Darkening of skin is a relatively common problem. It is usually harmless, but for cosmetic reasons, it is a nuisance to those who have it. Here we discuss some common causes of hyperpigmentation.
The skin gets its color from a pigment known as melanin. Increased production of melanin leads to darkening of the skin, known as hyperpigmentation. The melanin pigmented is produced by skin cells called as melanocytes. There can be some genetic or acquired conditions that increase the activity or number of melanocytes, thus causing hyperpigmentation.
Sun exposure
Sun exposure is the commonest cause of hyperpigmentation. When skin is exposed to sunlight, melanin production gets stimulated and tanning occurs. This is a natural respose of the body to prevent sunburn and damage of skin by harmful ultraviolet rays of sun. But excessive sun exposure can lead to hyperpigmentation. It is the single most important cause that needs to be addressed to get rid of hyperpigmentation.
Hormonal causes
Hormonal influences are the main cause of a particular kind of hyperpigmentation known as melasma or chloasma. Such pigmentation is particularly common among women of childbearing age. Here, usually a patchy pigmentation on face is triggered by hormonal changes in females during pregnancy or with uptake of oral contraceptive pills. Such pigmentation is thought to occur when the female sex hormones (oestrogen and progesterone) stimulate the overproduction of melanin on the skin exposed to the sun. Apart from this, some other underlying hormonal problems like polycystic ovaries, ovarian cancers, or thyroid disorders causing melasma.
Post inflammatory pigmentation
This type of pigmentation occurs as a result of resolution of skin injury. The skin injury can be due to damage after trauma, burn, infection, acne, allergic disorder, or any skin cosmetic procedure. Such pigmentation is more frequent in patients with darker skin types. It usually presents as irregular, darkly pigmented spots arising in areas of previous inflammation. Such lesions gradually improve with time if patient observes sun protective behaviour and uses sunscreens on regular basis.
Nutritional causes
Pigmentary changes in undernourished people are usually due to deficiency of iron, vitamin B12, folic acid, nicotinic acid, and vitamin C. A balanced diet rich in fruits and green vegetables replenishes vitamins, minerals and antioxidants. Studies have shown consumption of such diet has a defenite skin lightening effect.
Cosmetic induced pigmentation
Preservatives present in cosmetics and perfumes usually induce pigmentation around forehead, temples and under arms. Such pigmentation is bluish grey in colour. In such case any skin product causing itching, redness or burning sensation should be discontinued. And, also all cosmetics with multiple preservatives, fragrances and deep colours should be avoided.
Bindi, henna and kumkum may also induce photo contact dermatitis that results in hyperpigmentation.
Chronic illness
Chronic illness such as renal failure, cancer or liver cirrhosis lead to physical and mental stress. Such illnesses cause nutritional deficiency of vitamins and minerals and, thus, can lead to hyperpigmentation. Some chronic endocrine disorders effecting adrenals may increase melanin production causing generalised hyperpigmentation. Insulin resistance may cause hyperpigmenation at skin folds as neck and axilla.
Drugs induced Hyperpigmenation
Some medicines that are prescribed for treatment of depression, psychosis, seizures, cancer, malaria can also be the cause. Anti-seizure drugs as phenytoin, antifungal as griseofulvin and even some painkillers can cause hyperpigmented patches on face.
For successful treatment of hyperpigmentation, all these should be diagnosed and addressed. In our subsequent posts, we would discuss the treatment of hyperpigmentation.
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Dr Monika Misra
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