Pigmentation Treatment and Remedies

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 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 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 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 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 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.

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.

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)