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  5. What Is Hypopigmentation And How To Treat It

Do you have patches on your skin that are a tone lighter than your normal skin tone? Hypopigmentation might be the underlying reason.

Hypopigmentation is a common skin condition, however, most of the times the causes are not serious and it is easily curable. But, it’s important to identify its root causes before seeking any treatment.

Let’s take a closer look at what causes hypopigmentation, how is this condition diagnosed, and what are the different treatment options available.

What Is Hypopigmentation?

Hypopigmentation is the decrease in the amount of melanin in the skin. The natural coloration of your skin is due to the presence of the pigment known as melanin. Melanin is produced by specialised cells called melanocytes present in the epidermis layer of the skin. [1] Loss of melanin in a particular area of your skin results in patches that are lighter or whiter than your basal skin tone. Hypopigmentation marks are particularly prominent among people who have darker skin, however, it affects fair skinned people as well.

Hypopigmentation may be localised or generalised. [2]

1. Localised hypopigmentation

This results in the formation of patches of lighter skin, of varying shapes and sizes, localised in one or multiple areas on the body. Localised hypopigmentation may be caused by partial or total loss of melanin. It is also known as leucoderma or achromoderma. You can get this form of hypopigmentation either by birth or you can acquire it during your lifetime. A few medical conditions that may result in localised hypopigmentation are:

1. Halo naevus (a mole with a ring or halo of white skin around it)

2. Vitiligo

3. Pityriasis

4. Idiopathic guttate hypomelanosis

5. Macular hypomelanosis

6. Post inflammatory hypopigmentation or scarring

7. Lichen sclerosus

8. Leprosy

2. Generalised hypopigmentation

Also known as diffused hypopigmentation, generalised hypopigmentation affects the entire body. You may have generalised hypopigmentation due to your genetic makeup or due to medical conditions such as albinism. Malfunctioning of the pituitary gland may lead to the reduction in the melanocyte stimulating hormone (MSH) which results in a rare form of acquired generalised hypopigmentation.

generation of melanin

Does Hypopigmentation Go Away On Its Own?

Post inflammatory hypopigmentation, that is loss of coloration due to scarring usually goes away on its own. But it can take anywhere between a few weeks to a few months to disappear completely depending on the extent of the scar.

Congenital hypopigmentation such as vitiligo or albilinism does not go on its own. If your white patches are a result of bacterial or fungal infection, they will not disappear till you have the infection.

What Causes Hypopigmentation?

Hypopigmentation due to decrease in melanin can be driven by repression of melanin production or decrease in the melanocytes itself. A few common causes of hypopigmentation include:

  • Normal aging leading to the movement of melanin to the upper layers of the skin.
  • Environmental factors such as sunlight, other stresses to the skin.
  • Injury or trauma to the skin such as cuts, burns, blisters, etc.
  • Nutritional deficiency of vitamin B12, copper or iron.
  • Bacterial or fungal infections as in macular acne or pityriasis versicolor respectively.
  • Usage of cosmetic products containing lead or bleaching agents.
  • Certain medications such as imatinib mesylate may result in hypopigmentation.[3]
  • Post inflammatory hypopigmentation -

    This form of hypopigmentation is followed by a previous skin problem, such as the following:

    (i) Inflammatory skin diseases like atopic dermatitis, lichen striatus, etc.

    (ii) Previous infections like Herpes zoster, syphilis, etc.

    (iii) Procedures such as dermabrasion, cryotherapy, etc. can also sometimes lead to hypopigmentation. [4]

  • In very rare cases hypopigmentation may be associated with certain forms of cancers.

How To Diagnose Hypopigmentation?

The first step to diagnosing hypopigmentation is physical examination of the lighter patches on the skin. Your doctor may perform a Wood’s lamp examination to determine the specific type of hypopigmentation. You may also undergo a dermatoscopy in which a skin surface microscope is used to evaluate the pigment abnormalities of your skin if any.

