Hyperpigmentation of the areola and scrotum in infants is normal, but it is abnormal if it is caused by congenital adrenocortical hyperplasia. When an infant develops areola as well as scrotal hyperpigmentation, it may be normal. It is a normal physiological phenomenon that babies are affected by the mother’s hormone levels in the uterus during the fetal period, which can lead to hyperpigmentation of the areola and scrotum after birth. In addition to this, it can be caused by congenital adrenocortical hyperplasia. Congenital adrenocortical hyperplasia is caused by a defect in the acute regulatory protein for steroid synthesis, and the main symptoms in children are scrotal hyperpigmentation, penile enlargement, and early development of pubic hair. If the child has symptoms of congenital adrenocortical hyperplasia, it is an abnormal manifestation. When infants show symptoms of areola and scrotal hyperpigmentation, it may be a normal physiological phenomenon and does not require treatment. If it is caused by a disease, parents should take their children to the doctor in time and follow the doctor’s instructions for treatment.