Skin Pigment Disorders

What are skin pigment disorders?

Skin color is determined by a pigment (melanin) made by specialized cells in the skin (melanocytes). The amount and type of melanin determines a person's skin color.

What is the function of melanin?

Melanin's role is to protect DNA in body cells from sun damage. It gives color to the skin, hair, and irises of the eyes. Levels of melanin depend on race and amount of sunlight exposure. Sun exposure increases melanin production to protect the skin against harmful UV (ultraviolet) rays. In addition, hormone changes can affect melanin production.

What are the different types of skin pigment disorders?

Pigment disorder

Characteristics

Treatment

Albinism

This is a rare, inherited disorder. It reduces the amount of melanin pigment in the skin, hair, and eyes. People with albinism (albinos) have white hair, pale skin, and pink or blue eyes. Their eyes may seem red in different lighting conditions. Many also have vision problems.

There is no cure for albinism. People with this condition should avoid sun damage to the skin and eyes by wearing sunscreen, hats, and sunglasses.

Melasma

This causes dark brown to gray-brown, symmetric patches of pigment on the face. During pregnancy, this is called the mask of pregnancy. Sun exposure, hormones, and birth control pills are thought to cause melasma.

Sunscreens and avoiding sun exposure can prevent melasma from getting worse. Other treatment may include prescription creams containing hydroquinone and tretinoin to lighten the patches.

Chemical peels and laser treatment can also be used.

Pigment loss after skin damage

Sometimes after an ulcer, blister, burn, or infection, the skin does not replace some of the pigment in that area.

No treatment is needed. Makeup can usually cover the blemish.

Vitiligo

This causes smooth, white patches on the skin. It is caused by the loss of pigment-producing cells in the skin (melanocytes). It's thought to be an autoimmune disease. The white patches are very sensitive to the sun.

Treatment may include covering smaller patches with makeup or long-lasting dyes, light-sensitive medicines, UV light therapy, corticosteroid creams, surgery, and removing the remaining pigment from the skin (depigmentation) so that white areas are less obvious. A prescription skin cream for vitiligo called ruxolitinib was FDA approved in July 2022.

Solar lentigo

Commonly known as age spots or liver spots, these areas vary from light to dark brown. Age spots are caused by long-term sun exposure. They are found on areas of greatest sun exposure, like the face, forearms, and backs of the hands.

Treatment may include skin creams or procedures like chemical peels or laser therapy.