation into safe and effective treatments for pigmentary disorders, particularly those that disproportionately affect individuals with skin of color.
What else should dermatology clinicians know about public interest in hyperpigmentation?
One of the most important messages is that the general population is actively looking for
information—often before they ever see a dermatologist. That means dermatologists have an opportunity to educate the public, providing accurate, culturally competent, and accessible education both in the clinic and through online platforms. Understanding what patients are searching for can help us address misconceptions, guide discussions about treatment options, and better meet the needs of the diverse populations most affected by pigmentary disorders. While digital tools like Google Trends won’t replace traditional epidemiologic research, they can complement it by providing valuable insights into evolving public concerns and information-seeking behaviors.
Did you enjoy this JDD Buzz Expert Commentary? You can find more here.