November 12, 2012


The pigmentation or colour of our skin is dependant on a substance called melanin which is produced by melanosomes in the lower or basal layer of the epidermis (the epidermis being the upper layer of skin which is sub-divided into further layers). The amount of melanin in the other epidermis layers will also affect pigmentation as will the thickness of the epidermis layer and the number of blood vessels present. The lower level of skin – which is the largest organ in the body – is called the dermis and again this is sub-divided into further layers.

Some people may appear to have a decrease in their skin pigmentation, this may be due to one of several factors. In winter young children may appear to have patchy reduced pigmentation on their face, this is easily treated with a mild steroid cream applied locally. Another cause of loss of colour in the skin may be a superficial fungal giving rise to discoloured lesions covered with fine scales found on the torso, neck and sometimes face. This condition may be treated with anti fungal drups and creams.

A chronic disease which affects the skin and the nerves and which will give rise to discoloured patches which also lack sensation is lyprosy – again this is now easily treated with drugs.

Sometimes the loss of pigmentation is due to autoimmune deficiency as with vitiligo – where almost white patches devoid of colour will appear anywhere on the body.

Glue, or rubber, plastic, some chemicals may cause secondary leucoderma and loss of skin colour which has to be treated with spot dermabrasion or even a graft.

People who suffer with skin conditions such as psoriasis or eczema etc. may noticed decreased pigmentation in areas where a flare-up of their condition has healed.

Occasionally there may be a well defined patch of skin present from birth which is void of colour – again this may be treated by spot dermabrasion or skin graft.

At the opposite end of the spectrum there are those who suffer from an increase in skin pigmentation. Again this may be the result of one of a number of conditioners. There will an increase of melanin deposited in the epidermis or the dermis – conditions relating to the epidermis generally respond well to treatment but heightened colour in the dermis may take much longer to lighten in tone.

Melasma is a condition of the face it appears as brown patches and appears to be due to changes in hormone levels – it is much more pronounced after any sun exposure and is found more often in women.

Dark circles around the eye are a form of increased colour in the skin which may be hereditary, or simply due to stress or the need for new spectacles. Another genetic form is freckles – tiny dark spots found almost anywhere on the body.

A darkening of skin colouring often occurs after exposure to the sun, this may simply be a sun-tan due to over exposure or a condition known as photomelanosis which may appear to be patchy darkening of exposed skin.

Just as those who suffer with various skin conditions may notice a lightening or absence of colour after healing so they may also notice a darkening of healed areas.

Skin darkening may also occur with some drugs.

A birth mark is a darkening of a patch of skin sometimes seen at birth as the name suggests but it may also appear later on. These may also be called nevus and in severe cases may be removed using laser technology.

Those with darkened skin colour, for whatever reason, may seek and receive treatment with a variety of topical creams including steroids, hydroxy quinone, azelic acid. If these treatments don’t appear to be having the desired effect it may be that a more invasive procedure is needed such as skin peeling, laser surgery, pulse light treatment, electrical stimulation, dermabrasion or even a combination of several of these.

As always the advice of an experienced medical practitioner should be sought.

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