Abstract: Melanin is the pigment responsible for the color of the skin and hair. Melanin is formed and stored in the melanosomes. The intensity of skin pigmentation depends on the size and number of melanosomes present in the keratinocytes, the rate of melanin synthesis, and the rate of transport of melanin within keratinoocytes. Changes in skin pigmentation, especially on the visible parts of the body, can contribute to social withdrawal and psychological distress in children, adolescents, and their parents. This discussion also reviews common disorders of skin pigmentation including vitiligo, albinism, postinflammatory changes, tinea versicolor, and different medical disorders that are associated with changes in skin pigmentation. Psychosocial complications of skin pigmentation disorders and principles of management are considered as well in pediatric patients with skin pigmentation disorders.