The color of a person’s skin is is known as the skin pigmentation. When someone is in good health, the skin appears normal, but often after injury or illness, the person’s skin tone may change color, becoming either darker or lighter. Hyperpigmentation is the darkening of skin caused by the melancoyte cells producing increased quantities of melanin. Dark skin pigmentation is often seen in pregnancy (the ‘mask of pregnancy) and in Addison’s disease where a slowing of the adrenal gland may create greater production of melanin. Exposing the skin to sunlight to produce a tan can heighten any already darkened skin patches where melanin production is high. A number of antibiotic, antiarrhythmic and antimalarial drugs can also increase coloration in skin pigmentation. At the other end of the scale, lightened skin pigmentation is produced by a loss of melanocyte cell activity and a decrease in melanin production.
Small white patches, moles, age spots and changes in complexion appear in human skin as a frequent consequence of aging and exposure to sunlight. While most small skin blemishes are natural, moles that spread and have irregular boundaries must be carefully monitored as these can be attributed to malfunctioning melanocyte cells causing melanoma. Age spots, scarring and similar skin pigmentation changes are best dealt with by prevention rather than cure. Use sunscreen to protect the skin surface and minimize tanning. Hide imperfections with cosmetics to lessen the appearance of white patches. Limited areas of white patchiness can be concealed with self-tanning products to add color to the white patches. The coloring doesn’t wash away and gradually fades as dead skin cells fall away.
Skin pigmentation disorders arising out of hypopigmentation, or the reduction of melanin causing skin whitening cover a wide spectrum of known problems. Albinism is perhaps the most extreme sign of malfunction. This is an inherited disorder reflecting the complete absence of the enzyme producing melanin. It results in a total lack of skin pigmentation as well as pigmentation of hair and eyes. Albinos have an abnormal gene constraining the body from melanin production. Albinos are required to use sunscreen at all times because exposure is far more likely to cause damage and skin cancers.
Vitiligo is evident when white, milky smooth patches begin to appear on the skin. The patches can be in small areas or extend across the body. Other signs of vitiligo are premature whitening or graying of the hair, eyelashes, eyebrows and beard, whitening of the eye’s retina and loss of color in the mucus membrane of the interior of the mouth. Skin pigmentation that reflects a loss of color for the vitiligo sufferer takes several formats: focal, when the loss is limited to one or a few areas of the body; segmental if restricted to one area of the body; generalized, where pigment loss is widespread across many areas of the body.
Vitiligo can affect both sexes equally and all races suffer skin pigmentation disorders. Albinism is rare, affecting only one in 17,000 people. Other disorders such as the blemishes of age spots are very, very common. Simple visual examination by a physician can determine the type of disorder and the doctor may well go on to order blood and eye examinations too. There is no treatment for Albinism except to keep covered with sunscreen and clothing to lessen chances of developing melanoma. Vitiligo patients, however, can be prescribed a combination of photo-sensitive medications such as psoralen combined with ultraviolet light therapy. Where skin pigmentation loss covers a large area of the body, the patient may also be offered total depigmentation therapy using skin bleaching agents like monobenzone which tones down color in areas of normal skin pigmentation to match the areas of vitiligo.
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