Hyperpigmentation is a very common dermatologic disorder wherein the skin denotes its darkened areas as a result of increased melanin production within specific areas. Such conditions include age spots, melasma, and postinflammatory hyperpigmentation. Age spots, or sun spots, develop on those areas of skin that are mostly exposed to ultraviolet rays for a prolonged time, as in the case of the face and hands. Melasma is characterized by more massive and darker spots, frequently found on the face and usually caused by hormonal fluctuations such as in pregnancy or while on birth control pills. PIH stains develop following skin trauma or other disorders, such as acne, which result in the area around the injured skin darkening. The pathogenesis of hyperpigmentation includes increased production of melanin as a result of triggering by ultraviolet radiation, hormonal influence, use of some drugs, and skin injuries.
Sun exposure increases melanocyte production of melanin as a protective mechanism and can cause pigmentation unevenness. Hormonal influences, particularly estrogen-hormonal, may intensify melanin production and, with time, lead to conditions such as melasma. Together with this, inflammatory skin changes or injury may increase melanin production during healing, resulting in PIH. The management of hyperpigmentation involves inhibition of melanin production and promotion turnover in pigmented skin cells. Hydroquinone, retinoids, vitamin C, and azelaic acid represent some of the most commonly prescribed topical agents used for their skin-lightening effects. More recalcitrant cases may sometimes require procedural interventions such as chemical peels, laser therapy, or microdermabrasion. Prevention is important, aggressive sun protection using broad-spectrum sunscreens, and detailed lifestyle changes.
Comments