There has been no report showing the effect of arsenic level on digitized skin pigmentation level, a typical diagnostic marker for arsenicosis. Correlations among history of drinking well water, arsenic levels in hair and toenails, and digitalized skin pigmentation levels (L*-value) in sunlight-exposed (forehead) and unexposed (sole) skin areas digitally evaluated by using a reflectance spectrophotometer were examined in 150 residents of Bangladesh. Univariate analysis showed that arsenic levels in hair and toenails of subjects with a history of drinking well water were 10.6-fold and 7.1-fold higher, respectively, than those in subjects without a history of drinking well water. The mean L*-value of foreheads, but not that of soles, in subjects with a history of drinking well water was 1.15-fold lower (more pigmented) than that in subjects without a history of drinking well water. Significant correlations were found between duration of drinking well water and arsenic concentrations in hair (r = 0.63; P < 0.01) and toenails (r = 0.60; P < 0.01). Multivariate analysis showed that the arsenic levels in hair and toenails and the duration of drinking well water were strongly correlated with the digitized pigmented level of the forehead but not that of the sole. An increase in the duration of drinking well water may increase hyperpigmentation in the forehead, but not that in the sole, through an increased arsenic level in the human body as shown in cutaneous appendicular organs (hair and toenails).