Skin Pigmentation Disorders
Also called: Hyperpigmentation, Hypopigmentation
Pigmentation means coloring. Skin pigmentation disorders affect the color of your skin. Skin cells give your skin color by making a substance called melanin. When these cells become damaged or unhealthy, it affects melanin production. Some pigmentation disorders affect just patches of skin. Others affect your entire body.
If your body makes too much melanin your skin gets darker. Pregnancy, Addison's disease and sun exposure all can make your skin darker. If your body makes too little melanin, your skin gets lighter. Vitiligo is a condition that causes patches of light skin. Albinism is a genetic condition affecting all of a person's skin. Infections, blisters and burns can cause lighter skin.
Abnormal skin pigmentation
Skin is just like the humans who wear it -- it’s not perfect. If everything went as planned, the body would produce just enough melanin and blood vessels would behave. But that’s not the case. There are birthmarks and other pigmentation disorders that affect many people. Some of the most common pigmentation problems are listed below. Remember: never self-diagnose! If you think you have one of these skin pigmentation abnormalities, make sure to visit a physician or dermatologist to receive an official diagnosis.
Birthmarks
As might be expected, this abnormal skin coloration will appear at birth or in just a few weeks following birth. While it’s important to know that most birthmarks are non-cancerous, certain birthmarks, described below, can pose health risks.
- Pigmented birthmarks
The discoloration of the skin will appear smooth and flat. These spots are known by several names, including Mongolian spots -- bruised or bluish in color, typically appearing on buttocks; café-au-lait spots -- light brown; and typical moles, which are also called nevi. Moles should be monitored for bleeding, itching, and changes in color, shape or size. - Macular stains
These appear anywhere on the body, appearing as mild red marks, but they are not elevated. Macular stains are the most common type of vascular (from blood vessels) birthmark. These marks can come in two forms: angel’s kisses, which may appear on the forehead and eyelids, but will typically disappear after age 2; or stork bites, which will appear on the back of the neck and can last into adult years. Because these marks are often mild, no treatment is necessary. - Hemangioma
Hemangiomas are caused by many tiny blood vessels that are bunched together and vary in severity. Typically, this birthmark is just a small mark; however, in some children, the hemangiomas can grow very rapidly through the first year of life. There are two types of hemangiomas: strawberry hemagiomas, which are slightly raised and can appear anywhere on the body; or cavernous hemangiomas, which are a deeper birthmark characterized by a bluish color. Fortunately, most hemangiomas will go away on their own; 50 percent resolve by age 5, 70 percent by age 7 and 90 percent by age 9. Reasons to treat hemangioma include problems with functions (such as sight, eating, hearing, or defecation), ulceration or pain. Hemangiomas can be treated two different ways, each of which carries its own risks: corticosteroid medication, which is injected or taken orally. Risks associated with corticosteroid medication include high blood pressure, high blood sugar, poor growth, or cataracts. Certain hemangiomas can also be treated with lasers to stop them from growing. Risks associated with that treatment include ulceration and scarring. In some cases, a hemangioma can also be removed with surgery. - Port-wine stains
Port wine stains are caused by abnormal development of blood vessels (capillaries) and last a lifetime. The port-wine stain (also known as nevus flammeus) appears as a flat, pink, red, or purple mark, and occurs on the face, trunk, arms, or legs. Port-wine stains present on eyelids are thought to pose an increased risk of glaucoma. Physicians have tried many ways to treat port-wine stains, including radiation, tattooing, freezing, dermabrasion, or sclerotherapy. Laser treatment is currently the only method that destroys capillaries in the skin without causing damage to the rest of the skin. Port-wine stains may be seen in certain medical disorders, including Sturge-Weber Syndrome, whose symptoms include port-wine stains on the face, vision problems, convulsions, mental retardation and perhaps even paralysis; and Klippel-Trenaunay Syndrome in which a limb has a trio of many port-wine stains, varicose veins, and/or too much bone and soft tissue growth. Each of these syndromes is very rare.
Albinism
Albinism, an inherited disorder, is caused by the absence of the pigment melanin and results in no pigmentation in skin, hair, or eyes. Albinos have an abnormal gene, which restricts melanin production. There is no cure for albinism, and individuals should use a sunscreen at all times because they are much more likely to get sun damage and skin cancer. This disorder can occur in any race, but is most common in Caucasians.
Melasma
Melasma (also known as chloasma) is characterized by tan or brown patches on the cheeks, nose, forehead, and chin. Although this condition is typically termed the "pregnancy mask," men can also develop it. Melasma frequently goes away after pregnancy but can be treated with certain prescription creams and some over-the-counter skin care products. Remember to consult your physician or dermatologist for a proper diagnosis of this condition before you choose to treat it yourself. If you have melasma, use a sunscreen at all times because sunlight worsens the condition.
Pigmentation loss as a result of skin damage
If you’ve had a skin infection, blisters, burns or other trauma to your skin, you may have a loss of pigmentation in the affected area. The good news with this type of pigment loss is that it’s frequently not permanent, and cosmetics can be used to cover the area.
Vitiligo
Vitiligo has several possible causes including physical trauma or diseases such as diabetes, pernicious anemia, thyroid disease, or Addison’s disease. Vitiligo causes smooth, white skin patches. In some people, these patches can appear all over the body. There is no cure for vitiligo, but there are several treatments, including dyes or psoralens (light-sensitive drugs) used in combination with ultraviolet A light treatment.