The colour of human skin is determined by the pigment known as melanin, which can be yellow, brown, dark brown or black. Melanin is responsible for the colour of human skin. Levels of melanin in human body depend on heredity, race and amount of sunlight exposure. When the body produces too much melanin due to any cause it is termed as hyperpigmentation, which means darkening of skin. It may occur due to excessive sun bathing, hormone changes or drug reactions. Many a time wounds and scars leave a darker patch of skin. It is important to keep on the alert for any change in size, color or texture for indications of skin cancer. There is some variety of hyperpigmentation, as, birthmarks, moles, and aging spots are also indications of hyper pigmentation. Melasma, Lichen Simplex Chronicus, Birthmarks, Port-wine Stains, post-inflammatory hyper-pigmentation present as hyper-pigmentation.
Melasma: A dark mask appears over the cheeks, bridge of the nose and sometimes on chin and neck. The distribution is usually symmetrical. Melasma is mainly seen in women of child-bearing age which tends to occur during pregnancy and with use of oral contraceptives. The colour in melasma darkens during sunlight exposure. This condition usually disappears after the child birth or discontinuation of oral contraceptive.
Lichen Simplex Chronicus: This skin pigmentation disorder is characterised by dark patches of skin accompanied with severe itching. This can lead to permanent scar and infection if untreated.
Birthmarks: This type of skin pigmentation appears at birth or in the few weeks following birth. These birthmarks do not generally pose any health risks and persist throughout.
Port-wine stains: These skin pigmentation spots are caused by abnormal development of capillaries and appear as a red or purple mark on the body.
Post-infammatory hyperpigmentation: It is a discolouration that is left on the skin after an infection or an underlying skin disease which is healed.
A dermatologist will help in identifying the skin pigmentation condition with a visual examination and some simple tests. Most often skin pigmentation affects only the outward appearance and is not indicative of any underlying health risks. Sometimes a biopsy is done of the affected area to rule out any cancerous growth. The underlying skin disease may be trauma, skin infection, eczema, oral contraceptive pills or a drug reaction. One should avoid further trauma to the area or the cause, e.g. avoid frequent rubbing, discontinuation of oral contraceptives and keep away from sunlight exposure etc.
Most often people affected by skin pigmentation need to use sunscreen and avoid excessive sun exposure. Use sunscreen regularly and avoid sun exposure as far as possible. This will minimise further darkening of the lesions.
Bleaching agents such as hydroquinone can be used to lighten the colour. Skin-lightening creams are available for hyperpigmentation. Hydroquinone is widely used to block formation of new melanin. Retin-A is also prescribed to counter the effects of hyperpigmentation. Local application of steroid creams for short time can help alleviate itching associated with some form of skin pigmentation. But no drug should be used without consulting a skin specialist, especially the steroids, as wrong treatment result in many adverse effects.
Aesthetic skin procedures like skin peels (glycolic acid peel, TCA peel) or dermabrasion may help in improving the effectiveness of the bleaching agents. Cosmetic camouflage can be used to hide the discoloured skin. Skillfully applied makeup can help in covering affected areas of the skin. Hypoallergenic cosmetics can be used to cover uneven and blotchy skin.
Sometimes treatment takes longer time and normal skin colour returns slowly. In dark-skinned persons, the colour tends to be more intense and persists for a longer period. Treatment requires patience of the patient. And always consult an expert for treatment and make-over. Keep your confidence high with clear skin.
Dr Riffat H Lucy
Anti-aging and Aesthetic Medicine Specialist, ELIXIR & Prescription Point Medical Center
Source: The Daily Star, February 06, 2010
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