Mental retardation - hypotonia - skin hyperpigmentation refers to a form of intellectual disability that is characterized mainly by below-average mental ability, decreased muscle strength and greater-than-normal coloring of the skin. Hyperpigmentation usually means darkening of the skin as a result of abnormally high production of a protein, known as melanin. Thus, individuals with this form of intellectual disability often have skin problems as well as problems performing physical activity. Like other individuals with intellectual disability, an individual with this condition often has problems with reasoning and solving problems, as well as performing day-to-day tasks. The condition is also often diagnosed during childhood. Doctors diagnose this form of intellectual disability if darkening of the skin and muscle weakness are observed. Signs like walking and talking late, slow mastering of basic tasks, and having difficulty remembering things may also suggest this condition in children. Treatment is based on a case-by-case basis and depends on the specific needs of the patient. Physical therapists often help patients develop an exercise program to increase muscle strength. Dermatologists can provide treatment for the skin darkening symptoms (hydroquinone, kojic acid, or ascorbic acid). Patients are told to put on sunscreen frequently to prevent further darkening of the skin. Doctors seek help from various therapists and community services to provide support and care for families affected by intellectual disability.