Hyper Pigmentation

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Depigmentation

Introduction

Been in sun a lot without any precautions, popped that pimple and kept touching it all the time, had a minor cut and now it is darkening- all these brownish spots are nothing but Pigmentation.
Pigmentation is common and a usually harmless condition in which certain patches of the skin become darker in color as against the remaining. This darkening in color occurs mainly due to excess melanin deposition.
A small amount of pigmentation keeps happening and the skin also reverts back to normal after a time but if the pigmentation keeps increasing both in the size or the number of spots or keeps darkening further- this may be a cause of concern called Hyperpigmentation.
Not always harmful to health or a serious concern per se, hyperpigmentation is more of a concern on the aesthetic level.

causes of Pigmentation

Damage due to the Sun: The most common cause of pigmentation is the sun damage. The damage thus caused is usually recurring and is cyclical in nature. This is because the UV-A and UV-B rays in the sun speed up melanin production in the skin. This melanin then has a tendency to absorb additional UV-A and UV-B. This process causes inflammation of the skin. The immediate effects of the damage are negligible enough but over a time, they start showing up as tan patches.
Skin Cuts and Bruises: As was mentioned in the opening sentence itself, sometimes things are simple as a minor cut or a pimple popping act can result in pigmentation. This is because, as a repairatory response, the skin produces melanocytes which produce melanin at the affected site and hence causes pigmentation.
Allergic reactions to certain external factors or certain medications (such as retinoids, anti-seizure drugs, hormonal medications, non-steroidal drugs etc.) can also cause pigmentation of the skin.
Hormonal changes, especially around the time of menopause, are another major cause of pigmentation. Also, some women experience excessive pigmentation during pregnancy due to excess production of the hormones estrogen and progesterone.
Lastly, some people have it in their genes that their melanin production and hence deposition would be more than normal and hence heredity becomes another cause of pigmentation.

Why Patients approach dermatologist?

Various pigmentation causes for which people approach a dermatologist are,

1. Post pimple Pigmentation
2. Suntan
3. Melasma
4. Birth marks(Naevus of ota)
5. Lentigenes (Freckles)
6. Post inflammatory hyper pigmentation
7. Tattoo

Melanin production and deposition is a response to the internal systems against external stimuli and as such, no cure for the same has been developed. However, there are few precautions that can be taken in order to restrict the probable deposition to a minimum:

The first and most basic preventive measure lies in the use of broad-spectrum sunscreens. By broad spectrum, we mean that the sunscreen should be effective against both UV-A and UV-B with an SPF of 35 or more. Also, Sunscreens shouldn’t be used only when out in the sun. The UV rays are always present in the atmosphere and hence, even though it is rainy or you are inside your house, sunscreens should be worn.
Be mindful of the allergies or slight irritations that any of the make-up product is causing you. Even a slight itch should be a reason enough to discontinue the use.
For ladies who are taking pills for birth control, one of the side effects can be melasma. The ideal solution would be to look for alternative methods of control and stop usage of birth control pills. Also, using various skin lightening creams as prescribed by a dermatologist can be the treatment for pigmentation.