Skin Pigmentation: Causes, Symptoms & Solutions

May 19, 2021

Skin pigmentation treatment

What is Pigmentation?

Pigmentation refers to the colouring of the skin which depends on specialized cells that produce melanin. Melanin is the pigment that imparts different shades and colours to the hair, skin, mucous membranes, and retina of the eye. People with low deposits of melanin have a fair skin tone and the ones with high deposition have a darker skin tone.

Skin pigmentation disorders occur when there is an excessive production of melanin, called hyperpigmentation, leading to dark spots, patches, or discolouration of the skin. Over time, it can affect the colour of the skin and result in an uneven skin tone. Though hyperpigmentation isn’t a harmful condition, it may be an indication of another medical condition. Therefore, it is necessary to consult with a dermatologist to determine the right cause behind the pigmentation.

Types of Pigmentation

Pigmentation is of different types. It is essential to understand their types and causes to manage them when they appear.

Hypopigmentation

In hypopigmentation, the skin loses its colour due to the decrease in the production of melanin. It could affect individuals from their birth or at a later stage in life. Hypopigmentation can also be triggered due to a disease or trauma.

Hypopigmentation types include –

Albinism: This is a rare inherited disorder caused by the absence of melanin altogether, resulting in a complete lack of pigmentation in skin, hair, and eye. Unfortunately, there is no cure for albinism.

Vitiligo: Vitiligo is a type of hypo-pigmentation, where smooth white patches appear on the skin because pigment-producing cells are damaged.

Pityriasis alba: Pityriasis alba most commonly occurs in children with dark skin and involves white, slightly raised patches on the face. The cause of pityriasis alba is not known, but it may be associated with dry skin.

Hyperpigmentation

Hyperpigmentation is a term used to describe skin that has become darker than the surrounding areas. It may occur as small patches of pigmentation on the face, or large areas of the skin, and may affect the entire body as well.

Hyperpigmentation types include –

Melasma: It is the result of uneven production of melanin pigmentation on the skin which may be caused due to hormonal changes or pregnancy. Exposure to the sun has also been known as a cause of melasma.

Freckles: These are the most commonly occurring types of pigmentation. Genetics play a role in developing freckles on the skin. They appear as little dots after repeated exposure to the sun and are prevalent in individuals with a fairer complexion.

Solar lentigines: Caused due to excess exposure to the sun over time, solar lentigines are also known as liver spots or sunspots. Usually, solar lentigines appear on the hands and face in areas exposed to the sun.

PIH: PIH or Post Inflammatory Hyperpigmentation occurs in response to an injury or inflammation to the skin caused due to acne, burns, or aggressive clinical treatments like dermabrasion, chemical peels, laser, etc.

What Causes Skin Pigmentation?

Causes of skin pigmentation

Both internal and external factors can be responsible for increased production of melanin and lead to pigmentation disorders of the skin. To determine the exact cause, it is recommended to seek aid from a dermatologist.

Here are some of the common factors causing skin pigmentation.

External Factors

Injury – An injury to the skin caused by a cut, bruise, improper technique of hair removal, depilatory creams can lead to an inflammatory reaction on the site. This increases the production of melanin causing skin hyperpigmentation.

Allergies – Contact dermatitis in response to allergens present in cosmetics, hair dyes, etc.

Medication – Side effects from certain medications like tetracycline antibiotics or the ones used in chemotherapy can cause unwanted pigmentation of the skin.

Exposure to the sun – The sunlight reaching us contains long wave ultraviolet A (UVA) and short-wave ultraviolet B (UVB) rays. The UVA rays can reach deep into the skin and cause excessive melanin production.

Internal Factors

Hormonal fluctuations – Hormonal imbalance caused by the rise of estrogen and progesterone levels in the body can cause pigmentation known as melasma. The hormonal fluctuations may be triggered by birth control pills or pregnancy.

Hereditary factors – This is one of the major factors affecting pigmentation in the skin. For example, pigmented spots called lentigines that occur on the sun-exposed areas of the body are a condition associated with hereditary multisystemic syndromes.

Disease – Endocrine diseases and certain medical conditions like Addison’s disease affect the hormonal levels in the body leading to melanin production and skin pigmentation.

