Which Department

Which department should I see for skin hyperpigmentation?

2026-09-17 · Neutral information that names no hospital, doctor or region. No rankings, recommendations or reviews.

Short answer

Dermatology(피부과) is generally the first department to see for skin hyperpigmentation, as dermatologists evaluate the type, distribution, and possible cause of pigmented lesions. If hyperpigmentation appears to be related to an underlying systemic condition such as a hormonal disorder, a referral to Internal Medicine(내과) or Endocrinology(내분비내과) may follow.

Which department

  1. 1Dermatology (피부과)
    Dermatologists specialize in diagnosing and managing conditions affecting the skin, including various forms of hyperpigmentation such as post-inflammatory changes, melasma, and other pigmented lesions. They are trained to visually and, when appropriate, instrumentally assess the nature and depth of pigmentation. — First / second line: A dermatology clinic (의원) is generally a good starting point for most cases of hyperpigmentation without systemic symptoms. If the presentation is complex or requires advanced evaluation, the clinic may refer you to a hospital-level dermatology department.
  2. 2Internal Medicine / Endocrinology (내과 / 내분비내과)
    Some forms of hyperpigmentation can be associated with underlying systemic or hormonal conditions, such as adrenal or thyroid disorders, which fall within the scope of internal medicine and endocrinology. — First / second line: You would typically visit this department after a dermatologist suggests a possible systemic cause, rather than going here first. A referral or consultation is the usual pathway.
  3. 3Plastic Surgery / Aesthetic Dermatology (성형외과 / 미용피부과)
    These departments focus on the cosmetic and procedural aspect of skin concerns. They evaluate pigmentation from an aesthetic management perspective and may discuss procedural options, though any such approach requires a consultation with the physician to determine suitability. — First / second line: Patients who have already received a diagnosis and wish to discuss cosmetic management options may visit these departments. They do not replace a diagnostic evaluation by a dermatologist.
  4. 4Korean Medicine (한방피부과 / 한의원)
    Korean medicine practitioners approach skin pigmentation within the framework of traditional Korean medicine, evaluating constitution and systemic balance. The scope and methods differ from conventional dermatology. — First / second line: Some patients choose to consult a Korean medicine clinic alongside or after conventional dermatology care. Whether to combine approaches and how coverage applies may vary depending on the institution and situation, so confirming details in advance is advisable.

Go to the ER / call 119 if

If any of the following applies, do not choose a department — go to an emergency room or call 119 (Korea's emergency number).

  • A pigmented lesion suddenly changes color, shape, or size very rapidly over a matter of days and is accompanied by significant swelling, pain, or bleeding that does not stop — go to the emergency room rather than scheduling a regular outpatient visit.
  • Skin discoloration appears together with a sudden severe drop in blood pressure, extreme weakness, or loss of consciousness — call 119 or go to the emergency room immediately.
  • Widespread skin darkening occurs alongside difficulty breathing, throat swelling, or signs of a severe allergic reaction (anaphylaxis) — call 119 immediately.
  • Hyperpigmentation is accompanied by sudden high fever, rapidly spreading redness or skin breakdown suggesting a serious skin infection or sepsis — go to the emergency room or call 119.
  • Any pigmented skin change occurs together with sudden severe chest pain, paralysis, or sudden loss of vision — do not attempt to choose a department; call 119 immediately.

Before your visit

  • Note when the hyperpigmentation first appeared and whether it developed gradually or suddenly, as this information helps the doctor assess possible causes.
  • Observe and be ready to describe the location, size, shape, color, and number of affected areas, including whether they are flat or raised.
  • Think about any recent changes such as sun exposure, new skincare products, medications, hormonal changes, or skin injuries that preceded the pigmentation.
  • Bring a list of all medications and supplements you are currently taking, as some substances can contribute to pigmentation changes.
  • If you have had any previous skin evaluations, biopsies, or blood tests related to this concern, bring the results or a summary to the appointment.
  • If you have any family history of pigmentation disorders or systemic conditions involving the skin, mention this to the doctor during the consultation.

General principles

Hyperpigmentation refers to areas of skin that appear darker than the surrounding skin due to an excess of melanin or other pigments. It can have many different causes — ranging from sun exposure and post-inflammatory responses to hormonal influences or, less commonly, systemic conditions — which is why a physician evaluation is the starting point for understanding the underlying reason.

In the Korean healthcare system, a dermatology clinic (피부과 의원) generally serves as the first point of contact for skin pigmentation concerns. The dermatologist will typically assess the lesion visually, sometimes aided by a dermatoscope or Wood's lamp, and determine whether further evaluation or referral is appropriate. A referral letter (진료의뢰서) is generally required when visiting a tertiary hospital (상급종합병원 / university hospital) for a non-emergency condition.

If systemic causes are suspected based on the clinical picture, the dermatologist may coordinate care with internal medicine or endocrinology. This kind of stepwise approach — starting at the clinic level and escalating as needed — is the general pattern in the Korean healthcare system. Health insurance coverage for dermatology visits at the clinic level is generally available, though coverage for specific procedures can vary.

Pigmentation that changes noticeably over time, appears in an unusual pattern, or is accompanied by other symptoms is generally something a physician should evaluate without significant delay, even if it does not constitute an emergency. Bringing clear photographs of the affected area taken at different times can be helpful if the appearance has changed.

FAQ

Should I go to a dermatology clinic (의원) or a hospital-level dermatology department first?

For most cases of hyperpigmentation without urgent symptoms, starting at a dermatology clinic (의원) is the general approach in Korea's healthcare system. A hospital-level facility can be visited directly with normal insurance coverage, while a university hospital (tertiary level) generally requires a referral letter for insurance coverage. Bringing a referral letter is therefore required specifically for tertiary-level hospitals.

Could my hyperpigmentation be melasma, and does that change which department I visit?

Melasma is a specific pattern of facial hyperpigmentation that a dermatologist is trained to identify and differentiate from other causes. Whether your pigmentation is melasma or something else is a clinical judgment that requires a physician's assessment, so Dermatology (피부과) remains the appropriate first department regardless. The doctor will advise on the nature of your pigmentation after evaluation.

Is there any difference in how children or elderly patients with hyperpigmentation should approach getting care?

For children, a dermatologist will consider age-specific causes of pigmentation, and parents should note any changes since birth versus new-onset changes. For elderly patients, new or changing pigmented lesions may warrant prompt evaluation without delay, as the range of possible causes broadens with age. In both cases, Dermatology (피부과) is generally the starting point, and the physician will guide any further steps.

What kind of examinations does a dermatologist generally use to assess hyperpigmentation?

A dermatologist typically begins with a visual examination and may use tools such as a dermatoscope or Wood's lamp to assess the depth and character of the pigmentation. In some cases, blood tests or a skin biopsy may be considered to investigate possible underlying causes, though the specific approach depends entirely on the physician's assessment of the individual case.

Related questions

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This page is general medical information and does not replace diagnosis, treatment or choosing a clinic. Consult a doctor for any symptom. In an emergency, go to the ER or call 119 immediately.