Hyperpigmentation: Types, Causes, Treatment & Prevention

 

Some parts of the skin are darker than others due to a common condition called hyperpigmentation. Spots or patches that look brown, black, gray, red, or pink are caused by excess melanin. Although the areas don't hurt or itch, they can cause self-consciousness. Numerous treatments and lifestyle changes can be beneficial, especially in skin care and sun protection.

What is hyperpigmentation?

Some parts of the skin are darker than others due to a common condition called hyperpigmentation. "Pigment" means color, and "hyper" means more.

Hyperpigmentation can appear as brown, black, gray, red, pink spots or patches.The spots are sometimes referred to as age spots, sun spots, or liver spots.  

The spots can occur in just one area of the body or all over.

Also Read: Hyperthyroidism (Overactive Thyroid)

Hyperpigmentation types:

Melasma, sunspots, and post-inflammatory hyperpigmentation are the most common forms of hyperpigmentation, though there are other varieties as well.

Melasma. Melasma may appear during pregnancy and is thought to be brought on by hormonal changes. Although hyperpigmentation can occur anywhere on the body, the face and stomach are the most frequently affected areas.

Sunspots. Sunspots are frequently referred to as liver spots or solar lentigines. They  are associated with prolonged exposure to too much sun. They typically show up as spots on sun-exposed areas, such as the face and hands.

Post-inflammatory Hyperpigmentation. This is brought on by skin damage or inflammation. Acne is a common cause of this type.

Causes:

Why does hyperpigmentation occur?
Skin cells produce a chemical called melanin, which gives skin its color. Overproduction of melanin can occur when those skin cells are unhealthy or damaged. That region may appear darker due to melanin clumping.


Hyperpigmentation can result from a variety of factors:

• Addison's disease is an example of an adrenal disorder in which the body produces insufficient amounts of the hormone cortisol.

• Genetics, like freckles in a family.

• Hormonal shifts, like those that occur during pregnancy or puberty.

• Skin damage, such as acne, cuts, or burns, is sometimes referred to as postinflammatory hyperpigmentation.

• Medications that cause light sensitivity, including birth control pills and oral contraceptives.

• Melasma.

• Not enough of specific vitamins, including folic acid and B12.

• Sun damage (often referred to as solar lentigines).

• Thyroid disorders

How is a diagnosis of hyperpigmentation made?

To identify hyperpigmentation, a medical professional may:

• Inquire about your medical background, including the onset of the darkened skin and any medications you are currently taking.

• Examine your skin by doing a physical examination.

• Examine your skin using a Wood lamp, a specialized UV light source.

• To check thyroid function, vitamins, hormones, and iron, order blood tests.

• For a biopsy, which looks for any abnormal skin cells, take a small sample of the skin.

What is the treatment for hyperpigmentation?

Your doctor might recommend the following lifestyle modifications based on the causes of your hyperpigmentation:

• Avoiding sun damage by wearing protective clothes, applying sunscreen, and avoiding the sun.

• Discontinuing any drugs that might be the source.

• Taking vitamins.

• Additionally, your doctor might suggest topical therapy (creams or ointments applied topically) either with a prescription or over-the-counter:

• Acid azelaic.

• Corticosteroids.

• Alpha-hydroxy acid, or glycolic acid.

• Hydroquinone.

• One substance that can lower the body's production of melanin is kojic acid.

• Salicylic acid.

•  Skin bleach.

• Tretinoin.

• Vitamin B3 (niacinamide) or vitamin C.

Additional therapies could consist of:

• Chemical peels.

• Cryotherapy.

• Laser skin resurfacing.

• Pigmented lesions laser

How can hyperpigmentation be prevented?

Although it's not always possible to prevent hyperpigmentation, shielding your skin from the sun can help:

• Use sunscreen each day. Select one with an SPF of 30 or higher that is "broad spectrum," meaning it blocks UVA and UVB rays.

• Steer clear of excessive sun exposure.

• Make use of physical blockers like zinc oxide or titanium dioxide.

• Put on hats and protective clothes.

References:

• Hyperpigmentation.(n.d.). https://www.aocd.org/page/Hyperpigmentation

• Merck Manual (Consumer Version). Hyperpigmentation (https://www.merckmanuals.com/home/skin-disorders/pigment-disorders/hyperpigmentation). Accessed 10/18/2021.

• American Osteopathic College of Dermatology. What Is Hyperpigmentation (https://www.aocd.org/page/Hyperpigmentation)? Accessed 10/18/2021.

• U.S. National Library of Medicine. Skin Pigmentation Disorders (https://medlineplus.gov/skinpigmentationdisorders.html). Accessed 10/18/2021.

• Desai SR. Hyperpigmentation Therapy: A Review (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142815/). J Clin Aesthet Dermatol. 2014;7(8):13–17. Accessed 10/18/2021.

• American Family Physician. Common Hyperpigmentation Disorders in Adults (https://www.aafp.org/afp/2003/1115/p1955.html). Accessed 10/18/2021.

• TanE. (2007). Skin toxicity of chemotherapy drugs. https://www.dermnetnz.org/topics/skin-toxicity-of-chemotherapy-drugs/