Pigmentary Disorders result from excessive or reduced/absent pigment. It can be caused by inflammation, medication, hormonal fluctuations and UV exposure.
Post Inflammatory Hyperpigmentation and Hypopigmentation
It is a discolouration and/or palor of the skin that is left on the skin after an underlying skin disease has healed. The underlying skin disease may be trauma, skin infection, eczema or a drug reaction. This tends to improve with time. In dark-skinned persons, the dyspigmentation tends to be more intense and persists for a longer period.
Freckles and Lentigines
Freckles are light brown small flat spots less than 1cm that appear on areas of sun exposed skin such as the cheeks and nose. They are usually present at a young age and tend to increase with age. Solar lentigenes are brown spots 1 cm or greater in diameter, occurring usually on the face and back of the hands. Solar lentigenes are evidence of excessive sunlight exposure. They are found in individuals over 40 years of age, especially if they have a long history of sun exposure.
Melasma is a common pigmentary problem affecting the Asian skin, it usually appears as brownish patches over the cheeks although the forehead, temples, nasal bridge, upper lips and jawline may be affected as well. Melasma results from the interplay of genetic, hormonal and UV factors. Women are more commonly affected compared to men. Worsening is often reported after sun exposure, pregnancy and the use of oral contraceptives.
Pityriasis alba is a common skin complaint of children and young adults. It appears as pink scaly patches which later leave pale areas on the skin. These pale areas are more noticeable in people with dark skin, and more pronounced after exposure to the sun and the tanning of the non-affected skin. The cause is unknown. It is thought to be due to a minor form of inflammation in the skin, related to eczema.
Drug Induced Hyperpigmentation
Certain medications such as minocycline, hydroxychloroquine, hydroquinone and amiodarone can cause hyperpigmentation of the skin ranging from slate grey to blue-black discolourations.
Vitiligo is a skin disorder which presents as white spots and patches on the skin. This is due to a progressive loss of pigment cells (melanocytes). Vitiligo is not contagious. Vitiligo is considered to be an 'autoimmune' condition in which the body's own immune system rejects some of its own cells (melanocytes in the case of vitiligo). As a result, thyroid disease and other autoimmune conditions are more common in individuals with vitiligo. Repeated trauma such as rubbing or scratching the skin may trigger and aggravate vitiligo.
See your doctor if:
- You're so uncomfortable with the condition that it affects your quality of life
- You’re bothered by the cosmesis of the condition
- There is widespread involvement