What is Skin Pigmentation?
Excessive skin pigmentation is a result of abnormal production and deposition of melanin (pigment) by the melanocytes (melanocytes are pigment-producing cells). The number of melanocytes present in our skin will determine our skin colour (i.e. the more melanocytes, the darker the skin). Production of melanin is dependent on UV or sun exposure, and is a natural protective mechanism of the skin.
Hyperpigmentation, areas that are darker than the rest of the skin, result from excess melanin production and deposition.
What causes excessive Skin Pigmentation?
Excess skin pigmentation or hyperpigmentation is usually the result of the overwhelming of the melanin-protective system which leads to the excess production and clumping of melanin, and the appearance of brown or darker spots of pigmentation in the skin.
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What factors influence or cause excessive Skin Pigmentation?
Excessive exposure to the sun can cause hyperpigmentation especially in people with darker skin tones and especially in areas such as Australia that have high UV radiation levels. Usually, melanin absorbs most of the sun’s harmful ultra violet rays but if the skin is exposed to these UV rays for too long, increased melanin is produced. This may cause existing age spots, freckles and darkened skin patches to become darker and more noticeable.
Chemicals, Toxins, Medications & Trauma
Hyperpigmentation can also be caused by exposure to certain medications, chemicals or toxins, burns, injuries, acne and other skin conditions. This type of hyperpigmentation is known as Post-inflammatory hyperpigmentation (PIHP).
It can occur as a side effect of some medications especially skin care treatments or chemicals such as those used in drawing tattoos.
Hormonal Changes - Hyperpigmentation can be caused or triggered by natural hormonal changes and hormone treatments in the body, such as changes in oestrogen and progesterone levels and thyroid functions. It is very common among pregnant women and those using contraceptive pills. This type of hyperpigmentation is referred to as Melasma.
Although it is more prevalent in women, it can also affect males especially if they are undergoing or have undergone hormone therapy.
Birthmarks and acquired pigmentation
Skin pigmentation can be present at birth (birthmarks), appear in childhood, or adulthood. Examples of these include; congenital melanocytic naevus, cafe au lait spots, spilus naevus (speckled lentiginous naevus), hori’s macules, and naevus of ota.
What treatments are available for Skin Pigmentation?
The first line treatment for skin pigmentation is to avoid its production in the first place by using daily sun protection (sunscreen, hat etc). UV exposure from sunlight will invariably worsen any existing pigmentation and promote further production of pigmentation.
Laser can also treat certain types of skin pigmentation such as freckles, age spots (solar lentigines) and other benign pigmented spots such as seborrheic keratosis (sometimes referred to as senile warts). Lasers that selectively target melanin or simply remove the top layers will lead to improvement of the pigmented area.