Our skin is made of three layers- the upper ‘epidermis’, middle ‘dermis’ and lower ‘subcutis’. The color of our skin is predominantly determined by the pigment ‘melanin’ which is produced by certain cells called ‘melanocytes’ present in the epidermis. In simple terms, ‘hyperpigmentation’ means increased darkening of the skin. It occurs either due to an increase in melanin or in the number of melanocytes in the skin.

Hyperpigmentation is a very common disorder.It could be an aesthetic embarrassment for those who endure from it.Some of the common pigmentary disorders are-

 

Melasma

 

It is one of the most common causes of pigmentation on the face, often seen in females. Rarely it can affect males also.
 

What melasma looks like?

It presents as symmetrical brown patches over the cheeks, forehead, chin, upper lip, and bridge of the nose.
The exact cause of melasma is unknown. Patients with a family history of melasma are more likely to have melasma. Several studies have reported that both Ultraviolet A rays from the sun as well as visible light from light sources (eg light bulb, laptops) can increase melasma. Hormonal factors (pregnancy, thyroid disorders, endocrine dysfunction), drugs (phenytoin, oral contraceptive pills) and certain toxic ingredients in cosmetics and fragrances are other known risk factors. Melasma is not associated with any systemic disease or organ dysfunction.
 

How is it treated?
 

Melasma often fades over several months after you stop taking hormonal medicines or pregnancy ends.  However in a majority, it is a stubborn pigmentation that often recurs and needs multiple sessions of treatments.

 

How can the results be maintained?
 

Once the pigmentation has cleared, a maintenance treatment with sunscreens and skin lightening products must be continued to avoid recurrences. Maintenance sessions once every two to three months are advised in stubborn cases of melasma.
 

Can melasma be prevented?
 

Using sunscreen everyday helps prevent melasma. Sun-protection is the most important step to be followed. A skin that’s previously dark and pigmented, darkens even more when exposed to sunlight and hence needs to be protected.

Patients with melasma are recommended to use broad-spectrum sunscreens, with a sun protection factor (SPF) of 50 or higher, each day, whether it is sunny outside or not, or if you are indoors or outdoors. This is because you are exposed to significant amount of ultraviolet rays while driving your car, walking down the street and even while you are working on your laptops.

 

What is a lentigo?
 

A lentigo (plural: lentigenes) is a spot on the skin that is darker (usually brown) than the surrounding skin. Lentigines are more common among those with fair skin, but can occur in anyone. Lentigenes most often appear on parts of the body that get the most sun, including the face and hands.
 

What are the causes of lentigenes?
 

Sun exposure seems to be the major cause of lentigenes. Some lentigenes might be caused by genetics (family history) or by medical procedures such as radiation therapy.
 

What are freckles?
 

Freckles are small brown spots usually on the face and arms. Freckles are extremely common and are not a health threat. They are more often seen in the summer, especially among lighter-skinned people. However, freckles can occur in anyone, and appear as darker brown spots in people with darker skin.
 

What causes freckles?
 

Causes of freckles include genetics, diseases (such as xeroderma pigmentosum, a rare disease that causes an increased sensitivity to ultraviolet light, such as the sun), and exposure to the sun.
 

What is the treatment for freckles and lentigenes?
 

Since freckles are almost always harmless, there really is no need to treat them. As with many skin conditions, it’s best to avoid the sun as much as possible, or use a sunscreen.
Topical depigmenting creams, radiofrequency surgery, chemical peels and pigment lasers help in treating freckles.

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