Pigmentation Treatment and Remedies


You may have noticed some dark patches, freckles and other marks or moles on your skin that do not look normal to you. You might even worry about why these skin issues are emerging and if they can affect your health in the long run. While each of these problems may have a different cause, diagnosis and treatment, they are collectively known as skin pigmentation.

Skin pigmentation or pigmentation disorders affect the colour of your skin. The skin has cells called melanocytes that produce a pigment called melanin. This melanin provides your skin with its natural complexion. If your body makes too much melanin then your skin becomes darker, and if your body makes very little melanin then your complexion is likely to be lighter.

(Read more: Melanin deficiency)

When the skin cells become damaged or unhealthy, it affects the production of melanin and this leads to pigmentation disorders. Pigmentation may affect only a patch of your skin or the entire body, depending on the underlying cause. Not all skin pigmentation is something to worry about. Pregnancy and sun exposure for long hours can cause pigmentation that usually disappears with treatment or as soon as the underlying problem goes away.

(Read more: Melasma during pregnancy)

However, in other cases, pigmentation may be more difficult to tackle. For example, albinism is a genetic condition in which your skin is likely to have no or very little colour. People with vitiligo may also face health problems due to their skin pigmentation disorder. Similarly, while most birthmarks (abnormal skin colourations present at or presenting soon after birth) are considered to be non-threatening, some other types can pose severe health risks. Infections, blisters and burns can also cause skin pigmentation.

  1. Types of pigmentation
  2. Causes of pigmentation
  3. Diagnosis of pigmentation
  4. Treatment for pigmentation
  5. Prevention of pigmentation

Types of pigmentation

There are many types of skin pigmentations that you may experience during your lifetime, but not all types are harmful in the long run. However, keeping a check on skin changes is as important as consulting a dermatologist if you do come across any new pigmentation. The following are all the types of skin pigmentation you may come across.

  1. Pigmented birthmarks
  2. Vascular birthmarks
  3. Albinism
  4. Melasma
  5. Hyperpigmentation and hypopigmentation
  6. Vitiligo

Pigmented birthmarks

Pigmented birthmarks are those that present at birth or soon after it and have a particular hue or colour to demarcate them. The following are the key types of pigmented birthmarks:

  • Nevus of Ota: Bluish or greyish discolouration of the face is known as Nevus of Ota. It may also occur in the whites of the eyes. Nevus of Ota is caused by an increased amount of melanin produced by the melanocyte cells around the eyes. People with this particular type of birthmark have an increased risk of developing an eye- or central nervous system-related melanoma cancer. They may also have a higher risk of developing glaucoma. This is why people with Nevus of Ota should get their eyes checked regularly by an ophthalmologist and neurologist.
  • Mongolian blue spots: These large, flat, grey or blue patches usually appear on the back and buttocks at birth and are most commonly seen in Asian babies. Mongolian blue spots tend to fade and disappear over time, especially by the age of four years and do not require any treatment as such. However, if the condition continues well into childhood and is easily visible to others, it may have long-term psychological consequences too.
  • Cafe au lait spots: Literally translating to “coffee with milk” in French, cafe au lait spots refers to light brown or dark brown spots with smooth or irregular borders. The Cleveland Clinic says that about 10% of the general population has one or two of these spots - which is considered to be normal. However, if you have six or more of these spots that are greater than 0.5cm in diameter, it can be associated with the genetic disorder neurofibromatosis and may need to be cosmetologically treated. 
  • Moles: Nevi or moles are flesh-coloured or light-to-dark brown spots which may be flat or raised. These moles are mostly benign or non-cancerous and are unlikely to cause any problems unless they transition into melanoma, which is cancerous. This is why you should keep a close look on your moles, especially noting if there is any pain, itch, bleeding or changes in colour, shape, symmetry, sizes and even borders. 

Vascular birthmarks

Vascular birthmarks are those that are linked to your blood vessels and blood circulation. The following are the key types of vascular birthmarks:

