What is pigmentation?

Some individuals may have skin patches that may appear on the different parts of the body and with different sizes, shapes and colour, known as pigmentation. Pigmentation simply means colouring. Skin pigmentation disorders affect skin colour. Normally, your skin gets its colour from a pigment called melanin. Special cells in the body called melanocytes create this pigment.[1] When these cells become stimulated with UV or damaged, the production of melanin is affected. Some pigmentation disorders can lead to skin patches only, while some can affect the entire body. If your body makes too much melanin, your skin can get darker. An abnormally high amount of melanin known as hyperpigmentation may affect large body areas. When exposed to sunlight, melanocytes produce a significant amount of melanin as a reaction to the UV rays.[2] In some fair-skinned people, certain melanocytes can produce more melanin than others in response to UV rays. This uneven production of melanin results in spots of pigmentation called freckles. Increased amounts of melanin can occur in response to fluctuations in hormones, such as those that may take place in menstruation, pregnancy, Addison’s disease, or with use of contraceptives.

However, some cases of skin darkening are not related to increased production of melanin, but rather to abnormal pigments that make their way into the surface of the skin. In general, fair-skinned people have very little melanin in their skin, darker-skinned people have moderate amounts, and very dark-skinned people have the most melanin produced. For those with albinism, melanin can be very little or no melanin is produced. An abnormally low amount of melanin known as hypopigmentation may also affect large body areas or small patches. Decreased melanin usually results from skin injury such as ulcer, blister, burn, chemical exposure and skin infection. Sometimes, pigment loss can be a result of an inflammatory skin condition or in rare instances, related to the genes.

What causes pigmentation?

Irregular changes in the skin such as pigmentation are a common problem with a wide variety of potential causes. Such skin changes can be related to a difference in the level of melanin it contains.

Heredity:

Skin pigmentation disorders run in the family. If one or both of your parents has it, you are likely to inherit the disorder.

Prolonged sun exposure:

Ultraviolet rays from the sun stimulate the melanocytes to produce more melanin. This is responsible for unwanted dark patches.

Use of certain medications:

Drugs and chemicals such as amiodarone, antimalarial drugs, hydroquinone, minocycline, tetracycline, phenothiazines, chemotherapeutic drugs, heavy metals and tricyclic antidepressants can darken the skin as a side effect.[3]

Underlying medical condition:

Diseases such as jaundice, Addison’s disease, hemochromatosis (iron overload) or hemosiderosis can cause skin pigmentation. Also, certain fungal infections such as tinea versicolour and other skin conditions such as vitiligo can cause pigmentation.[4]

Hormonal fluctuations:

Menstruation, pregnancy and the use of contraceptive pill can alter hormone levels which can result to skin pigmentation.

Burns:

Sunburn or any kind of burn can damage the skin. As the burn heals, scar tissue forms and the healing area change its colour.

Infections:

This can cause localized changes in the colour of the skin. Wounds can develop infections that can make the surrounding skin red or white and change the skin’s texture.

Birthmarks:

Certain birthmarks such as café-au-lait spots are light-coloured spots on the skin. Moles are brown spots that may appear at birth. Over time, they can change in size or shape, and must be checked by your doctor as they can be cancerous.

Mongolian spots:

Are bluish patches on the backs of babies which are usually harmless and fade over time. Another birthmark called

Port-wine stains:

Are caused by swollen blood vessels which are usually flat and reddish. All of these marks can remain on the skin for a lifetime but they may lighten over the course of it.

What is the pigmentation treatment?

Pigmentation of the skin is a widespread problem among people of all ages, and is especially a beauty concern among women. Pigmentation is characterized by dark or light patches of skin, it is not a life-threatening condition, but the embarrassment the affected individual has to undergo can be much worse than the condition itself.

How to treat pigmentation:

Topical applications containing retinoids and alpha hydroxy acids (AHAs) can help exfoliate and rejuvenate the skin. Also, hydroquinone, soy, niacinamide, lignin peroxidise, licorice, ellagic acid, kojic acid, cucumber, arbutin, azelaic acid and mandelic acid can help lighten skin pigmentation, especially birthmarks, by slowing down melanin production and removing existing melanin.[5] Some of these ingredients are illegal in Australia and can be quite aggressive on the skin.

Serums.

Chi’s Illumination Brightening Serum ‘de-clusters’ melanocyte fibres which cause pigmentation. It works for both sun damage and melasma, however, it isn’t an instant fix by any means. A key ingredient, tranexamic acid is an anti-fibrinolytic agent and was used to control excess bleeding. The skin whitening effects of tranexamic acid was occasionally found when it was used as a coagulant to treat aneurismal subarachnoid haemorrhage. From then on, it has been used in physician’s prescription to treat liver spots and pigmentation. Results for melasma can be seen after eight weeks of use, whereas it can take up to 12 weeks to see a reduction in freckles etc.

Pigmentation Skin CareLimit your exposure to UV rays:

Too much sun exposure can stimulate increased melanin production, which may worsen the pigmentation. Always wear sunscreen with SPF 30 or more. In strong, direct sun, wear long sleeves and a hat. As much as possible, limit your sun exposure.

Consider getting a no ablative professional procedure

Your skin therapist might recommend procedures such as home care, intense pulsed light therapy, laser skin resurfacing such as China Doll Laser Skin Rejuvenation or hydro-microdermabrasion to target skin pigmentation if topical creams or lotions don’t work.

Unwanted pigmentation problems have many causes and can occur in almost all types of skin. Depending on the severity and extent of the pigmentation, the best approach to treat such conditions is through a combination of lifestyle modifications and management from a qualified professional. Always seek professional advice if the condition worsens or if self-help strategies to treat the pigmentation are not effective.

References:

  • 1. Lees, M. (2012). Skin Care: Beyond the Basics 4th Edition, page 13.
  • 2. Premkumar, K. (2004). The Massage Connection: Anatomy and Physiology 2nd Edition, page 59.
  • 3. Bolognia, J., et al (2003). Dermatology.
  • 4. Eversole, L. (2011). Clinical Outline of Oral Pathology: Diagnosis and Treatment, page 89.
  • 5. Beer, K., et a; (2011). Cosmetic Bootcamp Primer: Comprehensive Aesthetic Management, page 272.