Hypopigmentation refers to the loss of skin colour. It is very notable as these patches of skin tend to be lighter than your actual skin tone.
Your skin tone depends on the production of melanin. When your skin's pigment cells do not produce a sufficient amount of melanin, your skin will be lighter. Likewise, if more melanin is produced, your skin gets darker.
In fact, hypopigmentation can occur as patches or cover the entire body. It can also occur at birth or develop later in life.
Firstly, what are the types?
There are a few types and it depends on the underlying problem. To list, here are 4 common conditions:
Vitiligo
It is one of the most common and distressing conditions of hypopigmentation. This condition occurs in patches, and several causes may be contributory [1].
It may occur over the entire body — arms, face, mouth as well as hair! Possible causes include:
- An autoimmune disease harming cells that produce melanin
- Abnormal nerve cells producing toxic substances that end up attacking melanocytes. Melanocytes are the cells that produce melanin. Melanin gives you the skin tone that you currently have!
- Melanocytes destroying themselves
Pityriasis alba
It refers to the leftover white spots that are slightly raised on the face. Apart from that, it occurs more in kids with darker skin tone [2]. In some cases, these spots are from previous instances of red and scaly skin spots.
Thankfully, this condition tends to heal by itself, especially if exposure to the sun is avoided. It is best likened to mild skin inflammation. Also, it is seen in children with atopic eczema who have recently been out in the sun excessively, usually due to sporting activity [3][4].
Tinea versicolor
We all have yeast living on our skin. But, if it grows out of control, one can get tinea versicolor [5]!
Yeast is a type of fungus that grows even more in hot and humid weather [6]. Hence, those who live in tropical areas are more prone. Also, if you sweat excessively or have oily skin, you are also more prone to this condition [7]!
Post-inflammatory hypopigmentation (PIH)
When the skin gets inflamed, its melanocytes may be damaged and are not able to produce the melanin that gives the skin its normal colour.
Usually, only very intense skin inflammation tends to cause hypopigmentation as sequelae. It means that the conditions are the consequence of a previous disease or injury. To list, the conditions that may cause hypopigmentation include but are not limited to:
- Burns
- Liquid nitrogen treatment
- Deep blisters
- Infections
- Wounds
- Etc
Moreover, hypopigmentation may also develop following complications of cosmetic skin treatments. For example, treatments such as lasers and chemical peels [8].
So, what can I do to tackle this?
As there are many types of hypopigmentation, certain methods are more suitable for certain conditions. A majority of sufferers do not seek treatment unless it affects their quality of life. Apart from that, your treatment options also rely on:
- Age
- Area of coverage
- Overall skin health
Type:
Effective treatments that are often advised:
Vitiligo
- Topical steroids and calcineurin inhibitors
- Pigment-stimulating light therapy
- Non-cultured cellular grafting
Pityriasis alba
- Avoid too much sun exposure
- Moisturisers
- Mild topical steroids as well as calcineurin inhibitors
Tinea versicolor
- Topical or oral antifungal medications
Post-inflammatory hyperpigmentation (PIH)
- Treating ongoing inflammation effectively
- Avoiding further skin inflammation and injury to the skin
- Waiting patiently for skin colour to return on its own
- Pigment-stimulating light therapy
**
Creams**
If there is ongoing inflammation that plays a part in the hypopigmentation, you may ask your doctor for an anti-inflammatory cream. Examples of these creams are topical steroid and topical calcineurin inhibitor. It helps to reduce the skin inflammation so the skin can return to its original tone more quickly.
In fact, treatment is more effective if used early [9]. Also, the use of moisturisers often helps to reduce inflammation and prevents relapses.
Laser and light treatments
As per the American Academy of Dermatology Association, light treatments can help restore colour to the skin [10]. While it is more effective when applied to the skin around the head, it's less so for the skin on the hands and feet [11].
Some examples of these treatments include:
- Fraxel laser
- Excimer laser
- Intense Pulsed Light (IPL)
Because of the many types of treatments available, be sure to consult a doctor. Thus, it will help you to know treatment is more suitable for your condition.
Medication
Antifungal medication can either taken orally or applied topically. This will help those with tinea versicolor [12].
All in all
To sum up, those are the ways to help you reduce the white patches on your skin. However, different treatments tend to work better on different types of hypopigmentation.
Thus, it's best that you consult a doctor on the suitable treatments for your condition.
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Dr Chin Yee Choong is a medical director at DermClear Aesthetic & Laser Clinic. His area of practice is in the beauty aesthetics fields of dermatology and aesthetic medicine. In addition, he has had more than 12 years of experience in thread lifts and fillers. Also, he regularly travels to keep himself well-informed of the newest treatments available.
Would you like to ask any related health questions?
Also, read more from Dr Chin Yee Choong in his Q&A here.
Read more: 8 Dermatologist Clinics in Singapore for Your Skin Concerns (2020)