Hyperpigmentation is the appearance of dark spots and patches on the skin caused by the over-production of melanin, whereas hypopigmentation is skin that lacks pigment. The latter can be a genetic condition, caused by hormones, chemicals, or it can appear as a symptom of an autoimmune condition called vitiligo. It is, however, a condition that gets very little attention, even though it is a complex skin condition that can be difficult to treat.
About 2% of the population is affected with Vitiligo and it tends to run in families. While vitiligo affects people of all races, the condition is most noticeable in those with darker skin tones.
Vitiligo or hypopigmentation is not the same as albinism which is an rate, inherited disorder caused by an absence of melanin. Albinism affects the skin, hair and eyes, whereas vitiligo or hypopigmentation affects only the skin.
The most common cause of non-genetic, or non-autoimmune hypopigmentation, is due to damage or trauma to the skin. This can be from burns, skin infections, acne, blisters, scrapes or some other injury that destroys the production of pigmentation.
Improperly performed skin resurfacing treatments, such as chemical peels and Intense Pulsed Light (IPL) treatment like photofacials, and laser peels, can cause skin damage that results in hypopigmentation (called Post-inflammatory Hypopigmentation).
Hypopigmentation can also be the unintended result of damaged pigment cells from the over-use of Hydroquinone – a common topical agent prescribed to control pigment production in hyperpigmented skin. Ironically, the over-zealous treatment of hyperpigmentation with Hydroquonine can result in hypopigmentation – no pigment at all.
Some cases of hypopigmentation can be the result of seborrheic dermatitis – a skin condition that leaves the skin red, scaly, and patchy. The affected areas can become hypopigmented.
Some fungal infections of the skin, such as tinea versicolor, can result in a patchy appearance with blotches of lighter colored skin. This condition usually affects the back and chest areas and will respond well to antifungal medications.
Treatment of Hypopigmented Skin
Hypopigmentation can be difficult to treat. The condition can leave the affected person emotionally and socially traumatized.
There are topical medications and light-based procedures that may help. New lasers have been developed to repigment small areas where damaged skin has resulted in hypopigmentation. In these cases it may be that the pigmented cells have not been completely destroyed and the laser results in reactivating the production of pigmentation.
Cover up make-up solutions like MicroSkin® can provide effective, natural looking cover. According to Microskin®, the product is a “simulated second skin which is formulated individually to color correct skin conditions. It is a light liquidized application which is applied on to the epidermis (top layer of skin). Microskin is not a cream, and doesn’t have the makeup appearance like other camouflage products. Once applied, Microskin is durable, flexible, and it won’t rub off on clothing or linen. It’s waterproof and allows your skin to breathe. Microskin is suitable for all genders and skin types”. Source “Microskin, Liquid Cover up Makeup | Concealer Camouflage. Below is an example of before and after using Microskin Liquid Cover up Makeup – not just for the ladies, it’s for anyone deal with the difficult skin condition.
There has been some reported success in repigmenting small areas of hypopigmented skin by transplanting cultured melanocytes (pigment producing cells). In these cases, the skin will naturally repigment itself once the transplant has successfully taken.
Finally, medical tattooing is one approach that is effective in small areas. Skin-colored pigment is used to tattoo and disguise hypopigmented areas. This offers a permanent, long-term solution.