Skin pigmentation disorders affect the color of the skin. Skin gets its color from a pigment called melanin. Special cells in the skin called melanocytes make melanin. When the melanocytes are hyperactive or make too much melanin it will lead to hyperpigmentation or darkening of the skin and when melanocytes are underactive or make too little it will lead hypopigmentation or whitening of the skin. Some pigmentation disorders can affect the entire skin, whilst others affect the skin in patches.
Medical conditions that increase the hormone that stimulates melanocytes to produce melanin may lead to generalized hyperpigmentation. This includes conditions like Addison disease. Generalized hyperpigmentation is not very common.
Localized hyperpigmentation is very common. Some of the common causes include post-inflammatory hyperpigmentation from the previous injury, prior or current acne, following eczema, or following a fixed drug reaction a form of an allergy to medications. This condition is much more common in dark-skinned patients.
Other common causes of localized hyperpigmentation include melasma-a hormonal influenced pigmentation disorder more common in females, lichen planus pigments-also mainly affecting females especially in the sun-exposed areas. Freckles, moles, acanthosis nigricans, and dermatosis paulosa nigricans are also very common.
Worrying pigmented lesions on the skin can be skin cancers- if a new suspicious pigmented lesion with irregular borders and color appears or an old mole suddenly changes it needs to be check by a dermatologist to rule out skin cancers. Common pigmented skin cancers include basal cell carcinoma and melanoma.
Generalized hypopigmentation is found commonly in patients with albinism. It can also be as result of severe generalized vitiligo a condition in which melanocytes stop producing melanin.
Localized hypopigmentation is more common than generalized hypopigmentation. Common conditions resulting in hypopigmentation are vitiligo, post-inflammatory hypopigmentation, pityriasis alba, and idiopathic guttate hypomelanosis.
For the treatment of any of the pigmentation disorders, it’s best to see a dermatologist.
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