Michelle Rodrigues, MBBS, is a dermatologist in Australia.

Michelle Rodrigues, MBBS

Practical Approaches to Hyperpigmentation and Hypopigmentation, With Nada Elbuluk, MD, MSc, and Michelle Rodrigues, MBBS

In the second featured clip from the most recent episode of the 

 leaders, Michelle Rodrigues, MBBS, founder and director of Chroma Dermatology, and Nada Elbuluk, MD, MSc, assistant professor at the USC Keck School of Medicine, explore the diagnostic complexity of pigmentary disorders in patients with skin of color, emphasizing the importance of precision, pattern recognition, and patient-centered care.

Their conversation reinforces a key message: pigmentary change is not a diagnosis in itself, but rather a clinical sign with a broad and nuanced differential. Rodrigues opens by noting that terms such as “hyperpigmentation” or “hypopigmentation” are often used too broadly, which can lead to oversimplification and mismanagement. Instead, she emphasizes the need to identify the underlying cause, whether inflammatory, autoimmune, medication-related, or genetic. Elbuluk builds on this point by highlighting how post-inflammatory hyperpigmentation remains one of the most common concerns among patients of color, often arising from acne, eczema, or other inflammatory dermatoses.

While frequently dismissed as cosmetic, both experts stress that pigmentary disorders can have a profound psychosocial impact and deserve thoughtful evaluation and treatment. A significant portion of the discussion focuses on clinical assessment strategies. Rodrigues underscores the value of a careful history and physical examination, paying close attention to lesion distribution, color variation, borders, and evolution over time.

She also highlights dermoscopy as a valuable, noninvasive tool that can help distinguish epidermal from dermal pigment and guide management decisions, potentially reducing the need for biopsy in select cases. Elbuluk adds that understanding a patient’s background—including prior inflammation, treatments, and cultural skin-care practices—is essential to accurate diagnosis.

The conversation also addresses conditions such as vitiligo and acquired dermal macular hyperpigmentation, underscoring how these disorders may present differently across skin tones and how delayed diagnosis can worsen outcomes. Both speakers emphasize the importance of setting realistic expectations with patients, as pigmentary disorders often require prolonged treatment courses and careful maintenance.

Together, Rodrigues and Elbuluk advocate for a more deliberate, informed approach to pigmentary disease—one that recognizes both the biological complexity and emotional weight of these conditions for patients with skin of color.

To learn more about SOCS’s programs and initiatives, visit 

Editor’s note: This summary was edited with the help of AI tools.

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This segment of the latest Skin of Color Savvy episode highlights a conversation between Nada Elbuluk, MD, MSc, and Michelle Rodrigues, MBBS.

Skin of Color Savvy: The Art and Science of Treating Patients of Color

Skin of Color Savvy: Highlights From the Most-Watched Episodes of 2025

, the podcast revisits highlights from the three most viewed episodes of 2025, bringing together expert insights on inflammatory skin disease, pigmentary disorders, and diversity in dermatologic research. Featuring conversations with 

 leaders, Andrew Alexis, MD, MPH; Shawn Kwatra, MD; Crystal Aguh, MD; John Harris, MD, PhD; Nada Elbuluk, MD; and Michelle Rodrigues, MBBS, the episode underscores the breadth of clinical, scientific, and equity-focused discussions that resonated most with audiences throughout the year.

The episode opens with a return to one of the show’s most impactful early conversations, in which Alexis and Kwatra discuss diseases that disproportionately affect patients with skin of color, particularly chronic pruritus and inflammatory conditions such as atopic dermatitis and prurigo nodularis. Kwatra reflects on the disconnect between textbook imagery and real-world clinical presentations, noting that many diagnostic criteria and educational resources remain centered on lighter skin types.

Together, they explore emerging data demonstrating racial and ethnic differences in itch prevalence and presentation, while highlighting how environmental exposures, socioeconomic factors, and systemic inflammation intersect to influence disease burden. Alexis builds on this discussion by emphasizing the importance of recognizing how erythema and inflammation present differently in richly pigmented skin. Rather than classic redness, inflammation may appear violaceous, gray, or brown, a distinction that is critical to avoiding underdiagnosis and undertreatment.