Pigmentation facts

Pigmentation occurs in people usually due to an imbalance in melanin production. Although it is quite a common condition, many people don’t know how to manage skin pigmentation. Here are a few facts about pigmentation that will help you become clear about the condition and minimize it.

  • Melanin does play a role in determining your skin tone. The bottom layer of your skin’s epidermis called “the stratum basale” contains melanocytes, which are cells that produce melanin – the dark pigment responsible for skin colour.
  • Pigmentation results when the melanocytes are damaged due to some reasons or go through unhealthy changes causing dark patches on some parts or the entire body.
  • Sunlight does help in the synthesis of vitamin D, but too much of it is harmful. Overexposure to sunlight can lead to a number of skin problems. Hence, people with pigmentation-prone skin are advised to wear a scarf or apply sunscreen to limit exposure to sunlight.
  •  Even when it’s not sunny outside, UV rays still exist. Therefore, you need to protect your skin on overcast days as well.
  • Pigmentation is a stubborn condition but it is treatable. There are many home remedies for pigmentation as well as medical treatments, such as chemical peels, microdermabrasion, cryotherapy, laser resurfacing, etc.
  • Talking about the home remedies for the treatment of pigmentation, one should be very careful before trying them out. That’s because many fruits and vegetables that may be suggested to you as an effective home remedy for pigmentation can contain some enzymes and acids that may worsen the problem. Therefore, it is recommended to talk to a certified dermatologist before considering such a step.

Diagnosis

Diagnosis of skin pigmentation

For an accurate diagnosis, it is recommended to seek help from an experienced dermatologist. They can recommend treatment options depending on the type of pigmentation.

The different stages of treatment include

  • Visible examination,
  • Derma scan analysis, or
  • Biopsy of the specific skin area if required

Aside from that, the dermatologist may also review your medical or family history, followed by other skin examinations to figure out the cause of skin pigmentation. Once the factors are ascertained, the dermatologist either suggests topical medication or advanced treatments for cure.

Prevention and Management

Although treatments and procedures are available to correct skin pigmentation issues, it is also essential to prevent them from occurring or manage them once they occur. Some of the ways to do that are as follows.

You can use an over-the-counter product containing moisturizing agents like glycerin or hyaluronic acid to keep your skin moisturized. Many products also come with retinol which helps to boost cell turnover. This can help to protect the skin from the damaging rays of the sun.

It is crucial to avoid picking or scratching at the affected spot as that could further aggravate the inflammation responsible for skin discolouration. Besides, the pigment in brown spots tends to move deeper in the skin over time, so it is better to treat hyperpigmentation in its early phases.

In case the OTC remedies are not working as effectively as they should, you can talk with your dermatologist and try prescription-strength hydroquinone alone or in combination with other lighteners. It has proven to be effective in slowing down the production of pigment and fading the darkened spots. While using hydroquinone, it is essential that your dermatologist closely monitors it as it can cause sun sensitivity or bleach the skin.

The best way to prevent skin pigmentation is to avoid exposure to the sun without using a broad-spectrum sunscreen even on cloudy or cool days. Using a sun protection factor of 30 or higher will protect you from the UVB short-wave rays. For protection from the UVA long-wave rays, you can choose a product that contains Mexoryl, zinc oxide, titanium dioxide, or avobenzone.

Home Remedies for pigmentation

Below mentioned are some of the common home remedies for pigmentation.

 Olive Oil: Applying olive oil on the skin boosts the natural sun-blocking properties present in the skin. Moreover, it also contains squalene, a natural protective fat of the skin.

Apple cider vinegar: The acetic acid in apple cider vinegar may lighten skin pigmentation. It can be combined with water in equal parts and applied to the dark patches. After two to three minutes, it can be washed off with lukewarm water.

Aloe vera: Aloin is a naturally occurring depigmenting compound found in aloe vera. For best results, aloe vera gel can be applied to the pigmented areas before bedtime.

Red onion: Many skin and scar lightening creams contain extracts from red onion. Certain research studies have shown that the dried skin of red onions can work well to lighten skin pigmentation.

