PIGMENTATION

WHAT IS PIGMENTATION?

Pigmentation refers to the colour of our skin. Melanin is what gives colour to our hair, eyes, and skin and is produced by a specialised type of cell known as melanocytes. The more melanin there is in our skin, the darker it will appear.

Skin with pigmentation, determined by the body's melanin production, dictates skin color. Melanocytes in the skin's epidermal layer produce two primary melanin types: eumelanin and pheomelanin. The balance and concentration of these melanin define the skin's color and overall pigmentation characteristics.

WHAT CAUSES PIGMENTATION?

Pigmentation issues arise when melanin production in the body is imbalanced. Excess melanin leads to darker skin, often due to factors like pregnancy, Addison's disease, or sun exposure. Conversely, insufficient melanin production results in lighter skin, with conditions like Vitiligo causing light skin patches. Factors Contributing as follows:
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Genetics

Our genetic makeup is responsible for the natural colour of our skin as it determines the number of melanocytes present. Furthermore, it influences how our skin will react following external triggers and stimuli, such as in the case of suffering a sunburn.
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UV exposure

Harmful UV rays cause DNA damage within skin cells, corresponding to a type of cellular injury. This stimulates melanocytes to produce more melanin in a protective response, resulting in what we recognise as a tan. Severe sun damage can also result in inflammatory changes further contributing to pigment production.
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Medications

Certain medications can also cause changes in skin pigmentation and can trigger melasma. Common medications implicated include birth control pills and thyroid medications.
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Inflammation

Our imperfect healing processes following cuts, wounds, or acne often result in overactive melanocytes producing abnormal amounts of pigment. Injured skin may appear lighter or darker than surrounding areas during the healing process. While post-inflammatory hyperpigmentation can improve over time, this process may be long-drawn and can take weeks or months to resolve without treatment.
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Hormonal changes

Fluctuations in hormone levels can predispose to, trigger, or worsen various forms of pigmentation such as melasma. This is particularly common in females going through pregnancy or menopause, although hormone-related pigment changes can occur in either gender.

TYPES OF PIGMENTATION

Each type of pigmentation can be caused by different factors. An accurate and prompt diagnosis is essential and allows for appropriate pigmentation treatments to be performed for optimal results. Some of the common types of pigmentation skin are:
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Freckles

Small, flat, brown spots clustered around sun-exposed areas on the face, arms and body.
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Solar Lentigines

Also known as sun spots, age spots, or liver spots. These are larger brown spots of increasing incidence with age.
PIH Treatment: Topical retinoids include tretinoin, adapalene, and tazarotene.

Melasma

Irregular patches of pigments often scattered along the forehead, cheeks and nose, typically influenced by hormonal changes.
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Post-inflammatory Hyperpigmentation (PIH)

Pigmentation resulting from a localised inflammatory process such as a wound, cut, or acne.

TREATMENTS

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Topical and oral medications disrupt abnormal pigment production.

Examples: hydroquinone, cysteamine, tranexamic acid

PREVENTION

These are essential before pigmentary conditions even occur.
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Ensure adequate UV protection and appropriate sun avoidance.

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Good skin hygiene practices and appropriate skin care.

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Avoid unnecessary damage to your skin, such as picking at acne.

DOES SKIN PIGMENTATION GO AWAY?

Most dark spots gradually fade away over time, although the process can be lengthy. Skin injuries often result in dark spots or patches, which diminish as the wound heals. The key to reducing hyperpigmentation on face is to avoid further skin injury, allowing the natural fading process to occur.

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