  • Macular stains: Macular stains may appear anywhere on the body and they are the most common type of vascular birthmark. They usually appear as mild red marks but do not appear as a bump. Angel kisses and stork bites are the two forms of macular stains and neither need to be treated as such. However, if there are any changes in the shape or colour of these birthmarks, or if it hurts, you should contact a dermatologist.
  • Hemangiomas: These growths occur when tiny blood vessels get bunched together and they’re more common in women and premature babies. Hemangiomas usually appear as small marks on the face, trunk, arms and legs. In the case of some infants, they may grow rapidly large during the first year of life. There are two types of hemangiomas called strawberry and cavernous. Studies show that around 50% of hemangiomas disappear by age five, 70% by the age of seven and 90% by the age of nine. Some hemangiomas may turn serious, cause bleeding, ulceration or pain and affect functions like sight, eating, hearing and defecation. Hemangiomas may be treated with corticosteroids, laser treatment, topical or oral beta blockers and surgery. (Read more: Arteriovenous malformation)
  • Port wine stains: Port wine stains are flat pink, red or purple marks which appear on the face, trunk, arms or legs. These birthmarks can last a lifetime and are caused by an abnormal development of blood vessels. As you age, the port wine stain may turn thick and raised. This is not the only reason why this birthmark must be treated. Port wine stains on the eyes can increase the risk of glaucoma and are also linked with Sturge-Weber syndrome and Klippel-Trenaunay syndrome. Port wine stains may be treated through radiation therapy, tattooing, freezing, dermabrasion or sclerotherapy. 

Albinism

Albinism is an inherited skin pigmentation disorder that occurs due to low or no melanin creation. This causes the skin, hair and eyes to have no colour at all. Albinism is incurable and constant care is required to save the skin from exposure, damage and infections so that skin cancer risk can be reduced. Using sunscreen at all times and consulting a dermatologist regularly is necessary for people with albinism. People with albinism are also likely to have problems with their eyes, especially decreased vision and abnormal eye movement. This is the reason why an ophthalmologist must be consulted regularly.

Melasma

Melasma or chloasma, also known as the mask of pregnancy, usually appears during pregnancy on the forehead, cheeks, upper lip, nose and chin. The patches are usually symmetrical. They may also appear in men with hormonal problems and women on birth control pills or postmenopausal estrogen treatment. Melasma usually goes away if you get it during pregnancy but if it doesn’t, then you may need treatment by a dermatologist using creams and other care products.

Hyperpigmentation and hypopigmentation

Hyperpigmentation and hypopigmentation occur due to skin infections, blisters, burns or other kinds of trauma. If the melanin production in the body goes up due to any of these causes then it is called hyperpigmentation and if the melanin production decreases then it is known as hypopigmentation. These types of pigmentations are not permanent but may need time and treatment to fade completely. Using sunscreen can also help while you are recovering from either of these types of pigmentation.

Vitiligo

Vitiligo is an autoimmune disease where the body’s immune system starts attacking the melanocytes or pigment cells. It causes smooth, white skin patches around the mouth, eyes and the back of the hands. In some cases, the patches may appear all over the body. A few other diseases that can trigger or are associated with vitiligo are diabetes, pernicious anaemia, thyroid disease and Addison’s disease. There is no cure for vitiligo but the condition can be managed with immunomodulators, topical vitamin D analogs, light-sensitive drugs and ultraviolet A and ultraviolet B light treatment.

Causes of pigmentation

There are many reasons why pigmentation may occur and all of them are based on the basic health of your melanin-producing skin cells.

  • Sunburns: Sunburns, as well as other types of burns, can damage your skin quite severely depending on the time and type of exposure. Once a sunburn heals, it may leave behind scar tissue that is pigmented. This scar tissue may be dealt with through proper medications and guidance from a dermatologist. Applying sunscreen can protect your skin from this type of pigmentation. (Read more: Side effects of sunscreen)
  • Infections: Infections that affect your skin, especially bacterial infections and fungal infections, can also cause skin pigmentation and discolouration. Tinea and candida fungal infections can especially cause skin pigmentation, and so can the presence of ringworms. (Read more: Deworming for adults)
  • Autoimmune diseases: An autoimmune disease can cause your immune system to mistakenly attack healthy cells in your body, assuming them to be invaders. Vitiligo is an autoimmune disorder that causes skin pigmentation. Often, other autoimmune diseases like psoriasis and lupus may also cause skin pigmentation.
  • Hormonal changes: There are many stages of life, especially for women, where hormonal changes are likely to happen. Changes in the levels of estrogen and progesterone, particularly during pregnancy, can cause dark pigmentations known as melasma or chloasma to appear on your face and other parts of your body.
  • Skin cancer: Not all pigmentations are caused by skin cancer, but some could be at risk of becoming cancerous if they are left unchecked. Actinic keratosis, basal cell carcinoma, squamous cell carcinoma and melanoma are types of cancers that present with different types of skin pigmentations.
  • Birthmarks: Moles, Mongolian blue spots and port wine stains are all types of birthmarks. These birthmarks are usually harmless but any changes in their shape, texture or size should not be left unchecked as they may indicate changes in your melanin levels.
  • Dermatitis: If your skin comes in contact with an irritating substance and causes an allergy, this too may lead to skin pigmentation. Usually, these reactions fade when appropriate medications are administered. In a few cases, dermatitis may be chronic too.

