What is Skin Pigmentation?
Skin pigmentation is merely the natural color of the skin. The reason people have different skin color and shade is because of melanocytes which are the cells that are responsible for the production of melanin. Melanin is the pigment that is responsible for giving the skin, hair and eyes their color. It also helps with the regulation of heat, protects the body from UV radiation and provides cosmetic variation. The factors that affect the amount and distribution of melanin are genetics, endocrine system and the environment.
What are Skin Pigmentation Disorders?
Skin pigmentation disorders alter the color of the skin. This is caused by damage or abnormality of the cells that make melanin. Pigmentation disorders can affect the whole body or just patches of skin. If the body produces too much melanin, the skin becomes darker like in the case of pregnancy and sun exposure. If it makes too little melanin, the skin becomes lighter like in the case of vitiligo.
Types of Skin Pigmentation Disorders
UV exposure causes a higher production of melanin in the body. However, there are also other factors that can increase or decrease melanin production. Generally, there are two kinds of pigmentation abnormalities that can happen which are:
- Hyperpigmentation – this is when melanin production is higher than normal, which causes the appearance of brown or tan spots on the skin. It is also called melasma.
- Hypopigmentation – this is when melanin production is lower than normal, which causes the appearance of lighter patches of skin. It is also called vitiligo.
- Albinism – this is a rare and inherited disorder that is characterized by complete or partial lack of melanin as compared to the pigmentation of the patient’s siblings and parents. People with albinism have pale skin, pink eyes and white hair.
- Pigment loss from skin damage – in some cases after a burn, ulcer, blister or infection, the skin doesn’t replace some of the pigment in the affected area.
What are the Causes of Skin Pigmentation Disorders?
There is still no clear explanation of why skin pigmentation disorders occur. However, some skin pigmentation disorders like albinism have a particular cause; it is an inherited recessive trait. Hypopigmentation spots in connection to vitiligo can be due to injury like a cut. Studies indicate that the light patches of vitiligo don’t contain melanocytes, which are responsible for creating melanin. Some experts believe that vitiligo may be a direct result of an autoimmune disorder. It has even been linked to conditions like Addison’s disease and hyperthyroidism, which are connected to the adrenal gland.
Hyperpigmentation can be caused by a range of factors like poor nutrition and injury. There is even a psychological syndrome that causes a compulsive need to scratch which results to dark, leathery skin. The mask from melasma may be due to fluctuating hormone levels but it usually disappears after the woman gives birth.
Here are the tangible causes of pigmentation disorders:
1. Heat – too much sun exposure to heat is among the most common environmental causes of pigmentation. It disturbs the cells responsible for pigmentation. Even thermal radiation can affect melanocytes just like UV radiation which can cause hyperpigmentation.
2. Injury – is some cases after a wound from an injury heals, there will be some inflammation which can later develop into pigmentation.
3. Medication – there are certain medicines that can cause skin pigmentation as an adverse effect when they are used during treatment. The problem usually goes away once intake is stopped.
4. Diseases – there are also diseases that can cause skin discoloration including jaundice and cyanosis. In jaundice, the skin becomes yellowish but in cyanosis it turns bluish because of insufficient oxygen in the blood.
5. Emotional duress – there are some cases wherein extreme emotional stress can cause a change in melanin production.
Skin Pigmentation Disorder Symptoms and Signs
The symptoms and signs of skin pigmentation disorders is either darkening or lightening of the skin. It can affect the whole body or just certain areas.
How is Skin Pigmentation Disorder Diagnosed?
There are different diagnostic tests for specific skin pigmentation disorders. However, doctors and dermatologists can usually diagnose skin pigmentation disorders through physical examination and by taking a thorough medical history of the patient. For vitiligo, a visual exam is usually all that is needed for diagnosis. Other skin pigmentation disorders may require blood tests and eye exams. For conditions like skin cancer or lichen simplex chronicus, a biopsy may be conducted to study the skin under a microscope. Some physicians also use a black light test, wood’s lamp or other devices to diagnose a skin condition.
What is the Treatment For Skin Pigmentation Disorders?
There are specific treatments for different skin pigmentation disorders. For albinism, patients are advised to cover up, use sunscreen and as much as possible avoid sun exposure in order to prevent skin cancer. They also need to wear protective eyewear and/or prescription corrective lenses. For visual impairments, surgery may be needed.
For vitiligo, patients are prescribed a combination of photosensitive medications and ultraviolet light therapy to darken light spots. If the patient has de-pigmented patches that affect more than half of the body, skin bleaching agents like monobenzone may be used for a more uniform appearance of the skin. There are also cosmetic concealers that can be used but skin grafting is another option.
For hyperpigmentation disorders, there are skin lightening creams that can be used. Patients are also advised to avoid the sun. If the problem is connected to poor nutrition, a dietician may be needed for counseling. For people with lichen simplex chronicus, topical creams and/or antihistamines may be prescribed to stop itching. For birthmarks or moles that are suspicious, doctors may need to surgically remove it in order to prevent skin cancer.
