Hypopigmentation is the absence of normal amounts of melanin (the chemical that gives skin its color) caused by disease, injury, burns or other trauma to the skin. Hypopigmentation can be tricky to treat. There are topical medications that sometimes help, and light-based procedures like IPL, excimer lasers, and the Fraxel Restore laser can also be used.

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).