Dyschromia can be especially disfiguring in patients with skin of color. Exogenous ochronosis, postinflammatory hyperpigmentation (PIH), and vitiligo often are highly noticeable in darker skin types and cause anguish for individuals affected by these conditions. This article will review the literature regarding current medical and procedural therapies for pigmentary disorders to update physicians on specific treatment options that are available for patients with darker skin types. Although treatment of these disorders remains difficult, there is an increasing number of therapeutic options that could lead to improvement in both the cosmetic appearance of the skin and the quality of life of patients who are affected by these psychologically distressing conditions. Most of the existing literature on the safety and efficacy of these treatments consists of case reports and cohort studies; there is a lack of larger randomized controlled trials. Further studies are necessary to yield safe reproducible results for treating pigmentary disorders in patients with skin of color.