The melanin pigment in your skin is responsible for your skin colour. Special cells known as melanocytes produce this melanin. However, a damage to these cells alters melanin production. Moreover, patients suffer from pigmentation on the face, hands, back, chest.
Melanin is naturally produced in the skin by cells called melanocytes. This is the pigment that gives color to your eyes, hair, and skin. Damaged or overstimulated melanocytes may begin to produce an abnormal level of melanin. An increase in melanin causes the skin to become hyperpigmented. Correspondingly, a decrease in melanin leads to hypopigmentation.
Do & Don't for Getting Pigmentation
DO: Visit your dermatologist in the initial stages.
DO: Use a broad-spectrum sunscreen (> SPF 30).
DO: Use sun protection like scarves and hats.
DO: You need to avoid excessive sun exposure.
DO: Carry an umbrella, wear full sleeves clothing or broad-brimmed hats.
DO: Wear SPF 30 broad-spectrum sunscreen with PA++ protection.
DON’T: Overexpose yourself to the sun.
DON’T: Step outdoors without sunscreen.
DON’T: Ignore sunburns as they may lead to skin cancer
Types of Skin Pigmentation
A. Skin discoloration
Skin discoloration is defined as any change in the natural skin color. This includes lightening, darkening or reddening. Cuts, scratches, or burns may also result in skin discoloration.
A decrease in melanin production leads to hypopigmentation. Damage, inflammation or hereditary conditions may be the causative factors for this decrease. This condition may also be a result of a decrease in the amino acid tyrosine. This is because melanocytes use tyrosine as a catalyst to produce melanin.
Some of the disorders associated with multiple pale patches are:
Causes of Hypopigmentation
The following conditions could cause hypopigmentation:
- Firstly, injuries to the skin.
- Secondly, pimples, blisters, chickenpox, and minor cuts.
- Thirdly, skin treatments that have been carried out without medical supervision.
Types of Hypopigmentation
- Generalised - This type usually occurs due to congenital defects like albinism.
- Localised - This type is caused due to partial or complete loss of melanin in a given area. For example, vitiligo and leprosy are types of localized hypopigmentation.
An increase in melanin production results in hyperpigmentation. Triggers for hyperpigmentation include:
- Side effects of drugs
- Overexposure to the sun
- Inflammation caused by an illness or disorder
This condition is quite common and usually harmless.
Some of the disorders associated with hyperpigmentation are:
- Acanthosis nigricans
- Post-inflammatory hyperpigmentation (PIH)
Causes of Hyperpigmentation
- Firstly, improper laser and light treatment
- Secondly, exposure to certain chemicals such as salicylic acid
- Thirdly, tinea fungal infections such as ringworm
- Fourthly, hormonal imbalance
Types of Hyperpigmentation
- Generalised - This type is seen in 95% of people with Addison's disease. Additionally, 90% of people with hemochromatosis exhibit generalized hyperpigmentation.
- Localised - While this type can be due to melanin, it may also be caused due to hemosiderin. Hemosiderin is an iron storage complex. For example, lentigines, photo contact dermatitis, melasma.
Depigmentation is the complete loss of pigment. This loss of pigment may occur in individuals of both genders. The lesions are milky white, round or oval in shape.
Causes of Skin Pigmentation
1. Overexposure to sunlight: Overexposure to sun irritates our skin and triggers hyperpigmentation. Moreover, sunlight darkens or tans our skin. In some people, tanning can result in hyperpigmentation.
2. Skin damage: Damage to your skin results in the melanocytes producing excess melanin. Damage may include slight irritation, dermatitis or even a pimple. Additionally, your skin loses the capacity to recover the even skin tone after the damage. As a result, darker or lighter shades of skin are produced over the affected area.
3. Hypersensitive reactions: A hypersensitive reaction to an allergen may affect the skin. Consequently, this stimulates the melanocytes and causes hyperpigmentation.
4. Medicines: Pharmaceuticals that trigger hyperpigmentation include -
- Topical retinoids
- Anti-infection and anti-seizure drugs
- Non-steroidal medications
- Lastly, chemotherapeutic medications
5. Hair removal: Removal of facial hair may cause hyperpigmentation. However, threading or proper shaving does not cause hyperpigmentation. In fact, factors that may cause hyperpigmentation are -
removing hair from the root
exposing the root to reactive chemicals
6. Hormonal change: Hormonal changes like an increase in estrogen may increase melanin production. Pregnancy or contraceptive pills may cause melasma. Melasma may disappear without treatment in some individuals.
7. Hereditary: Pigmentation is a condition that may be genetic. In such cases, it is important to protect yourself from the sun, hormonal changes or skin damage.
