Skin pigmentation: Hyperpigmentation and hypopigmentation

Medically Reviewed by Dr. K on 15 March 2021

The colour of a person's skin is known as pigmentation. A person's skin tone would look natural because they are healthy. The colour of a person's skin can change due to illness or injury, becoming darker (hyperpigmentation) or lighter (hypopigmentation).

 

Hyperpigmentation

An increase in melanin, the colour-producing substance in the body, causes hyperpigmentation in the skin (pigment). Certain disorders, such as pregnancy or Addison's disease (abnormal adrenal gland function), may result in an increase in melanin production and hyperpigmentation. Sunlight is a major cause of hyperpigmentation, which can darken areas that are already hyperpigmented.

Various medications, such as some antibiotics, antiarrhythmics, and antimalarials, can induce hyperpigmentation.

Melasma

Melasma is an example of hyperpigmentation. Tan or brown spots, most often on the neck, characterise this disorder. Melasma is often associated with pregnant women and is referred to as the “mask of pregnancy," but it can also affect men. Melasma will fade away after a pregnancy. Certain drug creams may also be used to treat it (such as hydroquinone).

Limit your exposure to sunshine if you have melasma. Since sunshine will aggravate the disease, always wear a broad-brimmed hat and apply sunscreen with an SPF of 30 or higher. Sunscreens containing the physical blockers zinc oxide or titanium dioxide can also help to minimise hyperpigmentation by blocking UVA rays from the sun.

Before you start treating the issue yourself, talk to your doctor.

 

Hypopigmentation

Skin hypopigmentation is caused by a reduction in melanin production.

Hypopigmentation can manifest itself in a number of ways, including:

Vitiligo

Vitiligo is a skin condition that produces smooth, white patches. These patches will occur all over the body in some people. It's an autoimmune disease that affects the pigment-producing cells. Vitiligo has no cure, although there are many therapies available, including cosmetic procedures, corticosteroid creams, calcineurin inhibitors, and ultraviolet light therapy. Janus Kinase inhibitors are being tested as new topical therapies.

 

Albinism

Albinism is a genetic hereditary condition caused by a lack of a melanin-producing enzyme. This causes the skin, hair, and eyes to be completely devoid of pigmentation. Albinos have a mutation in their DNA that prevents them from producing melanin. Albinism has no proven cure. People with albinism should still wear sunscreen because they are more vulnerable to sun exposure and skin cancer. This disease can affect people of any colour, but it is more prevalent in caucasians.

 

Pigmentation loss as a result of skin damage

You may lose pigmentation in the infected region if you've had a skin infection, blisters, burns, or other damage to your skin. The good news is that this form of pigment loss is usually not lasting, but repigmentation can take a long time. As the body regenerates the pigment, cosmetics may be used to conceal the area.

Sources

Referenced on 2.3.2021:

  1. Merck Manual Home Health Handbook: “Overview of Skin Pigment."
  2. American Osteopathic College of Dermatology: “Hyperpigmentation."
  3. American Academy of Dermatology: “Melasma."
  4. National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Healthy Skin Matters."
  5. https://www.webmd.com/skin-problems-and-treatments/hyperpigmentation-hypopigmentation

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