Most of us are fully aware that the color and tone of our skin (as well as the way it responds to
sunlight exposure) is governed by cells in the skin that produce pigmentation known as melanin. The amounts of melanin in the skin give
us the full spectrum of skin colors – everything from pale ivory to dark black. The various ethnic groups – Negroid, Caucasoid, and
Mongoloid - each have “typical” melanin level-ranges, giving the spectrum of skin shades commonly found within each ethnic group.
However, there are factors and conditions that can result in abnormal melanin production. There
are genetic abnormalities that can result in lack of pigmentation – albinism – as well as some rare diseases – such as Addison’s
Disease – that can cause the skin to appear “suntanned” without exposure to the sun.
There are common factors that can cause discolorations of the skin – some fungal infections can
cause lighter or darker patches, sun exposure can result in freckles and moles, aging can cause some development of darkened patches,
and even some medications can cause skin discoloration. Treatment for these discolorations and pigment marks varies and some treatments
are more or less effective. Here are some of the more common pigment marks and their causes:
Melasma is a fairly common disorder that causes dark, blotchy patches on the face. The patches
darken as they are exposed to the sun and will often turn brown in the summer and fade in winter. Although men are known to suffer
from melasma, the condition usually affects women and often appears in women taking birth control pills or hormone replacement therapy,
or who are pregnant. When it appears in pregnant women, it is called chloasma and usually – but not always - disappears after a baby is
born. Women who have chloasma should wait several months after delivery before contemplating a cosmetic procedure. Women taking birth
control pills who experience melasma should speak to their doctor about another form of contraception. Changing pills, however, will
usually have no effect on the melasma you already have. Your dermatologist may suggest prescription bleaching creams, or a peel.
Solar Lentigoes are also known as age spots or liver spots, and are flat brown discolorations of the
skin that appear on sun exposed areas such as the backs of hands and the face. These harmless discolorations have nothing to do with how
old you are or how well your liver functions. They are the result of years of sun exposure and are caused by a local increase in pigment
producing cells. The dermatologist may recommend freezing or laser removal of them.
Post-inflammatory hyper-pigmentation results from any inflammatory injury to the skin. Acne —
particularly cysts or nodules — can leave these sorts of marks. So can insect bites, oven burns, scars and eczema. Chemical peels or
laser treatments can also cause hyper-pigmentation in susceptible individuals. Even seemingly innocuous things like leg waxing and
electrolysis can leave hyper-pigmentation marks. The degree of hyper-pigmentation varies depending on which part of the body it appears.
Discoloration on the torso and lower body tends to be much darker than discoloration appearing on the face. The darker your skin, the
more prone you are to this type of hyper-pigmentation. The dermatologist may recommend prescription fading creams, perhaps followed by a peel.