Cosmetics can be used to instantly even out skin tone and hide dark or light spots. There are tinted moisturizers, foundation and other cosmetic products that can be used as a temporary solution to skin pigmentation disorders. There are also home remedies that are cheap and safe wherein all-natural ingredients are used for skin pigmentation problems. For example, lemon can be used on dark spots since it is an effective bleaching agent. Other natural lighteners include honey, onion, milk and Aloe Vera. However, some people are sensitive to certain natural remedies which can result to the irritation of the skin.
Are Skin Pigmentation Disorders Triggered by Diet?
Poor nutrition can be one of the causes of hyperpigmentation. There are also certain foods that are known to accelerate skin darkening. For example, foods like celery, limes and parsnips contain psoralens which gather on the skin and attract harmful ultraviolet rays therefore accelerating darkening of the skin. If you have recurring dark spots on the face or neck, there is a possibility that it is connected to such foods. Consuming these foods may not really expose the skin but contact with the skin certainly can. Skin darkening can also be caused by caffeine but only when consumed in large quantities. A healthy, well-balanced diet can be helpful in preventing skin pigmentation disorders.
Tips to Prevent Skin Pigmentation Disorders
- Protect yourself from the UV rays of the sun by wearing appropriate clothing and using sunscreen.
- Eat a healthy, well-balanced diet.
- Be careful with the medication you are taking. If you notice any changes in the pigment of your skin after taking new drugs, talk to your doctor about it.
- Manage stress since it can sometimes cause pigmentation problems.
- Be careful of too much exposure to heat since it can disturb the cells that produce melanin.
Dos and Don’ts of Skin Pigmentation
- Do use sunscreen daily, even during cloudy days since UV rays can penetrate clouds and cause hyperpigmentation.
- Do not assume that results from skin lightening products or other treatments are permanent because hyperpigmentation is a long-term battle that requires maintenance.
- Do use safe and effective products that are clinically proven. If you are unsure, ask your skincare professional about a certain product before using.
- Do not use skin lightening products with potentially harmful ingredients. Research is very important since there are many dangerous ingredients in skin lightening products like those that can damage the skin or increase skin cancer risk.
- If you think you are having any skin pigmentation problem, consult a skincare professional as soon as possible in order to determine the cause and get the right treatment.
- Do follow a healthy and well-balanced diet rich in antioxidants and nutrients.
Frequently Asked Question’s (FAQ’s)
Why do skin pigmentation disorders occur?
There are different causes for specific skin pigmentation disorders. For instance, hyperpigmentation is commonly caused by prolonged sun exposure. The other common causes of skin pigmentation disorders are injury, too much heat exposure, medical conditions and intake of certain medications. There are also other possible causes like emotional duress and genetics.
Do skin pigmentation disorders go away as we age?
Some skin pigmentation disorders become more common as a person ages. For instance, age spots which are dark spots on the skin are among the major signs of skin aging. With the right treatment, there is also a possibility that certain skin pigmentation disorders can be managed. However, most cases require maintenance in order to keep symptoms in control.
Do all skin pigmentation disorders look the same?
Skin pigmentation disorders do not look the same. For instance, hyperpigmentation disorders cause the darkening of the skin. On the other hand, hypopigmentation disorders cause the lightening of the skin. With both, they can affect the whole body or just certain areas.
Do skin pigmentation disorders affect self-esteem?
Skin pigmentation disorders, just like any other visible skin condition can have a negative effect on a person’s self-esteem lowering self-confidence. This is the reason it is important to get help from a skincare professional and determine the best treatment as soon as possible. In some cases where the pigmentation disorder can’t be improved or hidden, counseling may be needed.
Is there a cure for skin pigmentation disorders?
There are cures for some skin pigmentation disorders but for most, continuous treatment or maintenance is necessary in order to prevent skin discolorations from reappearing. There are also some skin pigmentation disorders that cannot be cured like albinism. For these individuals, treatment is still important in order to keep the condition under control and prevent complications.
Skin pigmentation disorders are common and there are several types that can affect anyone. There are also different causes and treatments. In most cases, the cause is too much sun exposure (for hyperpigmentation) which is usually treated with over-the-counter products or skin lightening procedures. The good news is that there are treatments that can help with the management of skin pigmentation disorders. There are also ways to prevent such problems from occurring in the first place.
- Kim NY, Pandya AG, “Pigmentary Diseases”, Med Clin North Am, 1998
- 1Chang MW. Disorders of hyperpigmentation. In: Bolognia JL, Jorizzo JL, Rapini RP, eds. Dermatology. 2nd ed.
- Alexis AF, Sergay AB, Taylor SC. Common dermatologic disorders in skin of color: a comparative practice survey. Cutis. 2007
- Sturm, R.; Teasdale, R.; Box, N. Human pigmentation genes: Identification, structure and consequences of polymorphic variation. Gene 2001
- Ming ME, Bhawan J, Stefanato CM, McCalmont TH, Cohen LM. Imipramine-induced hyperpigmentation: four cases and a review of the literature. J Am Acad Dermatol. 1999
Elsevier Mosby; 2009