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Melanin is the substance that gives skin its color, or pigment. When the skin cells that produce melanin (melanocytes) reduce their production, the resulting condition is known as hypopigmentation (loss of skin color). Hypopigmentation is also known as skin depigmentation.
Hypopigmentation causes
The most common cause of hypopigmentation is damage or trauma to the skin. Burns, infections, pimples, blisters, scrapes, and any injuries that result in scarring can all lead to skin discoloration.
Improperly administered skin resurfacing treatments, such as Photofacials (IPL), laser peels, or chemical peels, can cause skin damage that results in hypopigmentation.
Post inflammatory hypopigmentation
In situations where hypopigmentation is the result of skin inflammation or damage, the condition may be referred to as post-inflammatory hypopigmentation, or PIH.
This can get confusing because PIH is also used to refer to post-inflammatory hyperpigmentation, a skin condition where pigmentation is increased, not decreased.
Other hypopigmentation causes
Some chronic skin disorders can also cause hyperpigmentation, such as the following:
- Albinism - characterized by colorless skin, hair, and eyes that occurs because skin cells produce little or no melanin
- Vitiligo - characterized by patchy loss of skin color that occurs when skin cells that produce melanin die or stop production for no known reason
- Seborrheic dermatitis - an inflammatory skin disease characterized by red, scaly, itchy patches of skin in areas prone to oiliness
- Tinea versicolor - caused by fungal (yeast) infection and characterized by scaly, itchy patches of lighter or pinkish skin
- Pityriasis alba - most commonly affects children and is characterized by colorless, scaly skin patches
Hypopigmentation treatment
Hypopigmentation treatment options are often limited. Treating post-inflammatory hypopigmentation may involve the use of topical corticosteroids or tars (topical cream), light or laser treatment, or surgical skin grafting.
Although the numerous lasers and other light-based treatments available today are often perceived as a cosmetic cure-alls, IPL, excimer lasers, and the Fraxel Restore laser are the only light-based procedures that have been suggested by the doctors on RealSelf for hypopigmentation treatment.
If a chronic skin disorder is causing hypopigmentation, then treatment will likely involve topical prescription medications. For hypopigmentation that is unresponsive to medications, camouflaging with cosmetic tattooing or permanent makeup may be the best option.
For patients who experience extreme hypopigmentation on over half of their body (a rare occurrence of vitiligo), overall depigmentation is an option.
Topical medications, such as hydroquinone, TriLuma, and other skin lightening agents, may be used to bleach skin not affected by hypopigmentation so that it can blend in better with hypopigmented skin (think the late, great Michael Jackson).
Preventing hypopigmentation
The causes of hypopigmentation are difficult to avoid. Most people always try to avoid skin trauma or injury instinctively. And there's not much you can do to avoid the onset of a chronic skin disease that occurs as a result of heredity or other unknown causes. However, a few simple precautions can help prevent hypopigmentation.
- Take care of your skin - Be mindful that abusing your skin or failing to properly cleanse, exfoliate, moisturize and generally care for your skin won't help any skin condition, including hypopigmentation.
- Help healing skin - After your skin has been damaged and begun the natural healing process, it is more susceptible to developing hypopigmentation. Protect healing skin from the sun, don't pick scabs, and use antibiotic ointment to promote the skin's natural repair process.
- If you have acne, treat it - Acne can cause scars and pigmentation problems as well as self-esteem problems if left unchecked, so see a dermatologist if you notice the affects of your acne lingering.
- Choose a doctor wisely - The skin is delicate, and improperly administered skin treatments involving lasers, chemicals, or other forms of ablation (removal of the outer layers of skin), can have devastating results. Make sure you trust your doctor, check out their credentials, certification, and before and after photos, and discuss all potential risks before undergoing skin treatment.