Pigmented disorders are a group of conditions that relate to melanocyte activity. Melanocytes have many different receptors that respond to a variety of stimuli such as UV radiation, stress, hormones, immune cells, and local cytokines in the skin. Hyperactive melanocytes can lead to disorders such as melasma and solar lentigines, whereas destruction and loss of melanocytes may lead to vitiligo or idiopathic guttate hypomelanosis. As humans age, exposure to stressors and acquisition of risk factors leads to persistent changes in the skin. Pigmented changes in the skin result in cosmetic concerns and emotional distress in patients. Due to the chronic, progressive nature of pigmented disorders, they may be resistant to treatment, requiring ongoing maintenance treatment.