Severe hyperpigmentation may be caused by post-inflammatory hyperpigmentation, acanthosis nigricans or certain metabolic diseases, and it is recommended that the patient be treated with medication or laser treatment after clarifying the specific cause of the disease under the guidance of the doctor. 1. Post-inflammatory hyperpigmentation: Post-inflammatory hyperpigmentation can be improved by topical hydroquinone cream, oral tranexamic acid, etc. It can also be improved or removed by laser treatment. 2. Acanthosis nigricans: the cause of this disease is not yet clear, may be related to obesity, genetic factors. Generally, it can be improved by taking vitamin A orally and using hydroquinone cream externally; obese patients can improve hyperpigmentation by controlling weight and correcting obesity. 3. Certain metabolic diseases: Certain metabolic diseases, such as hepatomegaly, skin amyloidosis, etc., through the treatment of the primary disease, the phenomenon of hyperpigmentation will also be improved. For patients with severe hyperpigmentation, it is recommended to go to a regular hospital in time for examination and treatment under the guidance of a professional doctor after a clear diagnosis.