There are many causes for the skin to be dull, patchy and  have an uneven tone. Common general causes include hormonal fluctuations, hydration levels, stress factors, general health, genetic predispositions and incorrect product use.

More specifically, there are a few conditions which can cause excessive oiliness which causes seborrheic melanosis of the face. This appears as overall skin dullness, with an increased pigmentation on the central forehead and the T zone of the face. Pigmentary demarcation lines occur as darker patches of skin over certain zones of the face. These appear typically in a spectacle pattern -around the eyes, and extending onto the temples on the sides. Conditions like diffuse and early melasma, may also cause patchiness of the skin. Some people experience a face-neck mismatch, most commonly arising from hormonal imbalances or improper use of bleaching creams and serums. Allergy to hair color may also cause uneven skin tone in the early stages, before pigmentation becomes more prominent. 

But the most common cause of uneven skin tone is sun tanning. Sun exposure causes the skin’s pigment cells to be stimulated and overproduce melanin as a protective mechanism. This causes tanning of the skin, which recovers on its own, given time. In some cases, this pigmentation sometimes persists long after the period of sun exposure, giving an overall dull skin tone and patchy pigmentation.

The first step is to arrive at a diagnosis- to understand the underlying cause of the uneven skin pigmentation. Once that is done, specific steps are taken to address the cause.

Simultaneously, the plan to manage the patchy pigmentation is also set in motion. This may include a combination of medical and procedural management,with LED therapy and lasers forming the mainstay of in clinic treatment. 

Over a period of 3-6 months, the initial treatment plan is iterated based on clinical response. Once results start coming in, the plan switches over to maintenance, and then eventually to a self care regimen, as the skin starts clearing up. 

The best treatment for uneven skin tone, is a good self care regimen and some good discipline, to keep the routine up.

The most important principles to be followed, either during the treatment, or during the maintenance phase, of an uneven skin tone are good sun protection and optimal skin rehydration.