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Dr. Alpana Mohta Ranka, MD, DNB, IFAAD, is a triple-board-certified dermatologist with over 100 research publications in peer-reviewed scientific journals.

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What is Dyspigmentation?

Updated: Apr 12

Dyspigmentation refers to an alteration in the normal pigmentation or color of the skin. It involves changes in the production, distribution, or concentration of melanin, the pigment responsible for skin, hair, and eye color.

 

Table of Contents

 

Importance of Understanding Dyspigmentation


Dyspigmentation can affect a person's appearance and self-esteem, leading to emotional and psychological distress. It can also indicate underlying health issues or be a symptom of certain medical conditions.


Types of Dyspigmentation

Hyperpigmentation


Hyperpigmentation refers to areas of the skin that are darker than the surrounding skin due to an excess of melanin production or uneven distribution of melanin.

Melasma, post-inflammatory hyperpigmentation (PIH), and age spots (lentigines) are common forms of hyperpigmentation.


Causes of Hyperpigmentation

  • Environmental factors: Excessive exposure to the sun's ultraviolet (UV) radiation can trigger dyspigmentation. It can lead to increased melanin production (hyperpigmentation) or uneven distribution of melanin, causing darker or lighter patches on the skin. Exposure to pollutants, such as air pollutants and chemicals, can disrupt the normal functioning of melanocytes (cells responsible for producing melanin), leading to dyspigmentation. Factors like heat, humidity, and allergic reactions to chemicals in skincare products can also contribute to dyspigmentation.

  • Hormonal factors: Hormones, such as estrogen and progesterone, can influence melanin production and distribution in the skin. Fluctuations in hormone levels during pregnancy, menopause, and thyroid disease can lead to dyspigmentation. Conditions like melasma (commonly known as "the mask of pregnancy") and hormonal imbalances, such as those seen in polycystic ovary disease (PCOD), can cause dyspigmentation.

  • Medical conditions and medications: Certain conditions, including post-inflammatory hyperpigmentation, vitamin B12 deficiency, Addison's disease, and acanthosis nigricans can cause hyperpigmentation. Autoimmune disorders and skin infections like seborrheic melanosis may also contribute to this condition. Blotchy hyperpigmentation can also arise from inflammatory skin conditions like lichen planus and ashy dermatosis. Certain medications, such as antibiotics, antimalarials, and chemotherapy drugs, have also been associated with hyperpigmentation as a side effect.

Hypopigmentation


Hypopigmentation refers to areas of the skin that are lighter than the surrounding skin due to a decrease or absence of melanin production.


Common causes include vitiligo, albinism, and pityriasis versicolor (a form of fungal infection by malasezzia).


Hypopigmentation can also arise in genetic conditions like albinism, Waardenburg syndrome, and piebaldism.


Symptoms and Diagnosis


Symptoms

Symptoms of dyspigmentation vary depending on the underlying cause but include the presence of dark or light patches on the skin, uneven skin tone, and changes in pigmentation over time. In cases with inflammatory skin conditions like lichen planus, ashy dermatosis, seborrheic melanosis, and pityriasis versicolor, there might also be other symptoms like itching and scaling.


Process of diagnosing dyspigmentation


  • Physical examination: A dermatologist or healthcare professional will visually assess the skin to evaluate the nature and extent of dyspigmentation.

  • Medical history evaluation: A comprehensive medical history, including a discussion of symptoms, family history, and any medications or treatments being used, can help diagnose the underlying cause of dyspigmentation.

  • Diagnostic tests and procedures: In some cases, additional tests such as skin biopsies, blood tests, or Wood's lamp examination may be performed to aid in the diagnosis.

Treatment and Management of Hyperpigmentation

Topical treatments for hyperpigmentation


Skin-lightening creams and serums containing ingredients like kojic acid, retinoids, vitamin C, arbutin, azelaic acid, niacinamide, and licorice extract can help reduce hyperpigmentation by inhibiting melanin production or promoting its breakdown.


Procedures and therapies

  • Laser therapies like Nd:YAG laser, Alexandrite laser, and Ruby laser can target and break down melanin pigments, reducing hyperpigmentation. Intense pulsed light (IPL) is also known to help.

  • Chemical peels containing AHAs, kojic acid, and trichloroacetic acid (TCA) exfoliate the outer layers of the skin, improving overall skin tone and reducing the appearance of dyspigmentation.

  • Dermatologists may also offer treatments like dermabrasion, microdermabrasion, and micro-needling to address specific types of dyspigmentation.


Lifestyle and home remedies

  • Consistent use of broad-spectrum sunscreen with 30 or higher sun protection factor (SPF) and PA+++/PA ++++ rating is essential. Other sun-protective measures, such as wearing hats and protective clothing, can help prevent further dyspigmentation. Limiting sun exposure during peak hours (typically 10 am to 4 pm) when UV radiation is strongest can help reduce the risk of dyspigmentation.

  • A skincare routine involving gentle cleansing, moisturizing, and using fragrance-free products containing antioxidants and gentle exfoliants can help improve skin health and reduce the appearance of dyspigmentation.

  • Healthy lifestyle habits: A well-balanced diet rich in fruits, vegetables, antioxidants, and essential nutrients like vitamins A, C, and E can support healthy skin and reduce the risk of dyspigmentation.

  • Managing stress levels and prioritizing quality sleep can contribute to overall skin health and reduce the likelihood of dyspigmentation.

Before you go...


Please don't let changes in your skin colour get in the way of your happiness. Seek medical consultation as soon as you notice something unusual. The bitter/sweet truth about pigmentary disorders is that if you catch them early, their treatment and management become much more manageable. If you delay too much, many times, it becomes too late.


Well, if you are looking for a dermatologist, you know what I am going to say next.


If you are worried about dark spots caused due to insect bites or pimples, you can read the following articles:


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