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.

B. Hypopigmentation

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:

• Vitiligo
• Leprosy

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.

C. Hyperpigmentation

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
• Melasma
• 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.

D. Depigmentation

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. Factors in this case 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.

Diagnosis 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, the Wood’s Lamp diagnosis can spot vitiligo, erythrasma, porphyria cutanea tarda, and other pigmentary disorders. Generally, doctors recommend a microbiological culture and microscopy of affected skin and skin biopsy.

Treatments for Skin Pigmentation

The treatment modalities to treat pigmentation are -

• Skin Lightening Creams: Creams act by inhibiting the production of melanin and reducing the existing melanin from the skin.  These usually contain one or more of the following compounds: hydroquinone, kojic acid, and mandelic 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.
• Chemical Peels: Chemical peels exfoliate and peel the skin off. Mild acids and other agents are used to exfoliate superficial layers of the skin that is hyperpigmented. The chemicals used include tri-chloro-acetic acid, salicylic acid, and phenol. Chemical peels should always be done under the supervision of a trained dermatologist to avoid burning or scarring of the skin. 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 Isotretinoin in the last 6 months or retinoids in the last 48 hours you should avoid using chemical peels.
• Microdermabrasion: The mechanical exfoliation of the superficial layers of the skin helps in improving skin tone and texture.

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.

• Laser Peel Therapy: This is also known as skin resurfacing therapy. Targeted beams of light are used to reduce hyperpigmentation. Lasers are of two types: ablative and non-ablative. Ablative lasers target and remove layers of your skin whereas non-ablative lasers target the dermis and cause lesser side-effects. The cost of laser treatment for pigmentation in Pune is decided based on the degree of hyperpigmentation, the cause, and the skin type.

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. The types of laser therapy treatments include: 

• Q-switched Laser: This is a new technology that is highly safe and effective. The skin is exposed to a beam of light that only targets the melanin pigment and causes its breakdown. This does not affect the surrounding cells and can reach the deeper layers of the skin, giving an even skin tone.

• Erbium Yttrium-Aluminium-Garnet (Er: YAG) Laser: This laser has fewer side-effects when compared to the CO2 laser and can be used to treat hyperpigmentation as well as moles, wrinkles, and fine lines.

• Intense Pulsed Light (IPL): Also known as a photofacial, this therapy requires multiple sessions and is effective for overall pigmentation issues, especially flat spots. This therapy promotes the growth of dermal collagen and is also effective against wrinkles and enlarged pores.

• Alexandrite Laser: This laser uses the principle of photothermolysis and affects only the targeted lesion, leaving the surrounding skin cells unaffected.

ClearSkin offers a multitude of treatment options for hyperpigmentation and hypopigmentation after careful assessment of your skin problems and your skin type. If you are looking for a doctor for pigmentation in Pune, look no further.

Why choose ClearSkin for Skin Pigmentation Treatment in Pune?

If you are looking for a Pigmentation specialist in Pune, pay us a visit and bid goodbye to your skin problems. ClearSkin has a team of Dermatologists who are trained and specialized in the various subspecialties of skin and hair care. With the latest FDA approved technologies and treatment methodologies, we give you a long term solution to your skin problems.