Everyone wants fresh, healthy skin and a youthful, even skin tone. As a result, the sudden emergence of brown blotches or pale patches across the surface of the skin which bespeckles the forehead or dapples the arms can be very alarming. However, skin discolouration is more common than people might think, and there are various ways in which the symptoms of skin pigmentation disorders can be treated or alleviated.

What Is A Skin Pigmentation Disorder?

A skin pigmentation disorder is a condition that changes the colour of your skin. Some of these disorders affect patches of skin – creating spots or blotches – whilst others alter the colour of the entire body. However, regardless of the symptoms, every type of skin pigmentation disorder is caused by fluctuating levels of melanin in the body.

What Is Melanin?

Melanin is a skin pigment. It is responsible for giving colour to the hair, skin and eyes. Melanin is produced by specialised pigment cells, called melanocytes. When these cells are healthy, your skin maintains its natural colour.

How Does Melanin Cause Skin Discolouration?

When the melanocytes are unhealthy or damaged, they are unable to produce healthy levels of melanin, and this alters the colour of your skin. If the melanocytes are unable to produce enough melanin, the skin will become lighter in colour. Alternatively, if the cells produce an excess of melanin, the skin will become darker.

Types of Skin Pigment Disorders

There are a few types of skin pigment disorders and we have listed them below.

Albinism

Albinism is a skin pigmentation disorder that reduces the amount of melanin that a person has in their body. Some sufferers of the condition have no melanin at all, whilst others have very low levels of pigment. The disorder is genetically inherited from one’s parents and it affects a person for life, but there are treatments available that can help to manage its symptoms.

Symptoms

The symptoms of albinism depend on the amount of melanin that the body is able to produce. Typically, the condition affects the colour of the skin, hair and eyes. Those affected by the disorder often have very pale skin, which is highly sensitive to the sun and may burn easily. Albinism is also characterised by white or light blonde hair, though it is possible for those affected by the condition to have brown or red hair, depending on the levels of melanin in the body.

It is common for those with albinism to have blue eyes, though sometimes the coloured part of the eye (known as the iris) can lack a sufficient amount of melanin for the eye colour to show. In these cases, the blood vessels in the iris can make the eyes appear pink or red. Additionally, albinism can affect one’s vision and cause poor eyesight.

Treatment

Unfortunately, there is no cure for albinism because it is a genetic disorder. However, glasses and low-vision aids can be used to improve the eyesight of those who suffer from the condition. It is recommended that patients with albinism arrange an annual eye examination with an ophthalmologist. In some cases, an ophthalmologist may recommend surgery to improve a patient’s vision or alter the appearance of the eyes. Additionally, it is important for people with albinism to have an annual skin examination to check for signs of skin cancer.

Vitiligo

Vitiligo is a skin pigmentation disorder caused by a shortage of melanin. It causes patches of pale or white skin to appear on the body. In some cases, it can affect the colour of the entire body, though this is very rare. The symptoms of the disorder are usually permanent and will not disappear on their own.

Symptoms

Vitiligo causes white blotches to appear on the skin. These patches can develop anywhere, but they are most commonly found around the eyes, hands, mouth or groin area. The disorder is most detectable in people with darker skin, as the contrast between healthy and unhealthy skin is most pronounced. Sometimes, white patches appear on the scalp, and, in these cases, the hair in the affected area can turn grey prematurely. Similarly, it is possible for the eyelashes and eyebrows to turn white. Fortunately, however, vitiligo does not cause any itchiness, dryness or discomfort.

Treatment

Medications, such as topical steroid creams, can be prescribed to patients with vitiligo. If these topical treatments fail to normalise the appearance of the skin, a surgical procedure called a skin graft can be performed to treat the symptoms of the disorder. During this procedure, a healthy section of skin (known as a skin graft) is removed from an unaffected area of the body. The skin graft is then used to cover and conceal the white patches of skin.

