What is pigmentation?
Colours are made of components called as pigments. This is the etymology for the term ‘pigments’ which means ‘colouring’. The skin looks best when it has an even tone throughout, and has no individual patches of colour that might look out of place or odd. But various skin pigmentation disorders affect the even colouring of the skin.
Pigmentation of the skin usually is largely dependent on racial origin and the amount of sun exposure. Skin pigmentation disorders are more prominently known in skin of colour rather than generally white skin. The darker the skin, the harder the recovery, remedies and treatment.
Melanin – The Colouring Pigment
The skin gets is colour from a pigment called as melanin. There are special cells in the skin that are dedicated to produce melanin. The pigment cells are called melanocytes and are located at the base of the epidermis, constantly producing melanin. The melanin is then carried to the surface of the skin by keratinocytes. If these cells (melanocytes and keratinocytes) are damaged (due to various reasons including but not limited to sun exposure) or become unhealthy, the production of melanin is affected.
If the body produces excess melanin, the skin is darker. Melanocytes of darker people produce more melanin in general. Excess melanin production can happen with sun exposure, pregnancy (the hormonal effects of oestrogen) or Addison’s disease. If, on the other hand, the body makes too little melanin, the skin gets lighter. For example, vitiligo is a condition where the skin gets patches lighter in colour.
Albinism is a condition where the person’s skin may have no colour or be very lighter than the normal skin colour or even patches where the colour seems to be missing completely. The recovery from skin pigmentation disorders including treatment and remedies are hard due to the many forms that are difficult to diagnose and treat.
What are the types of pigment disorders?
Hyperpigmentation- The most noticeable of skin pigmentation disorders is hyperpigmentation – the darkening of an area of skin (sometimes nails) caused by the increase in production of melanin.
- Sun exposure – Including sun damage and exposure to radiation.
- Inflammation – Of random areas of the skin due to some irritants or allergies.
- Racial causes- Darker Asian and African skin tones are more prone to hyperpigmentation, additionally because they have excess sun exposure.
- Pregnancy – The hormonal effects can cause pigmentation in vulva and abdomen.
Generalised Hyperpigmentation Skin Pigmentation Disorder
This is a rare condition triggered by excessive circulating melanocytes stimulating hormone (MSH). The individuals suffering from this usually have a bronze hue over the skin. This occurs due to Addison disease, and is more prominent on pressure areas, skin folds or scars. This skin pigmentation disorder is also common amongst those suffering from haemochromatosis which is prominent on skin folds and sun exposed sites. It can also occur rarely in metastatic melanoma.
Localised Hyperpigmentation Skin Pigmentation Disorder
Localised hyperpigmentation usually occurs due to melanin haemosidering or any other externally derived pigment and causes dark skin in patches instead of as a whole.
It may be due to benign pigmented skin lesions, skin cancers (including melanoma) and pigmented basal cell carcinoma), diseases like eczema or any post inflammatory pigmentation, due to chronic pigmentary disorders (melasma or facial pigmentation), photocontact dermatitis, skin thickening, bleeding in capillaries.
The treatment (recovery or remedies) of hyperpigmentation include chemical peels, lasers, intense pulsed light or dermabrasion. Cryotherapy is also an option.
Hypopigmentation Skin Pigmentation Disorder
Hypopigmentation skin pigmentation disorder is the loss of skin colour happening due to depletion of the colouring pigment melanin or the cell that produces it. It can even occur due to a decrease in tyrosine, the amino acid that produces melanin.
It is the pigmentation at birth and may be caused by racial origin or in a disease called as albinism. Pituitary failure, blood loss and anaemia are also other causes.
Localised hypopigmentation is a skin pigmentation disorder caused due to partial or complete loss of melanin. This might also be congenital or due to guttate or macular hypomelanosis. Vitiligo is the most commonly known skin pigmentation disorder that causes white patches in the skin. Extreme cases include leprosy. Hypopigmentation usually is resolved by itself if it is caused by inflammatory skin pigmentation disorders once the root cause has been identified and remedies are done. Vitiligo and other more serious forms of this skin pigmentation disorder are slightly difficult to treat mainly because of the varied responses to the treatment.
Skin pigmentation disorders are all boiled down to one basic factor – the production of melanin, the excess or lack of it. Skin colour is actually a product of the brown melanin pigment, the blue from the reduced haemoglobin, the red from the oxyhaemoglobin, and yellow from the carotenoids included as part of the diet. But the amount of melanin actually determines skin colour. There are various remedies and recovery treatments for the skin pigmentation disorders. More information here: http://skindoctorIndia.com/common-dermatologic-problems/skin-pigmentation/
Dr. Rinky Kapoor is a consultant cosmetologist and dermatologist. She is also a trained dermatologist (MD in dermatology) and a Fellow in cosmetic dermatology and lasers, National Skin Centre (Singapore) and Fellow, Stanford University, USA. She is a practicing dermatologist and trichologist in Mumbai India and her testimonials praise her as one of the best cosmetic dermatologists in Mumbai, India.