What is hypopigmentation?
Melanocytes, the factories that produce natural pigments, are distributed at the base of the epidermis. These pigment cells release protein melanin continuously. This protein structure is carried by keratinocytes to the superficial surface of the skin, which will eventually determine one’s skin, hair, and eye colour. A dark-skinned person simply has more melanin compared to a person who is fair-skinned. While the pigmentation of the skin is usually influenced by one’s racial origin, the amount of sunlight exposure can also alter the skin pigmentation. The skin pigmentation and its response to ultraviolet (UV) rays can be classified based on the Fitzpatrick scale. Unfortunately, one’s skin pigmentation can be affected when the normal synthesis of melanin gets altered. One such skin pigmentation disorder is hypopigmentation; it is a skin disease that is marked by a distinctive loss of pigments in the skin, resulting in patches of skin that are lighter than the overall skin tone.
What are the causes of hypopigmentation?
There is a myriad of factors that could result in unsightly skin hypopigmentation. Some of them include:
- Genetics: Some patients may be born with defective genes. One such example of a congenital disorder of the skin pigmentation is albinism. Albinism occurs when the enzyme that is responsible for synthesizing melanin from the amino acid tyrosine is defective, resulting in partial or complete absence of melanin in the skin, hair, and eyes. Albino patients are characterized based on their very light-coloured skin, white hair, and eye colour, which may alter with age. Patients diagnosed with albinism are also predisposed to developing vision impairments like nystagmus (involuntary eye movement), amblyopia (lazy eye), and photophobia (abnormal intolerance to visual perception of light). Another hypopigmentation skin condition that could be due to genetic susceptibility but triggered by environmental factor is vitiligo. Patients with this disorder develop patches of skin that have lost the skin pigments. Most of these patches become white with sharp margins and may cause a great deal of psychological stress to those with the disorder.
- Skin injuries: Besides genetics, another major cause of hypopigmentation is injuries to skin. Trauma like blisters, boils, burns, pimples, scraps, infections. Improperly administered skin treatments such as chemical peels and lasers rupture the skin. Deep injuries tend to damage the melanocytes and a potentially permanent drop in the production of pigments in the damaged area.
- Specific skin disorders: Certain skin conditions like Pityriasis versicolor and Pityriasis alba are known for their white patches on the affected skin areas. The former is actually a type of fungal infection whereby white, flaky discoloured patches appear on areas that perspire heavily such as the abdomen and the back. Pityriasis alba, on the other hand, is diagnosed by the presence of ill-defined, scaly, and faintly reddish patches that will leave behind hypopigmented regions once the condition improves.
What are the treatment methods for hypopigmentation?
Fortunately, hypopigmentation can still be treated using a few methods depending on the underlying cause of loss of pigments, patients’ overall health status, and age. Most patients can notice skin improvements using the treatment methods detailed below:
- Topical corticosteroid creams: Corticosteroid agents like hydroquinone is usually applied to the skin to overcome skin inflammation. It is also used to lighten the skin thanks to the following mechanisms: initial blanching caused by vasoconstriction, reduced cellular turnover and activity of melanocytes, and reduced production of melanocyte stimulating hormone (MSH). Skin bleaching helps to camouflage the hypopigmented areas into the rest of the skin.
- Aesthetic procedures: When the hypopigmentation condition affects a large area of the skin, and the use of topical lightening creams as well as makeup is not effective, patients are encouraged to undergo aesthetic procedures like dermabrasion, chemical peel, and laser resurfacing therapy. These treatments help to blend the regions of hypopigmentation with other normally pigmented skin areas. However, it is important that only certified and skilled medical practitioners perform those procedures to avoid exacerbating the skin condition.
Patients who do experience hypopigmentation must get the skin areas checked as soon as possible for quick and effective treatment methods. They must also be taught to take better care of their skin (e.g. following a through skincare routine, applying sunscreen, etc.) so as to prevent the worsening of skin condition.