The second segment revisits a widely viewed episode focused on pigmentary disorders, featuring Elbuluk and Rodrigues. The pair emphasize that “hyperpigmentation” is not a diagnosis, but a broad category encompassing more than 45 distinct conditions. They discuss common causes of hyperpigmentation, hypopigmentation, and depigmentation seen in patients of color, including post-inflammatory hyperpigmentation, acquired dermal macular hyperpigmentation, melasma, vitiligo, and less common congenital or medication-induced disorders. Key diagnostic principles—such as evaluating lesion location, color, morphology, and patient history—are highlighted, along with the value of dermoscopy as a noninvasive bedside tool to guide management and avoid unnecessary biopsies.

The episode concludes with highlights from a conversation featuring Aguh and Harris, which centers on the importance of diversity in dermatology research and clinical trials. Using examples from alopecia and autoimmune disease research, the discussion expands the definition of diversity beyond race and ethnicity to include diversity of thought, training background, and scientific perspective. Both speakers emphasize that collaborative, multidisciplinary research leads to stronger study design, fewer blind spots, and more clinically meaningful outcomes for patients.

Together, this Savvy Stories episode captures why these three conversations stood out among viewers in 2025. By blending clinical insight, scientific rigor, and a commitment to equity, the episode reflects Skin of Color Savvy’s mission to elevate dermatologic care through education, representation, and inclusive dialogue.

This new episode from January 2026 features a compilation of 3 clips from the most viewed episodes of 2025.

Skin of Color Savvy: Insights on Hyperpigmentation from EADV, With Michelle Rodrigues, MBBS

In this Savvy Stories episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, recorded on-site at the 

European Academy of Dermatology and Venereology (EADV) Congress

 spoke with Michelle Rodrigues, MBBS, dermatologist, founder and director of the Pigment and Skin of Colour Centre at Chroma Dermatology in Australia, and associate professor at the University of Melbourne. Rodrigues discusses her presentation at the Skin of Color Society’s (SOCS) symposium, “Unmasking Facial Hyperpigmentation in Richly Pigmented Skin Types,” and offers practical insights for clinicians managing these complex and often misunderstood disorders.

 and hosted by SOCS, Rodrigues explains that facial hyperpigmentation is a broad clinical category, with over 45 potential causes. Differentiating among conditions such as melasma, post-inflammatory hyperpigmentation (PIH), acquired dermal macular hyperpigmentation (ADMH), and exogenous ochronosis can be challenging even for experienced dermatologists. She emphasizes that accurate diagnosis is essential, as management strategies vary widely. Misclassification, she notes, can lead to unnecessary or even harmful treatments.

To improve diagnostic precision, Rodrigues advocates for greater use of dermoscopy. This noninvasive technique can reveal key visual clues: for example, melasma typically spares the eyelids and earlobes, whereas PIH and ADMH may present with “peppering” patterns or ashy-gray hues. In ochronosis, blue-gray amorphous areas and obliteration of eccrine structures may appear. She stresses that subtle color differences in richly pigmented skin—ranging from shades of brown to violaceous or grayish tones—offer valuable diagnostic guidance.

Rodrigues also discusses the psychosocial impact of facial hyperpigmentation, citing global data showing high rates of depression, anxiety, and social isolation among affected patients. These burdens are compounded in individuals with richly pigmented skin, who often face diagnostic delays, limited treatment access, and unique cosmetic challenges in covering pigmentation changes.

On the treatment front, Rodrigues underscores that broad-spectrum photo protection, including visible light and long-wave UVA (UVA1) coverage, is foundational. Topical antioxidants, niacinamide, and emerging non–hydroquinone-based agents such as thiamidol offer promising results, while traditional hydroquinone and retinoid combinations remain the gold standard when used with care. She also highlights the potential role of oral antioxidants, tranexamic acid, and low-dose isotretinoin in selected cases.

Rodrigues concludes by encouraging clinicians to refine their diagnostic skills, adopt a “360-degree” approach to photoprotection, and engage with the Skin of Color Society for mentorship and collaboration. Her key message: with careful assessment and culturally informed care, dermatologists can significantly improve outcomes for patients with facial hyperpigmentation in richly pigmented skin.

To learn more about SOCS’s mentorship programs and initiatives, visit 

Editor's note: This summary was created with the help of AI tools.

In this episode, Michelle Rodrigues, MBBS, joins Skin of Color Savvy from EADV 2025 to discuss facial hyperpigmentation in richly pigmented skin.

Michelle Rodrigues, MBBS

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