Are pigments caused by toxins, heavy metals and or medication? Some of them can be for sure. One of the most common sites to see a secondary pigment is in an area representative of a bone that has been broken. Did you know that they can also develop in areas of trans-generational interest. I have a number of families where I have seen 3-4 generations. Interestingly, some of the children and grandchildren have developed pigments in areas where either a parent or a grandparent