Pigmentary disorders can be either due to increase in pigmentation (Hyperpigmentation or darker skin) or decrease in pigmentation (hypopigmentation or lighter skin). Hyperpigmentation is due to increase in melanin ( hypermelanosis) which is due to an increased number of pigment producing cells (melanocytes) or from increased production of melanin.
Hypopigmentation is due to decrease in pigment producing cells or decreased production of melanin resulting in pale patches of skin (hypopigmentation or hypomelanosis) or depigmented (white) patches.
The causes of pigmentary changes could be several such as post inflammatory, an underlying skin or systemic condition. Hormonal changes such as in pregnancy can also cause pigmentary changes.
Increased pigmentation or hyperpigmentation is usually more of a problem in pigmented skin such as Asian skin but is seen in all skin types. Treatment ususally is with topical agents using a wide range of preparations but mainly skin lightening agents used in combination such as
- Steroid based creams
- Retinoic acid based preparations
- Alpha and Beta hydroxy acids such as glycolic acids
- Azelaic acid cream
Preparations such as topical steroid creams and hydroquinone should be used under medical supervision because of the risk of side effects.
Other forms of treatments such as light treatment and Lasers (IPL), Chemical peeling and microneedling can also improve pigmentation but can also cause further inflammation and pigmentation in the skin and more so in the darker skin types.
Hypopigmentation which is post inflammatory can resolve spontaneously but can persist indefinitely if the damage was deep. Conditions like vitiligo can be treated with various treatment options but ususally the outcome is not satisfactory.
We value your feedback which also helps us to reflect and learn. At times we may call you after your treatment to check the results and to discuss any adjustments if needed.
The Abington Clinic