Green tea extract: Green tea extract has been known to produce a depigmenting effect on the skin. To apply on the skin, green tea bags can be boiled in water for a few minutes and then cooled down before applying.

Black tea water: To prepare black tea water pigmentation treatment at home, add a tablespoon of black tea leaves to boiling water, steep for two hours, and strain to remove the leaves. Use a cotton ball to soak the black tea water and apply it to the area of hyperpigmentation.

Licorice extract: The active ingredients in licorice extract work best for hyperpigmentation caused due to sun exposure and melasma.

Milk: Milk can also be used as an effective skin lightening and pigmentation removal remedy. You can use a cotton ball to soak the milk and then apply it to darkened skin patches.

Tomato paste: Tomato is rich in lycopene, which protects the skin from environmental pollutants and photodamage.

Superfoods and diet to reduce skin pigmentation

Your diet can play a significant role in the management of skin pigmentation conditions, such as sunspots, melasma, or PIH. One thing that’s common in these conditions is that they occur when the skin is stressed through hormonal imbalance, infection, environmental exposure. Eating a balanced diet, in general, can help decrease the effects of these factors. For proper skin health, it helps to include these foods in the diet.

Fatty fish: Include fishes like mackerel, herring, and salmon in the diet. They are rich in omega-3 fatty acids and loaded with zinc which can reduce inflammation and promote healthy skin.

Seeds and nuts: Seeds and nuts are a great source of zinc, vitamin E, selenium, and omega-3 fatty acids.

Avocados: Avocados contain healthy fats and antioxidants that help to protect the skin from sun damage and premature aging.

Citrus fruits: Grapes, oranges, and lemons are rich in vitamin C which helps to promote healthy and youthful skin.

Sweet potatoes and carrots: They contain high levels of carotene and provitamin A which act as a natural sunblock for your skin.

When to consult a doctor?

Skin pigmentation treatment

If a new patch of discoloured skin appears and does not go away, it is best to see a doctor. It is also important to seek medical attention if a mole changes size, shape, or texture.

Consulting a doctor is a must in the following cases.

  • Severe acne, rosacea, or hypopigmentation
  •  Increase in the size of birthmarks
  • Severe burn injuries

Treatment Options for Skin Pigmentation

There are several medical treatment options available for pigmentation removal. These include:

Topical creams

Typically, the first line of skin pigmentation treatment is the application of topical creams. One has to be consistent in the application of creams or serums for weeks or months before they start seeing significant results. Some of the topical creams used are:

Hydroquinone: It is a skin lightening agent that works by decreasing the amount of melanin in the skin.

Azelaic acid: Generally used for the treatment of hyperpigmentation caused by acne and inflammation. The azelaic acid is a safe and gentle exfoliant and is quite effective for hyperpigmentation treatment.

Kojic acid: This skin lightening agent is derived from a fungus. It works by inhibiting the production of tyrosine, which is an amino acid required for the synthesis of melanin.

Retinoids: Retinoids are broadly the derivatives of vitamin A. Retinol and tretinoin are the commonly used forms of retinoids for hyperpigmentation due to their anti-aging and skin-lightening properties.

Vitamin C: It reduces hyperpigmentation caused as a result of sun damage.

Niacinamide: It is a vitamin B3 derivative that is known to aid in the production of collagen.

Chemical peels

Chemical peels are cosmetic treatments that are used to improve the appearance of the skin. The procedure involves applying chemical solutions to the area affected by pigmentation which exfoliate the skin eventually causing it to peel off. The result is a smoother and younger-looking skin that was lying underneath the skin that was treated. Chemical peels may be recommended for individuals with conditions like acne scars, sun damage, wrinkles and fine lines, melasma, hyperpigmentation, scars, redness, and uneven skin tone, etc.

In this pigmentation treatment procedure, three different types of chemical peels are used, which include:

Superficial peel: It penetrates the outermost layer of the skin and gently exfoliates it. Here, mild acids like alpha-hydroxy are used.

Medium peel: This is quite effective for removing damaged skin cells as it can penetrate the middle and outer layers of the skin. Here, trichloroacetic or glycolic acid are used.

Deep peel: This is used to penetrate the middle layer of the skin to remove the damaged skin cells. For deep peel treatment, phenol or trichloroacetic acid is used.

