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More than 10% of these cases have a genetic basis, and the proportion of genetically defined cases increases to over 40% among those with a disease onset before the age of 30 years [43]

Rotate sites systematically (abdomen at least 2 inches from navel, thighs, upper arms) to avoid lipohypertrophy [13]

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While these can be helpful for surface-level brightening and exfoliation, they often struggle to penetrate deep enough into the dermis to affect the melanocytes where pigment is actually made

Orlistat can impair absorption of fat-soluble vitamins (A, D, E, K), so supplementation is recommended