Two of the most vexing skin conditions that we manage as dermatologists are melasma and vitiligo. In one condition, too much pigmentation is present because of genetic, hormonal and environmental factors. In the other, there is a lack of melanin in the skin, presumably on an autoimmune basis. Seemal Desai, M.D., board-certified dermatologist, clinical assistant professor in the department of dermatology at University of Texas, Southwestern Medical Center in Dallas, and medical director of Innovative Dermatology, discusses treatment options for these two conditions with Dermatology Times editorial advisor, Norman Levine, M.D