Treatments for Skin Pigmentation
Hyperpigmentation is only a visual discomfort, not a physical one. It is completely harmless unless associated with medical disorders. Wood’s lamp examination assists in the diagnosis of various pigments and infectious disorders. This diagnostic method uses UV light in the 365 nm range.
Additionally, Wood’s lamp diagnoses vitiligo, erythrasma, porphyria cutanea tarda, and other pigmentary disorders. Generally, doctors recommend a microbiological culture and microscopy of affected skin and skin biopsy.
The treatment modalities to treat pigmentation are:
Various experts have started using lasers for the treatment of skin pigmentation. Lasers treat only the affected skin and have minimal to no impact on the normal skin. They use the principle of selective photothermolysis. Hence, the laser selectively destroys the pigmented cells with no damage to the surrounding skin.
Dermatologists treat pigmentation with different types of lasers depending on the type of pigmentation, the area, and the level of recovery time. Lasers stimulate collagen growth in the underlying layers of skin. As a result of this, the skin tightens and the skin tone also improves.
- Q-switched laser: This is another type of laser which is commonly used for treating pigmentation. These lasers emit nanosecond pulses of light which target the melanin in pigmented skin. They selectively heat the pigment to destroy it. However, since the pulses are much shorter, they may also result in a photomechanical effect. Consequently, they shatter or shock the pigment causing it to breakdown. Generally, these lasers have an advantage because these lasers require fewer treatments to treat pigmentation.
- Erbium Yttrium-Aluminium-Garnet (Er:YAG) Laser: This laser can be used to cure pigmentation problems. Additionally, it also treats acne scars, sun damage, fine lines, small to moderate wrinkles, and moles. Moreover, it has lesser side effects as compared to the Co2 laser.
- Intense Pulsed Light (IPL): IPL therapy delivers a broad range of wavelengths of light at the same time. Hence, it can treat a combination of skin issues at the same time. This treatment is effective in treating hyperpigmentation and sun damage. Basically, they work by killing the affected skin cells, thereby rejuvenating the skin.
- Alexandrite laser: Alexandrite lasers treat pigmented lesions using the principle of photothermolysis. These lasers destroy the affected skin very precisely. Moreover, they leave the surrounding area undamaged. Dermatologists prefer the Alexandrite laser to treat superficial pigmentation. Redness, swelling, itching are common side effects.
Chemical peels exfoliate and peel the skin off. Basically, chemical peels help in the generation of new skin. Chemical peels are of 3 types - superficial, medium and deep. Hyperpigmentation can be treated using chemical peels that contain trichloroacetic acid (TCA), salicylic acid or phenol. However, make sure you do it under the experienced eye of your dermatologist, to avoid scarring and pigment irregularities.
Nursing or pregnant women should not use chemical peels. Additionally, even psoriasis, eczema, dermatitis or rosacea patients should avoid chemical peels. Likewise, if you have taken Accutane in the last 6 months or retinoids in the last 48 hours you should avoid using chemical peels.
In this treatment, a stream of microcrystals or a diamond head exfoliates the affected skin and rejuvenates it. It is a non-invasive technique.
Microdermabrasion is appealing to many patients. It also has other advantages like:
- Brightening up dull complexion.
- Improving uneven skin tone or texture.
- Reducing age spots.
- Reducing dark spots that can appear when acne starts to clear.
- Toning down melasma.
Additionally, dermatologists use microdermabrasion to enhance the results of anti-aging products and skin-bleaching products. This treatment aids the easy penetration of these products.
Skin lightening creams:
These creams inhibit melanin production and reduce the existing melanin from the skin.
Hence, it is helpful to use products that contain a combination of the following ingredients:
- Kojic acid
- Azelaic acid
Prescription-based topical treatments
These topical applications exfoliate and rejuvenate the skin.
The following types of topical applications are useful:
- Hydroquinone - is the only FDA approved skin lightening cream.
- Kojic acid - is a derivative compound. It is extracted from a fungus that works like hydroquinone.
- Azelaic acid - is useful in treating acne and hyperpigmentation.
- Mandelic acid - is derived from almonds. This acid treats all types of hyperpigmentation.
- Applications that contain retinoids, Retin-A or alpha-hydroxy acids (AHAs) like glycolic acid.
- Peptides - are new generation amino acid molecules. Lightening agents containing peptides do not have any side effects.
- Creams that contain licorice and kojic acid.
- Sunscreen - SPF 30, broad-spectrum sunscreen.
Dermatologists assess the pigmentation to treat it effectively. However, dermatologists may recommend various treatments to treat skin pigmentation. READ MORE
After 2 Months
After 3 Months
After 4 Months
After 6 Months
Skin pigmentation takes time for the pigmented skin to return to its original tone after pigmentation occurs. This may happen without treatment in some cases, but it may require treatment in others.
Skin Pigmentation – Q&A
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