What is Skin Pigmentation
Skin Pigmentation refers to the colouring of the skin and this colouring is affected by the deposition of the pigment called melanin, which in turn is produced by specialised cells called melanocytes. Damaged or unhealthy melanin cells caused their production to be affected and causes skin pigmentation disorders. Some pigmentation disorders affect only certain areas or patches of your skin while others affect the whole body. Skin pigmentation disorders affects people of all races, genders and ages.
Causes of Skin Pigmentation
In some cases of skin pigmentation disorders, the causes are easily identifiable, while others do not have a clearly identifiable cause. Sun spots (Solar Lentigens) are formed due to an increase of melanin (skin pigment) through exposure to ultraviolet (UV) radiation via sunlight. UV radiation stimulates an increase in melanin, and excessive melanin can be focused on one particular spot, giving rise to the formation of a sun spot. Melasma is a result of a combination of factors (genetic / UV radiation / hormonal) and women tend to be more affected by this condition than men due to overstimulation of melanocytes by the female hormones oestrogen and progesterone. This normally affects pregnant women who are also more exposed to Sunlight (UV radiation). Freckles are usually caused by overexposure to sunlight and tend to lighten or darken according to the amount of sun exposure. Hori’s Naevus is a pigmentation disorder that particularly affects Asians. Melanocytic Naevi or moles arise due to an abnormal cluster of melanocytes (pigment producing cells) in the skin.
Types and Symptoms of Skin Pigmentation
There are various types of skin pigmentation conditions. We’ve included some of the most common types and their symptoms below:
|Type of Skin Pigmentation||Symptoms|
|Age Spots (Seborrheic Keratoses)||Raised Sun Spots with rough texture formed due to an increase of melanin over time due to prolonged exposure to sunlight (UV radiation)|
|Freckles||Clusters of melaninised cells appearing as light brown or red spots predominantly on faces of people with fair skin. As freckles are triggered by exposure to sunlight they appear more numerous in people after extended exposure to sunlight. Freckles are usually present since youth and increase with age.|
|Hori’s Naevus||Affects predominantly Asian women in 30s – 50s. Brown and greyish spots, formed deep within skin and located over upper cheeks and nasal bridge.|
|Melanocytic Naevi (Moles)||Mostly occur during childhood, adolescence and early adulthood. Pigmentation colour ranges from dark pigmented spots to lighter and even flesh coloured spots. With age, the spots become raised and “dome-shaped”.|
|Melasma||Brownish dark, irregular patches over several areas on the face – cheeks, forehead, temples, nasal bridge, upper lips and jawline. These patches develop gradually over time. If appearing on pregnant women, they normally disappear once the hormones are balanced again.|
|Nevus of Ota||A blue hyperpigmentation that occurs on the face. It can also appear as spots in the eye.|
|Sebaceous Hyperplasia||Yellowish lesions found primarily on the cheeks. It is a benign tumour that has a characteristic central “dimpling”.|
|Sun (Solar) Lentigo / Liver Spots / Sun Spots||Hyperpigmentation blemishes on the skin due to sun exposure. They appear in areas of skin most exposed to the sun (hands / shoulders / face / arms) and range in colour from light brown to red or black.|
Treatments for Skin Pigmentation
The types of treatments for skin pigmentation conditions differ according to the condition itself. It is essential that you go to a skin care specialist to get a proper diagnosis of your condition and treatment for it. For some conditions, if the pigmentation is light enough the dermatologist may prescribe treatments with creams that contain hydroquinone and tretinoin which can be applied topically.
For pigmentation conditions that are the result of UV exposure, prevention is often more effective and encouraged. Hence, the use of sunblock regularly to block the effects of UV radiation on your skin is an effective preventative measure. There are various types of sunblock that can be used – these include physical sunblocks that contain zinc and titanium dioxide which reflects the UV rays away, as well as chemical sunblocks that absorb UV energy and prevent them from damaging the skin.
For other pigmentation conditions, your dermatologist may advise you to go for treatments that might include cryotherapy, electrocautery or lasers to get rid of the pigmentation. Age spots, freckles, Hori’s Naevus and solar lentigens (Sun spots) can be removed with laser treatments such as Fractional CO2 Lasers, Intense Pulsed Light Lasers (IPL) and Pigment Laser Treatments. They can also be treated with chemical peels as they cause the skin to peel/exfoliate, encouraging skin regrowth around the area. The regenerated skin would be lighter. Pigmentation in melasma should not be treated by pigment lasers as this may cause the pigmentation to become even darker. For this skin condition, chemical peels and IPL treatments are recommended. For sebaceous hyperplasia, the recommended treatments are electrocautery or lasers to get rid of the pigmented lesions, though there is a risk of scarring from these treatments.