The doctor may further ask you to go for a skin biopsy if leprosy, sarcoidosis or other malignancies are suspected. Skin scrapings are used for detection of fungal infections such as Tinea versicolor.

Your age, race and family history will also be considered by your healthcare professional for an assessment of your skin condition. Genetics play an important role in conditions such as vitiligo, which sometimes run in families. [5]

How To Treat Hypopigmentation?

Treatment of your hypopigmentation will depend on the underlying cause therefore a correct diagnosis of your condition is essentially the first step towards its treatment. Most post inflammatory hypopigmentations usually resolve by themselves but it may take some time. Controlled exposure to sunlight may help in production of melanin, which evens out the skin tone.

For hypopigmentation resulting from rashes you have to make sure to treat the infections that have caused the rashes in the first place. For fungal or bacterial infections, appropriate antifungal or antibiotic medications will be prescribed by your doctor.

1. Topical Creams

A. Topical steroids may be prescribed by your doctor to reduce discoloration or to add color to the lighter skin. In some cases a moisturising lotion may be used when there is dryness and irritation along with hypopigmentation.

B. A topical formulation with coal tar has been recorded to help vitiligo patients when used daily. It has to be prescribed by a certified healthcare professional though.

C. You can try a hydroquinone containing gel for evening out skin discoloration.

2. Cosmetic Procedures

A. Laser treatment might be effective in removing hypopigmentation due to scars. A combination of psoralen and light therapy is sometimes effective in treating vitiligo patients. Psoralen should be avoided by small children and pregnant women.

B. Fractionated resurfacing can help smoothening the complexion in patients with a mix of hypo-and hyperpigmentation due to sun damage.

C. Skin grafting can be used in patients who have discoloration due to severe burns.

3. Home Remedies

A.Make a paste of 5 teaspoons of turmeric in sufficient quantity of mustard oil and apply on the affected area twice daily. This might take upto a year to show any visible results.

B. Ginger juice, especially the roots of ginger are effective in treating hypopigmentation. Grate some ginger or its roots and rub it on your scars with hypopigmentation. Do this twice daily for best results.

C. You can mix powdered bakuchi seeds in coconut oil and apply on you hypopigmented patches to make them fade away over time.

white men with hypopigmentation

Risks Associated With Hypopigmentation

Most cases of hypopigmentation are harmless and subside by their own over time. But in rare cases hypopigmentation may be associated with skin cancers especially in patients with albinism. Avoiding direct sunlight and using high spf sunscreen can help protect from the detrimental effects of sunrays.

Certain forms of hypopigmentation can indicate the presence of a systemic disorder. For example the appearance of ash-leaf spots on the body are often the first indicators of tuberculosis sclerosis in infants which requires immediate medical attention. [6]

Last but not the least the uneven skin coloration and white patches affects the looks of a person. This often causes mental stress and anxiety, and sometimes even social stigma against the person having hypopigmented skin lesions.

Tips To Prevent Hypopigmentation

  • Certain forms of hypopigmentation such as vitiligo, albinism etc. are congenital (acquired by birth) therefore cannot be prevented. Avoiding direct exposure to sunlight will prevent worsening the skin condition.
  • For hypopigmentations resulting from infections care should be taken to avoid possible reinfection. You should complete the full antibiotic or antifungal course to avoid resistance to the medications.

How Long Does Hypopigmentation Resulting As A Side Effect Of Treatment Last?

Certain cosmetic treatments such as laser therapy may result in hypopigmentation patches especially in people with darker skin tones. Normally such patches appear within a few weeks of the treatment and may stay up to a few months. In extremely rare cases such patches may become permanent. [7]

Wrapping Up

Hypopigmentation is mostly harmless and most forms of skin discolorations go away by themselves over a certain period of time. But, the uneven skin coloration may be a reason for psychological stress in some people, who therefore opt for different treatment strategies to get a more even complexion. However you should discuss thoroughly with your doctor and understand the pros and cons of a certain treatment option before starting. In rare cases hypopigmentation may be the foreteller of serious diseases which may require immediate medical attention.

Begin By Knowing Your Skin

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