Diagnosis of pigmentation

Understanding the underlying cause behind your skin pigmentation is very important because it can help you get the right treatment and prevent complications like glaucoma, skin cancer, etc. This is why going to a dermatologist and getting your pigmentation checked is very important. Once you do go in for an appointment with your doctor, he or she will make a proper physical examination of the pigmented skin patches. You will also be asked a couple of questions to establish when you first started noticing changes in your skin colour, whether the pigmentation appeared slowly or rapidly, if the discolouration is changing or getting worse and if you are experiencing other symptoms.

(Read more: Skin disorder and skin disease)

You should let your doctor know about any skin injuries, sunburns or infections you may have had lately. You should also let them know if you are taking hormone treatments or are pregnant. If your dermatologist suspects that you may have any underlying condition causing the pigmentation then you may have to go through some diagnostic tests to discover the problem. This may include blood tests, Wood’s lamp examination to check for fungal or bacterial infections and a skin biopsy to examine a sample of the affected area to check for abnormal cells.

Treatment for pigmentation

The treatment for skin pigmentation depends on the underlying cause. The treatments prescribed by most dermatologists include a combination of treatments depending on the underlying problem. These treatments could be simple home remedies and changes in lifestyle or medications and/or therapy you may need to take for the long- or short-term. The following are the types of treatments your doctor may recommend, depending on the underlying issue. 

  1. Medical treatments for pigmentation
  2. Home treatments for pigmentation

Medical treatments for pigmentation

If your doctor prescribes medical treatment for you then you should discuss which one is best suited for you in terms of side effects, cost and effectiveness. The following are the key types of medical treatments recommended for pigmentation.

  • Laser therapy: Pulse light devices with a high intensity and Q-switched lasers are used in laser therapy to lighten skin patches that have pigments.
  • Topical creams: Topical creams with corticosteroids, hydroquinone, retinol (vitamin A), vitamin C, vitamin E or vitamin D may be recommended to decrease the dark patches. 
  • Chemical peels: Chemical peels with salicylic acid and glycolic acid can be used to remove the outer layer of darkened or discoloured skin.

Home treatments for pigmentation

There are a number of home remedies and treatments your doctor may recommend for pigmentation. The following are some of the remedies that are easiest to adopt:

  • Consuming plenty of vitamin C through your diet can improve your skin health. Not only can this help control your pigmentation issue but prevent further complications too. Therefore, it is necessary to get plenty of oranges, cantaloupes, pineapples, berries, capsicum and onions in your diet.
  • Applying castor oil or lemon juice on the affected areas of your skin may help lighten the pigmentation by breaking down the excess of melanin. (Read more: Lemon)
  • Some types of herbal teas may also help reduce skin pigmentation naturally. These teas are made of burdock, red clover or milk thistle. 
  • You may want to discuss taking vitamin A, vitamin C and vitamin D dietary supplements on the recommendation of your doctor if your dietary pattern does not seem sufficient.

(Read more: Home remedies for pigmentation)

Prevention of pigmentation

Not all types of skin pigmentation are preventable or curable; those like vitiligo and albinism are inherited. Even birthmarks are types of pigmentation that you cannot prevent. However, you could use a few methods to prevent other forms of pigmentations from appearing and, at the same time, you can control the kind of pigmentation you already have as well. The following preventive methods may help in this regard:

  • Eat a nutritious and balanced diet throughout your life which is packed with macronutrients like carbohydrates, proteins and fats as well as micronutrients like vitamins, minerals and antioxidants.
  • Prevent undue sun exposure and sun damage. Apply a good sunscreen with a high SPF throughout the year, even in winters, to keep your skin safe from ultraviolet ray damage.
  • Recent studies have shown that even blue and fluorescent lights from bulbs and digital devices can harm your skin. The same goes for air pollution, especially particulate matter pollution. Ensure that you have plenty of safeguards against these damaging factors too.
  • If you already have pigmentation, scar tissue from burns or even acne, then make sure you don’t pick at the scabs. This can worsen the pigmentation as it irritates the skin further.
  • Drink plenty of water. Water can help flush out damaging toxins and microbes and help you keep your skin clear. It may also help prevent skin inflammation and thereby reduce pigmentation. (Read more: Water for weight loss)

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