PIGMENTATION
What is the basic
structure of the skin and what is responsible for giving it a color ?
Skin
is the largest organ of the body. It is made up of two layers, the upper
'epidermis' and the lower 'dermis'. The epidermis and the dermis are further
divided into other layers.
The lower most layer of the epidermis is known as the basal layer and it contains organelles called 'melanosomes'. These melanosomes contain cells called melanocytes which produce a pigment called 'melanin'. The color of skin depends mainly on this melanin and the amount of melanin present in the other layers of the epidermis. The thickness of epidermis and vascularity of the epidermis are other factors affecting the color of skin.
The lower most layer of the epidermis is known as the basal layer and it contains organelles called 'melanosomes'. These melanosomes contain cells called melanocytes which produce a pigment called 'melanin'. The color of skin depends mainly on this melanin and the amount of melanin present in the other layers of the epidermis. The thickness of epidermis and vascularity of the epidermis are other factors affecting the color of skin.
What are the causes of
hypo pigmentation (decrease in skin pigmentation) ?
1.
Pityriasis alba : Hypo pigmented patch
may be seen on the face usually in young children. It is common in winter and
in those with history of atopy. It can be treated with a mild topical steroid.
2.
Pityriasis versicolor : It is a
superficial fungal infection caused by a yeast 'pityrosporum orbiculare'.
Well defined hypo or hyper pigmented lesions with fine scales are found on the chest, back, neck and sometimes on the face. It is treated with topical and oral anti fungal drugs.
Well defined hypo or hyper pigmented lesions with fine scales are found on the chest, back, neck and sometimes on the face. It is treated with topical and oral anti fungal drugs.
3.
Leprosy : It is a chronic disease
caused by 'mycobacterium leprae' and affects mainly the skin and nerves.
A hypo pigmented patch with absent or decreased sensation is seen in tuberculoid type of leprosy (good immune response) whereas in lepromatous type (low immune response) the sensations may be normal. It can be cured with the help of drugs.
A hypo pigmented patch with absent or decreased sensation is seen in tuberculoid type of leprosy (good immune response) whereas in lepromatous type (low immune response) the sensations may be normal. It can be cured with the help of drugs.
4.
Vitiligo
: This is an autoimmune diseases where de pigmented patches are seen, they may
occur any where on the body..
5.
secondary leucoderma : This occurs due
to contact with certain chemicals phenol derivatives, glue of 'bindi', rubber
slippers, plastic watch straps, photograph developing solutions or burns.
It can be treated by spot dermabrasion or skin grafting.
It can be treated by spot dermabrasion or skin grafting.
6.
Post inflammatory hypo pigmentation :
It occurs after the healing phase of certain dermatoses such as eczemas,
psoriasis, candidiasis etc.
7.
Nevus depigmentosus : It is a congenital,
well defined, hypo pigmented patch present since birth. It can be treated by
spot dermabrasion or ablation with Co2 laser followed by ultra thin skin
grafting.
What are the causes of hyper pigmentation (increase in skin
pigmentation) ?
Hyper pigmentation
may either be due to increased melanin deposition in the epidermis or dermis.
Epidermal pigmentary disorders respond well to treatment while dermal pigmentation may take a long time to lighten.
Epidermal pigmentary disorders respond well to treatment while dermal pigmentation may take a long time to lighten.
1. Melasma
: Seen as brown patches on the face, it is more commonly seen in females. It
occurs due to hormonal changes in the body. The pigmentation increases on sun
sun exposure.
2. Peri-orbital
melanosis : Also known as 'dark circles' may be
heriditary, due to stress or eye strain
3. Freckles
and Lentigenes : These are tiny black spots on the
face and are genetic in origin.
4.
Photomelanosis : This is increased
pigmentation due to sun exposure. The pigmentation occurs on exposed skin,
commonly on the face, neck and the back. The pigmentation may be patchy or as
diffused darkening of the exposed skin.
Sun burn (tan) : A condition commonly encountered in fair skinned people due to excessive sun exposure.
Sun burn (tan) : A condition commonly encountered in fair skinned people due to excessive sun exposure.
5.
Post inflammatory hyper pigmentation :
It may be seen in the following cases
·
Seen after healing has occured, like
in acne, eczemas, contact dermatitis etc.
·
Drug induced pigmentation.
·
Pigmentation due to cosmetics
especially those containing fragrance.
6.
Macular lichen amyloidosis.
7.
Nevus or 'Birth mark' : Usually seen
at birth but may also appear at a later age.
8.
Tattoo : Tattoos are pigments inserted
into the skin for decorative purpose which may at times be a part of tradition.
Usually these artificial pigments are inserted deep into the dermis which makes
them permanent and stubborn.
What is the treatment for
hyper pigmented disorders ?
Melasma, Photomelanosis and post
inflammatory hyper pigmentation can be treated with topical creams such as
hydroxy quinone, tretinoin, topical steroids ,alpha hydroxy acid creams or
azelic acid. If the patient does not improve with these medicines other
modalities should be used, which may be ;
For
more details & Consultation Feel free to contact us.
Vivekanantha Clinic Consultation Champers
at
Chennai:- 9786901830
Panruti:- 9443054168
Pondicherry:- 9865212055 (Camp)
For appointment please Call us or Mail Us
For appointment: SMS your Name -Age – Mobile Number - Problem in Single word -
date and day - Place of appointment (Eg: Rajini - 99xxxxxxx0 – Pigmentation Disorders
– 21st Oct, Sunday - Chennai ), You will receive Appointment details through
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