Previous studies showed the prevalence of melasma, plateau facial telangiectasia, and vitiligo varied in different regions but were absent in high-altitude areas.To investigate the prevalence of three common pigmented skin disorders (melasma, plateau facial telangiectasia, and vitiligo) among the general population in Lhasa, aiming to provide a scientific basis for their prevention and management in high-altitude areas.From May 2021 to October 2021, multistage stratified cluster random sampling was conducted in Lhasa to carry out a questionnaire and a second on-site physical examination, and the results were statistically analyzed.The study included 4988 participants, revealing a prevalence of 14.94% for melasma, 17.14% for plateau facial telangiectasia, and 0.38% for vitiligo. Notably, the prevalence of melasma and plateau facial telangiectasia were significantly higher among women, particularly those aged 31-50 years, compared to men. Urban residents also showed a higher prevalence than their rural counterparts.Our study concludes that the prevalence of the three pigmented skin disorders in Lhasa is notably higher than in lower-altitude areas, with UV radiation being a significant risk factor. Our findings underscore the need for enhanced public health interventions, including screening, education, and prevention efforts, to mitigate the impact of these skin disorders in high-altitude regions. Our research contributes valuable insights toward the understanding and management of pigmented skin disorders in such unique environments. It may also provide an easy-to-use epidemiological survey method for socioeconomically underdeveloped areas.© 2025 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.