Hypopigmentation: Causes, Treatment and Prevention

 

Light patches of skin that contrast with your normal skin tone may be the result of insufficient melanin production by your skin cells. We refer to this condition as hypopigmentation.

The lightening of your skin tone is known as hypopigmentation. Wounds or skin disorders primarily cause hypopigmentation. The cause of hypopigmentation will determine the course of treatment, which may involve medication or therapies. There is no treatment if you have albinism or scarring.

Also Read: Hyperpigmentation: Types, Causes, Treatment & Prevention

What is Hypopigmentation?

A low level of melanin in your skin is known as hypopigmentation. Certain areas of your skin are paler than the rest of your skin.

Melanin is the chemical responsible for the color of your skin, hair, and eyes. Certain parts of your skin lighten when your skin cells aren't producing enough melanin.

Causes:

Why does hypopigmentation occur?

The most frequent cause of hypopigmentation is skin injuries, such as:

• Burns

• Infections

• Blisters

• Exposure to chemicals

• Scars that are lighter than the surrounding skin may form as these injuries heal.

Large patches of your skin may become hypopigmented due to uncommon genetic conditions. Among these genetic conditions are:

• Albinism. A genetic condition known as albinism causes low level of melanin from birth. The majority of individuals with albinism have light or white hair, pale eyes, and extremely pale skin throughout their bodies.

• Pityriasis Alba. Your skin may develop scaly patches if you have pityriasis alba. Your affected areas become hypopigmented once the scales disappear.

• Vitiligo. A skin condition called vitiligo makes parts of your skin appear white. It happens when your melanocytes are destroyed by your immune system. The skin cells that make melanin are called melanocytes.

Additional causes of hypopigmentation include:

• Tinea versicolor. An excess of yeast on your skin can lead to tinea versicolor, a fungal infection.

• Lichen sclerosus. One condition that affects the skin on your genitalia or anus is lichen sclerosus.

• Psoriasis. The long-term (chronic) condition known as psoriasis results in thick, scaly skin patches called plaques. You may experience hypopigmentation after your plaques disappear.

• Eczema. When you have eczema, your skin gets dry, bumpy, itchy, and discolored. You may experience hypopigmentation in the affected areas following treatment.

Hypopigmentation can also result from certain skin care procedures, such as:

• Laser skin resurfacing. Your doctor will use lasers to remove skin imperfections from the outermost layers of your skin during this procedure. Age spots, wrinkles, acne scars, and sun damage are examples of skin abnormalities. New, smoother skin is the result of laser skin resurfacing, which promotes the formation of new collagen fibers. Your treated areas may become hypopigmented.

• Hair removal with lasers. Your hair follicles are destroyed by the heat from a laser during laser hair removal. The heat can cause hypopigmentation and damage to the surrounding skin.

• Dermabrasion. The top layers of your skin are scraped away by a plastic surgeon or dermatologist during this procedure. After dermabrasion, hypopigmentation is more likely to occur if you have colored skin.

• Chemical peels. Your skin's imperfections are improved with chemical peels. Your skin becomes smoother and brighter after the top layers are removed by a chemical solution. After receiving treatment that targets deeper layers of your skin, you are more likely to experience post-inflammatory hypopigmentation if you have colored skin.

Diagnosis:

To make a diagnosis, your doctor will consider the findings of a physical examination as well as details about your family history.

Your doctor will examine every part of your skin during your physical examination and note any areas with lighter pigmentation than others. Any suspicious-looking moles or other areas of concern will also be noted.

Your physician may occasionally conduct a biopsy. A tiny sample of skin will be scraped off for this procedure and sent to a lab for additional examination. This is most prevalent in suspected cases of tinea versicolor, lichen sclerosus, and pityriasis alba.

Inquiries about skin pigmentation in your immediate family may also be made by your doctor. They can identify any genetic components with the aid of this.

What is the treatment for hypopigmentation?

The cause of the lightening of your skin will determine how to treat hypopigmentation.

You probably won't require treatment if you have hypopigmentation as a result of skin injuries or treatments. As your injured areas heal, your skin cells will begin producing melanin once more. Usually, hypopigmentation disappears in a few weeks or months.

Hypopigmentation usually resolves on its own without treatment if you have pityriasis alba, psoriasis, or eczema. A few weeks or months may pass.

Certain medications can treat hypopigmentation if it's a sign of a skin disorder. Corticosteroids and topical calcineurin inhibitors, such as tacrolimus ointment and pimecrolimus cream, may be among these medications.

If you have laser-induced hypopigmentation, or hypopigmentation from laser treatments, phototherapy can help. These procedures include laser skin resurfacing, laser tattoo removal, and laser hair removal. Ultraviolet (UV) light from specialized lamps is used. Psoralen combined with ultraviolet A (PUVA) or ultraviolet B (UVB) is a medication that your doctor may prescribe. According to studies, phototherapy can help people with color skin who have laser-induced hypopigmentation.

Albinism and scars with hypopigmentation have no effective treatments.

Prevention:

 To avoid hypopigmentation, you can:

•  Getting treatment right away for the skin conditions that cause it, like tinea versicolor, psoriasis, and eczema

•  Limiting your exposure to substances that can cause trauma or burn your skin

•  Taking care of skin infections as soon as they appear and seeing them through to the end

•  Throughout the day, always wearing protective clothes and sunscreen

References:

• Rodney IJ, Park J, Hexsel D, et al. Disorders of Hypopigmentation. In: Kelly A, Taylor SC, Lim HW, et al., eds. Taylor and Kelly's Dermatology for Skin of Color, 2nd Edition. McGraw Hill; 2016. Accessed 6/27/2022.

• National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Vitiligo,” “Vitiligo: Diagnosis, Treatment, and Steps to Take.”

• Bolognia JL, Braverman IM. Skin Manifestations of Internal Disease. In: Jameson J, Fauci AS, Kasper DL, et al., eds. Harrison's Principles of Internal Medicine, 20th Edition. McGraw Hill; 2018. Accessed 6/27/2022.

• DermNet NZ. Pigmentation Disorders (https://dermnetnz.org/topics/pigmentation-disorders). Accessed 6/27/2022.

• The Skin and Nails. In: Suneja M, Szot JF, LeBlond RF, et al., eds. DeGowin’s Diagnostic Examination, 11th Edition. McGraw Hill; 2020. Accessed 6/27/2022.

• Das S. (n.d.). Overview of skin pigment. http://www.merckmanuals.com/home/skin-disorders/pigment-disorders/overview-of-skin-pigment

• Hughes KA, Usatine RP, Smith MA. Vitiligo and Hypopigmentation. In: Usatine RP, Smith MA, Mayeaux, Jr. EJ, et al., eds. The Color Atlas and Synopsis of Family Medicine, 3rd Edition. McGraw Hill; 2019. Accessed 6/27/2022.