Skin Care 101
Skin Care Tips
Pigmentation Disorders
Pigmentation is simply the coloring of a person’s skin. In a healthy person, the skin will appear normal in color. However, when a person is ill or sustains an injury, the skin may change color. When it becomes darker, it is called hyper pigmentation. When it becomes lighter, it is called hypo pigmentation.
Exposure to sunlight is also a major cause of hyper pigmentation and will cause already darkened areas to become even darker. Hypo pigmentation is the direct opposite condition and is much less common. It occurs when the melanocytes are either damaged or destroyed, thereby halting the production of melanin. Consequently, the skin becomes lighter. In the following paragraphs, we will review the most common pigmentation disorders.
Skin conditions known as hyper pigmentation
Hyper pigmentation may be caused by inflammation, sun damage, or other skin injuries, including some related to acne. People with darker African, Asian or Mediterranean skin tones are much more prone to hyper pigmentation, especially if they have excessive sun exposure. Here are some of the more prevalent conditions:
Freckles
Freckles are flat, tanned circular spots that are usually about the size of the head of an ordinary nail. The spots are multiple and may develop randomly on the skin, especially after repeated sun exposure. They are much more common in people with a fair complexion and tend to appear on the upper-body skin areas, like the nose, cheeks, arms and shoulders. They can appear on people as young as 1 or 2. Most freckles on a person’s skin are uniform in color, although the shades may vary on different people. They may be yellow, tan, light brown, reddish, brown or black, but they are usually darker than the surrounding skin. They normally become darker after sun exposure and actually can lighten in the winter months when exposure to sunlight is limited. Researchers have isolated a receptor gene (MC1R) and have found that people who have this gene tend to develop freckles. Simple freckles are usually tan in color, round, and small. Sunburn freckles are often darker and can have irregular borders. They may also be larger than a pencil eraser. These freckles are more common on the shoulders and upper back where people tend to get the most severe sunburns. Most freckles are perfectly harmless and are considered more of a cosmetic annoyance than anything else.
Age Spots
Age spots (sometimes referred to as “sun spots” or “liver spots”) are the common names for the dark spots seen in adults, usually on the arms, face and frequently on the back of the hands. The term “liver spot” is actually not an appropriate name for this condition since these spots are not caused by liver problems or liver disease. In reality, these spots are not an indication of age but they do tend to develop over time and with repeated sunlight exposure. It is thought that the UV radiation in sunlight triggers mutations which, in turn, cause an increase in the production of melanin. It is this increase in melanin that produces the so-called age spots. In most cases, they are totally harmless, also.
Melasma/Chloasma
Melasma, also known as chloasma, is a condition that is characterized by tan or brown patches, most commonly on the face. This disorder can occur during pregnancy and is sometimes referred to as “the mask of pregnancy”. However, men can also develop this condition. Melasma frequently goes away after childbirth. In addition to pregnancy, melasma can be triggered by oral contraceptives and occasionally other hormone imbalances. These hormonal changes are thought to be the leading cause of developing melasma, but other factors may contribute to its formation. The combination of sun damage and the use of certain products, such as deodorants, toiletry and other personal care items to which a person has a sensitivity, is believed to play a role in the development of melasma. In the case of hormonal-induced melasma, once childbirth has occurred or the use of oral contraceptives has been discontinued, the condition usually will dissipate on its own. If the cause if non-hormonal, avoiding sunlight exposure may limit the severity of the condition.
Hypo pigmentation skin conditions
Hypo pigmentation occurs much less often than hyper pigmentation. It is the result of a reduction or absence of melanin production. This condition is usually caused by a serious injury to the skin, such as a burn, or to an autoimmune disease which attacks the melanocytes (which stimulate melanin production). Following are some of the better known examples:
Albinism
Albinism is an inherited disorder which is caused by the absence of an enzyme that produces melanin. This condition results in a total lack of pigmentation- hair, eyes or skin. Albinos have an abnormal gene which inhibits the body from producing melanin- hence the lack of pigmentation. There is no cure for albinism.
Pigmentation loss as a result of skin damage
When someone sustains an injury to the skin, whether it is a skin infection, blisters, burns or other types of trauma, it is quite common to experience a loss of pigmentation around the affected area. On a positive note, this is usually a temporary condition, although it may take a long time for the skin to return to its normal color. This depends, for the most part, on the severity of the skin injury.
Vitiligo
Vitiligo is a condition which causes smooth, white patches on the skin. In some cases, these patches can appear all over the body. This is related to an autoimmune disorder which damages the melanocytes, which, in turn, reduces the production of melanin. There is no cure for vitiligo.
How to prevent pigmentation disorders
Almost all problems associated with hyper pigmentation can be traced to over-exposure to the sun. This is why routinely using a sun protection product is extremely important. Women who have a history of developing melasma may be able to lower their risk of a recurrence by using a non-hormonal form of birth control. This is something that needs to be discussed with a physician so that all the factors and risks can be evaluated.
Pigmentation disorder treatments
Many different treatments are available to those who are affected by hyper pigmentation disorders. These include chemical peels, cryotherapy, laser/intense pulsed light, and even topical lightening agents.
The treatments for hypo pigmentation conditions are much more challenging. Pigment damage to the skin where a burn or other severe trauma has occurred can resolve itself over time. The melanocytes can migrate to the affected area and, slowly over time, the damaged skin can begin to regain its normal pigmentation. It can be a very slow process. Treatments for vitiligo currently have little effectiveness. Many people choose to apply sunless tanning products to the affected areas.
