- Skin pigmentation can be observed as the general darkening of skin or having dark patches on the face and body.
- It is caused by both internal (genetic) and external factors. It is noted more commonly in women but is also seen in men.
- Pigmentary concerns affect skin of all colour. As sun exposure is a major cause of pigmentation, this skin condition is common among Asian people or those living around equatorial regions.
- It is more prominent among middle-aged people as some types of pigmentation are accelerated with aging.
What is Pigmentation?
The normal colouring of the skin, hair, mucous membranes, and the retina of the eye is due to the deposition of the pigment, melanin, which is produced by specialized cells called melanocytes. Whenever there is an excess production of melanin (hyperpigmentation), it causes dark spots, patches or the discolouration of the skin. This eventually affects the colour of our skin leading to uneven skin tone.
Hyperpigmentation usually affects patches of the skin making our skin appear darker than usual in some areas. They may vary in size or appear anywhere on the body. Therefore, a dermatologist will be the right person to determine the exact cause behind pigmentation.
What Causes Skin Pigmentation?
Increased production of melanin due to certain internal or external factors can lead to the disorders of skin pigmentation.
• Sun exposure – Pigmentation can be caused by sun exposure, specifically by its UVA rays, which penetrate deep into the skin and can cause excessive melanin production.
• Injury – An external injury such as a cut, bruise or even pimples, improper hair removal, or depilatory creams can trigger an inflammatory reaction to the injury, leading to the production of extra melanin.
• Medication – Certain medication can result in unwanted pigmentation as a side effect and is commonly seen with chemotherapy, tetracycline antibiotics etc.
• Allergies – Contact dermatitis to cosmetics, hair dyes, etc. can cause pigmentation.
• Hormonal fluctuations – Pigmentation occurs as a result of a hormonal imbalance due to a rise in levels of estrogen and progesterone in the body. This type of pigmentation, known as Melasma, can be triggered by pregnancy or birth control pills.
• Hereditary – Hereditary factors can play a major role in pigmentation of the skin. For instance, lentigines are a type of pigmentary condition associated with hereditary multisystemic syndromes.
• Illness or disease – Certain medical conditions such as Addison’s disease and other endocrine diseases result in the disruption of the body’s hormonal levels, and this can increase melanin production.
You will notice discolouration on the skin or dark patches on specific areas that may be brown or black in colour. When exposed to sunlight, these patches can grow darker.
Common types of pigmentation include –
• Freckles – Freckles are a common type of skin pigmentation occurring as a result of frequent exposure to sunlight. They appear as tiny circular spots on exposed areas, like the face etc., and they usually affect people with a lighter skin tone. Heredity factors also play a role in causing them.
• Post-inflammatory pigmentation – This occurs as our skin’s response to an injury such as bruises, burns, friction or harsh chemical treatments. This can also occur post-acne breakouts resulting in reddish, brown, or black marks.
• Melasma – Melasma is a type of facial pigmentation that affects the deeper layers of the skin. It occurs in women more commonly as irregular brown to grey patches on the cheeks, nose, jawline, etc.
• Sunspots – Also referred to as solar lentigines, these are pigmentation spots with clearly defined edges. These spots form due to sun exposure and the extent of pigmentation depends on the exposure of melanin pigment to UV rays.
An experienced dermatologist can diagnose accurately and recommend treatment options to treat the specific type of pigmentation. The treatment starts with a visible examination, a dermascan analysis, or a biopsy of the dark patch. The dermatologist will also review your medical history, family history and conduct further skin examination to ascertain the factors responsible for pigmentation.
After careful examination, the dermatologist often suggests topical medication or advanced dermatological procedures for treating the specific type of pigmentation.
Are You At Risk?
Regardless of skin type, geographical location, age, or gender, everyone is susceptible to pigmentation though it is slightly common in Asians. Most times, pigmentation is caused by sun exposure. A single day of sun exposure can damage the skin. Those who have a hereditary tendency are more prone to have pigmentation. Hence, timely diagnosis and early intervention are helpful to reverse it effectively.
Prevention and Management
- Always use a broad-spectrum sunscreen with the highest SPF that protects from both UVA and UVB rays of the sun.
- Follow a good skin care routine to protect it from environmental damage, pollutants, and dirt.
- Wear hats or scarves to avoid sun exposure during peak hours of sunlight.
We do not recommend home remedies as there is no scientific data to support them. Furthermore, it may even irritate the skin, prolonging the course of treatment. Medical intervention is important for appropriate treatments and results.
- Topical medication
- Chemical Peels
- Laser therapy with Q-switched NdYAG lasers
Pigmentation on the skin may not be a serious medical condition, but it may aggravate if not treated in a timely manner. Dark spots, acne marks, and sunspots may fade with topical treatments, but severe discolouration requires an advanced treatment procedure such as laser therapy. A dermatologist can determine the extent of pigmentation and suggest the treatment method that works best for you.