Microdermabrasion

It is a minimally invasive procedure used to improve the skin tone and texture and enhance the appearance of skin pigmentation caused due to acne scarring, sun damage, melasma, and other skin concerns and conditions. In the microdermabrasion procedure, an applicator with an abrasive surface is used to gently sand away the thicker outer layer of the skin to renew or rejuvenate it.

There is another form of microdermabrasion technique as well where fine particles of aluminum oxide or sodium bicarbonate are sprayed with the help of a vacuum or suction to create similar results as the abrasive surface.

Microdermabrasion is a safe procedure that works on most skin types and colors and is sought by people having skin problems like wrinkles, fine lines, age spots, blackheads, stretch marks, dull complexion, enlarged pores, uneven skin tone and texture, melasma, sun damage.

Intense pulsed light (IPL)

Intense pulsed light is a form of light therapy used for the treatment of spots, wrinkles, and unwanted hair. IPL is recommended for minimizing or removing the following conditions:

Sun damage, freckles, age spots, birthmarks, rosacea, varicose veins, broken blood vessels on the face, and unwanted hair on the face, neck, etc.

Intense pulsed light works like laser treatment, but there is one difference. Laser treatment involves focusing a single wavelength of light on the skin, while in IPL, lights of different wavelengths are used. Unlike a laser, the light released from IPL is more scattered and less focused and can easily penetrate to the second layer of the skin. As the pigment cells in the skin absorb the light energy, it is converted into heat which then removes the unwanted pigment causing the spots and freckles. The heat generated also destroys the hair follicles that prevent the unwanted hair from growing again.

Although IPL treatment can be applied anywhere on the body, it may not be effective in uneven areas. Besides, it is not recommended for individuals with darker skin tones or those with thick keloid scars.

Laser resurfacing

A laser resurfacing procedure is performed by a certified dermatologist or physician to improve the appearance and texture of the skin. Your dermatologist will recommend ablative or non-ablative procedures depending on your requirements. 

Ablative lasers are wounding laser procedures that stimulate the growth of new collagen fibers by removing the outer layer of skin and heating the underlying skin. Carbon dioxide or Erbium are involved in the ablative laser resurfacing treatments. The CO2 laser procedure is recommended for the treatment of scars, warts, and deep wrinkles, while the procedure involving erbium is used when the individual wants to get rid of fine lines and wrinkles or other superficial skin concerns.

Non-ablative lasers use light and heat to induce controlled injury in the dermis without affecting the upper layer or epidermis of the skin. They are less invasive and don’t remove any skin layers. 

Skin Pigmentation FAQs

What is hyperpigmentation and how does it develop?

Hyperpigmentation refers to the darker than usual colouration of your skin. This happens when your body’s pigment cells melanocytes, produce more than usual melanin. This can cause skin discoloration and make it look darker. It can be caused due to certain triggers like diseases, exposure to the sun, etc. The darkening of the skin can also result when endogenous or exogenous pigments are deposited in the dermis of the skin.

How does pigmentation develop?

Pigmentation develops when the skin is stressed from UV rays leading to the overproduction of melanin. When the production of melanin increases in the epidermis, it results in freckles. Upon further accumulation of melanin due to sun damage, the darkened spots can become large which are commonly referred to as solar lentigines or age spots. Long-term sun exposure over the years can also cause actinic keratoses, which are precancerous lesions of the skin with the potential to become malignant.

How do I avoid pigmentation?

You have to limit your exposure to the sun to avoid pigmentation. Whenever you have to go out in the sun, use sunscreens to protect your skin from the harmful UVA and UVB rays. In addition, it also helps to use sunglasses and hats to protect your skin from the sun.

Why choose ClearSkin?

ClearSkin offers thoroughly selected solutions for the treatment of all skin problems including acne, scarring, laser hair removal, sun damage, and many more. Our panel of experienced dermatologists is here to listen carefully to your individual needs and offer their advice and support at every step of the way. We follow the latest and relevant treatment procedures to identify the type of your skin condition and recommend the best possible option for treatment.

If you are worried about pigmentation disorders affecting your confidence, schedule an appointment with ClearSkin’s experts today.

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