What causes skin pigmentation?Things you should know

What is hyperpigmentation?

Hyperpigmentation is not a condition by definition; it is a term that explains the darkening of the skin. It can:

• Occur in small patches
• Cover large areas
• Cover the entire body

Types of hyperpigmentation

There are many types of hyperpigmentation; the common ones are melasma, sunspots, and post-inflammatory hyperpigmentation.

• Melasma or Chloasma spots- occur due to hormonal changes and may develop during pregnancy. Pregnancy sometimes can stimulate hyperproduction of melanin that results in the 'mask of pregnancy' on the face, and the skin gets darkened on the abdomen and other areas. Birth control pills may also result in hyperpigmentation. The pigmentation can be on any area of the body, but they arise most commonly on the stomach and face.
• Sunspots- known as liver spots or solar lentigines, are related to surfeiting sun exposure over time. They appear as spots on parts exposed to the sun, like the face and hands.
• Post-inflammatory hyperpigmentation- occurs due to an injury or inflammation to the skin. Acne is the most common cause of post-inflammatory hyperpigmentation.

Symptoms and risk factors to be aware of

Darkened areas will be formed due to pigmentation. The patches are variable in size and can appear anywhere on the skin. The significant factors that cause skin pigmentation are exposure to the sun and inflammation. These two factors result in an increase in melanin production.

The few other risk factors for hyperpigmented patches on the skin depending on the type of disorder includes:

• Use of oral contraceptive pills or during pregnancy, as seen with melasma
• darker skin type, that is more vulnerable to pigmentation changes
• drugs that expands your sensitivity to the sunlight
• trauma to the skin, such as a superficial burn injury or wound.

Causes of hyperpigmentation

Skin pigmentation often is a great concern and worry for patients. What causes skin pigmentation or what causes hyperpigmentation of the skin are as follows:

• certain medications, including chemotherapy drugs.
• Pregnancy hormones.
• Endocrine diseases
• melasma.
• Insulin resistance.
• Skin irritation or trauma.
• Some medical conditions such as systemic lupus erythematosus (SLE)
• Allergies
• Chemical or physical injury
• Inflammatory diseases
• Tobacco smoking
• Obesity
• Diabetes
• Hormonal causes
• Ageing
• Certain ethnic races
• Long exposure to a variety of topical products
• Contact with plants that has furocoumarins
• Constant scratching or other minor trauma to skin
• Exposures to moderate heat or infrared radiations

What causes skin pigmentation due to certain medical conditions includes:

• Addison's disease, which is a disorder of the adrenal glands where they do not form enough steroid hormones.
• Diabetic dermopathy (pigmentation spots in the thigh area of people with diabetes)
• Acanthosis nigricans (a skin condition causing dark discolouration in the body folds and creases)
• Hyperthyroidism
• Hereditary hemochromatosis ( it is a genetic disorder of iron overload)
• Post-chikungunya fever pigmentation
• Lichen planus pigments (a chronic inflammatory skin condition
which affects the skin

What causes hyperpigmentation?

Excessive production of melanin in the body is a common reason for hyperpigmentation. Melanin is produced by the skin cells known as melanocytes. Melanin is a pigment that gives the skin its colour. Various contrasting factors can alter the melanin production in the body and can be the reason for hyperpigmentation.

One of the main causes of pigmentation is a rare endocrine disease: Addison’s disease can lead to hyperpigmentation that is visible in areas of excess sun exposure, such as the face, neck, hands, and also areas that are exposed to friction like elbows and knees.

What causes skin pigmentation? Increased hormonal levels cause increased melanin synthesis in the body. Excessive sun exposure also increases the amount of melanin and is one of the main causes of pigmentation.

Another major reason for hyperpigmentation is vitamin B12 deficiency.

Also Read: | Can acne scars be removed permanently? |

Prevention

Prevention from pigmentation is not always possible. Prevention can be done

• by applying a good sunscreen with an SPF of at least 30, that will provide a shield and act as a barrier against strong and harmful rays of the sun.
• by wearing hats or clothing that will block direct sunlight
• by avoiding the sun during peak hours

The production of melanin is triggered by the exposure of the skin to UV rays, but dark patches are formed due to overexposure. Eluding defined medications may also help prevent pigmentation of the skin.

Prevention from pigmentation can also be done by reducing oxidative stress. It means reducing the exposure of the skin to free radicals. These free radicals can be neutralized by antioxidants which can be used orally or topically.>

• Orally- Vitamin C and Glutathione as prescribed help reduce oxidative stress. A good diet should also be maintained for healthy skin.
• Topically- Skincare products containing Vitamin C, Ferulic Acid, and Retinol prevent pigmentation.

Pigmentation cure is simple: a variety of creams are available in the market that asserts to cure pigmentation. The creams include active topical agents with berry extracts, arbutin, Vitamin C, and glycolic acid (extract of sugarcane juice, kojic acid, arbutin, and azelaic acid). Undoubtedly these creams give the best results, but they need to be used in the correct proportions.

Diagnosis and treatment

Pigmentation diagnosis and treatment

What causes hyperpigmentation can be easily diagnosed and detected by a dermatologist. The doctor will look into the medical history of the patient and will ask them to go through a physical exam to determine the cause. A skin biopsy helps to know the cause early. Some cases of hyperpigmentation can be cured with the help of topical prescription medication. The presence of hydroquinone in these medications helps to lighten the skin.

Hydroquinone, if used for a prolonged period, causes the skin to darken, called ochronosis. It is best advised to be used under the observation of a dermatologist who can properly guide the patient to use it without any adverse effects.

The use of topical retinoids helps in lightening dark skin spots. The effect is not immediate; it might take a few months for both the medications to work.

Home care methods do not contain as much hydroquinone as prescription medications. The home care method not only comprises over-the-counter medications but also includes the use of sunscreen. One of the most important ways of curing hyperpigmentation is by using sunscreen. Look for:

• a physical blocking sunscreen, something with zinc oxide as the main active ingredient
• at least an SPF 30 to 50
• broad-spectrum coverage

Sunscreen should be used on a regular basis. It should be reapplied every 2 hours if the person is out in the sun and more frequently if he/she is swimming or sweating.

In skin disorders like melasma, visible light plays a role in sustaining hyperpigmentation. In such cases, a mineral sunscreen that contains iron oxide can be really useful, which blocks some visible light.

The dermatologist may also suggest the patient undergo laser treatment or chemical peels to reduce pigmentation, depending on the cause of pigmentation. Visit Skinalaya, one of the best skincare clinics in Delhi for any skin problems.