Alternatively, vitiligo can be treated via a procedure called phototherapy. This treatment reduces the appearance of white skin spots through the use of light. Prior to the treatment, the patient is given an oral medicine called psoralen, which makes the skin more sensitive to light. Then, rays of Ultraviolet A and B are directed at the skin. This must occur two to three times a week for three months before changes in the skin’s colour are noticeable.

Melasma

Melasma is a common skin disorder, which is caused by an excess of melanin in the body. Whilst patients of either sex can suffer from it, melasma affects women more than men. Moreover, pregnancy can trigger melasma, because pregnancy hormones can encourage the overproduction of melanin.

Symptoms

Melasma is characterised by brown blemishes and spots which resemble freckles. These usually appear on the face, though they can emerge on any area of the body. The spots may disappear on their own after a few months. However, they are unlikely to disappear if you are using the birth control pill, are pregnant, or if you suffer from a medical condition that affects your hormones.

Treatment

Melasma is often treated via a medical skin peel. This non-surgical procedure works by removing the top layers of skin (which are marked by brown spots and patches) to reveal clean, healthy skin underneath.

Alternatively, non-invasive laser treatment can be used to treat melasma. During this procedure, a beam of wavelength energy light is directed at the melanin pigmentation in the skin. This lowers the amount of melanin in your body, which eradicates the brown marks and spots.

Hyperpigmentation

Hyperpigmentation is not a skin pigmentation disorder itself; rather, it is the medical term for skin that has turned darker in colour than its natural skin tone. Melasma is a type of hyperpigmentation, as are freckles or sunspots. Every type of hyperpigmentation is caused by the overproduction of melanin, which can be triggered by hormonal fluctuations, excessive sun exposure, injury or inflammation.

Symptoms

Hyperpigmentation causes the colour of the skin to darken. Sometimes, only small spots of the skin become darker (this is the case with freckles, for example). In other cases, hyperpigmentation can cause large patches of skin to darken. These patches can appear anywhere on the body, though they are most likely to emerge on areas that are most exposed to the sun, such as the face, arms and legs.

Treatment

Like melasma, any type of hyperpigmentation can be treated via a chemical skin peel or a laser treatment. Additionally, it is possible for hyperpigmentation to be treated by Platelet-Rich Plasma (PRP) Therapy. This non-surgical procedure works by taking a small sample of blood from the patient’s arm, which is then spun in a centrifuge to separate the platelet-rich plasma from the other components in the blood sample. The platelet-rich plasma is then injected into the darkened areas of skin. Platelets are responsible for healing damaged tissues, and so the injection of a concentrated solution of them back into the skin prompts the body to repair the damaged skin and even out the skin tone.

Pigment Loss After Skin Damage

Injuries, such as cuts, burns, ulcers, infections or blisters, can alter the amount of pigmentation in the area of the skin that has been damaged. When this happens, the injured area of skin can change colour. This change is usually impermanent, though it can take several months for the damage to diminish and disappear.

Symptoms

When your pigment-producing cells are damaged by an injury, they are unable to produce enough melanin, resulting in an absence of pigment in the skin. As a result, the skin usually looks brighter or paler in the area in which it was damaged. The size and shape of these pale patches depend on the type of injury that occurred.

Treatment

Cosmetic treatments are not usually required to treat skin discolouration that is caused by injury or damage, as the pale spots can be concealed using make-up and will heal on their own.

When Should You See a Doctor?

It is always best to see a doctor if the colour of your skin changes colour abnormally and unexpectedly. Your GP can examine the skin discolouration, check for signs of cancer, and offer advice regarding treatment.

Skin pigmentation disorders vary widely in their symptoms and treatability. If you think that you may be suffering from one of the above disorders, it is important to have your symptoms examined by a doctor. If the skin discolouration proves to be harmless but upsets you nonetheless, it is best to consider cosmetic solutions – from skin peels to laser treatments – which could restore your confidence and provide peace of mind.

About the Author

Dr Anny Choudhry

Dr Choudhry, also commonly known as Dr Anny, is trained in a variety of medical and surgical specialities including Dermatology and Plastic Surgery in London and East of England Deanery.

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