What makes the skin produce more melanin and why.
There are several causes for hyperpigmentation:
Sun damage from excessive and cumulative sun exposure
* Hormonal imbalances and pregnancy
* Genetic skin coloring and race
* Injuries and inflammation
* Certain types of disease
* Side effects of some medications
Probably the biggest factor in hyperpigmentation is chronic and cumulative sun exposure. Hyperpigmentation is a definite symptom of sun damage or dermatoheliosis, the dermatological term for skin that has suffered damage from cumulative and excessive sun exposure.
Various stages of hyperpigmentation
One of the most frequent signs of sun damage to appear is uneven skin coloring, primarily seen on the face, neck, chest and shoulders. Sun-related, dark, splotchy hyperpigmentation can affect not only the face but also the body. It can be present in any areas of the skin that have been repeatedly exposed to the sun over the years. On the body, it usually shows up first on the hands and arms.
Uneven pigment or solar mottling is often the first symptom of cumulative sun damage to appear. This can occur as early as the late teens or early 20s, but it usually appears in the late 20s or early 30s. In older skin, the skin can become mottled and almost leather-colored. This looks even worse when it is accompanied by sun induced wrinkles and rough skin texture.
Many pigmentation problems are related to hormone fluctuations and disorders, and because of that females are much more likely to have problems with hyperpigmentation. Males can certainly also have problems with hyperpigmentation, but these are primarily related to sun exposure and sun damage.
The second most frequent reason for hyperpigmentation is an imbalance of hormones that signal the melanocytes to produce more pigment. This is a common problem for women using birth control pills or other forms of hormonal therapies, and some pregnant women. Hyperpigmentation associated with hormonal influence is known as melasma. Sun exposure may make the symptoms of melasma worse, and it may be worse in women who already have significant sun damage before having hormonal imbalances. Pregnancy mask is another term for melasma, but specifically melasma that occurs in the pattern of a mask affecting the forehead, cheeks, chin, and upper lip. This pattern can be strong and distinctive or occur in only certain of these facial areas. It has been estimated that about 70% of all pregnant women have some form of melasma during pregnancy, but hormonal imbalances can cause pregnancy mask or melasma in women who are not pregnant. Rarely, it also occurs in men.
Genetic skin coloring and race
Hyperpigmentation can be hereditary. Just as skin color is genetic, tendencies for hyperpigmentation can also have a genetic connection. Dark skin types (Fitzpatrick types IV-VI) are much more likely to have problems with hyperpigmentation. This includes black skin, Asian skin, dark Hispanic skin and Middle Eastern skin tones.
Injuries and inflammation
Many skin types tend to have hyperpigmentation after a pimple, a scrape, or minor injury. This is known as post inflammatory hyperpigmentation, also known as PIH. The inflammation that has occurred in the area of the pimple or injury has triggered melanin production as an immune response. In many cases, PIH fades over time as the epidermal cells are replaced. Unfortunately, acne often tends to be chronic and may produce chronic PIH in the area of breakouts. PIH in acne-prone skin occurs frequently in skin of color.
Certain types of disease
Lack of pigment in the skin is called hypopigmentation. There are several causes for hypopigmentation:
Sun damage or dermatoheliosis can cause absence of pigment from damage to the melanocytes. This is usually mixed in with splotchy hyperpigmentation, so it appears as a small area of light skin within a speckled area of various shades of hyperpigmentation. This occurs primarily in persons who have had excessive and frequent exposure to the sun.
Tinea versicolor is a fungus that causes white spots on usually tanned skin. These light splotches are frequently seen on the backs and chests (and sometimes faces) of surfers and frequents beachgoers. The fungus inhibits the production of melanin in the areas that it is present.
Vitiligo is a chronic condition, believed by some medical scientists to be an autoimmune disease, in which the skin loses the ability to make pigment. Vitiligo may also be genetic. The disease varies in effects. Some people have small areas of pigment loss, and others have widespread loss, to the point of an entire area of the body being a lighter color due to complete pigment loss.
It can be obvious in persons of color, and sometimes depigmentation— destroying pigment in the surrounding areas with the use of depigmenting drugs may be used to even out the color.