Hyperpigmentation is the appearance of pigmented spots on individual areas of the body or on the entire body. These spots have no health effects, but can be perceived as unaesthetic. Above all, direct sunlight should be avoided to prevent and treat hyperpigmentation.
What is hyperpigmentation?
Hyperpigmentation, also known as chloasma or melasma, occurs as patches of pigment whose color is darker than the actual skin color. The color scale can differ from brown tones to red and yellow tones. The affected areas of hyperpigmentation are flat and not palpable. In medicine, a distinction is made between different types of hyperpigmentation, in which pigment spots occur due to different causes. In hyperpigmentation, too much melanin is stored in the skin. In this case, the pigments are either produced by the body itself or supplied from the outside, e.g. by drugs or cosmetics. Often, hyperpigmentation is only temporary, so that the pigment spots fade again completely or partially after a few months or years. Hyperpigmentation is basically not a health concern.
Causes
Hyperpigmentation can have various causes and can be localized or generalized. In localized hyperpigmentation, the pigment spots occur only on specific and limited areas of the body. In generalized hyperpigmentation, the pigment spots occur all over the body. Hyperpigmentation can be triggered by pregnancy hormones, among other things. In this case, the pigment spots appear in the area of the nipples, abdomen and genitals and in many cases fade after delivery or the end of breastfeeding. Hyperpigmentation can also be caused by diseases and inflammations, as well as by the supply of pigments through medications, cosmetics or even tattoo ink. Hyperpigmentation also frequently occurs in connection with excessive natural or artificial UV radiation. Mechanical pressure or friction over a long period of time can also lead to localized hyperpigmentation. Sunlight also promotes the darkening of pigment spots that are already present.
Symptoms, complaints and signs
Hyperpigmentation involves the appearance of highly pigmented patches on the skin. These pigmentary disorders are localized and occur in one or more areas. In individual cases, the entire skin is affected by hyperpigmentation. Depending on the form, other symptoms may be added. Freckles, for example, are manifested by the fact that the pigment spots appear only on the areas exposed to sunlight. They are small, round and appear in large groups on the face, shoulders and neck. Lenticular spots are larger and darker and can appear all over the body. Hyperpigmentation is usually harmless. In most cases, only external changes occur that recede after some time or remain symptom-free. However, hyperpigmentation can be emotionally stressful for the affected person. Especially in the case of extensive skin changes, inferiority complexes, social anxiety or depressive moods repeatedly arise. The hyperpigmentation may cause further skin changes in the course of time. Thus, a permanent pigment disorder may develop in the affected skin area, which is manifested by the fact that the skin area is no longer affected by UV radiation. In general, however, hyperpigmentation is harmless and does not result in serious symptoms or discomfort.
Diagnosis and progression
Localized hyperpigmentation is noticeable as grayish-brown, reddish, or yellowish darker areas of skin. The pigmented patches are usually clearly demarcated and appear symmetrically only on individual parts of the body. If the hyperpigmentation is hormonal, the pigmentation occurs mainly on the face and neck as well as around the nipples and in the genital area. If there are already known cases of hyperpigmentation in the family, a hereditary pigment disorder is likely. The development of hyperpigmentation can vary greatly and depends on the type and severity of the disorder. Hyperpigmentation caused by pregnancy hormones subsides in two-thirds of affected individuals after the end of pregnancy or breastfeeding, and the pigment spots fade within a few weeks.In the case of hyperpigmentation supplied by the intake of pigment from medications, cosmetics or other external factors, avoiding the causative factors may cause the pigment spots to disappear after a few months.
Complications
Usually, hyperpigmentation does not cause any negative health effects to the patient. No further discomfort or pain occurs, so hyperpigmentation does not necessarily need to be treated. The spots can form either on the entire body or only in certain areas. It is usually impossible to predict if and when a particular region will be affected by the disease. Due to the high sensitivity of the skin, the affected person must avoid direct sunlight and is thereby restricted in his daily life. Not infrequently, hyperpigmentation also leads to psychological discomfort and depression. Most patients feel ashamed of the disease and suffer from inferiority complexes and lowered self-esteem. However, hyperpigmentation does not affect the health of the affected person, so the life expectancy is also not limited by this disease. In some cases, the patient also experiences spontaneous healing of the disease. As a rule, there is no treatment available. However, the symptoms of hyperpigmentation can be limited by cosmetic means. In this case, the patient may not tolerate a certain ingredient and have an allergic reaction to it.
When should one go to the doctor?
If unusual pigment spots are noticed in individual areas of the body, it may be hyperpigmentation. The spots usually do not require treatment and often disappear on their own after some time. Anyone who finds these spots to be an aesthetic blemish should consult a dermatologist. Medical clarification is also advisable in the case of any accompanying symptoms. A doctor should be consulted if the spots become inflamed or cause pain. If the skin spots increase after contact with direct sunlight, a dermatologist should also be consulted. The skin is particularly sensitive in the corresponding areas, which is why precautionary measures must be taken in any case. That is why a specialist should be consulted with the suspicion of hyperpigmentation. If the spots should cause psychological problems, the doctor can establish contact with a therapist. If there is a suspicion that the skin changes are triggered by a certain medication, a change of medication should be discussed with the doctor.
Treatment and therapy
Even if hyperpigmentation does not pose a health risk, the dark pigment spots are often perceived as unaesthetic and disturbing. To lighten the affected areas, there are various treatment options. The local application of bleaching creams or chemical peelings should be avoided, as these are very aggressive to the skin and may cause the pigment spots to become even darker or, if the dosage is too high, result in scarring. Severe hyperpigmentation can be treated with modern laser procedures that specifically destroy only the pigmented skin. Treatment with a Fraxel laser or thulium laser is the most suitable. With laser treatment, however, the risk remains that light or white spots will be left in place of the dark pigment spots. The most gentle treatment of hyperpigmentation is the use of special cosmetics that lighten and reduce pigment spots with natural agents, such as yeast extracts and vitamin derivatives, when used for a long time. The basis of any treatment of hyperpigmentation is in any case the avoidance of sun exposure of natural sun as well as the solarium. UV rays darken pigment spots very quickly and, if care is not taken, can also reverse any treatment progress already made in a short time.
Outlook and prognosis
Hyperpigmentation leads to a steady increase in the changes of the skin appearance in the course of life. Nevertheless, in normal cases there is no need for action, since from a medical point of view there is no disease of the patient. Rather, it is an optical blemish that has no effect on the physical condition of the affected person. However, if the pigmentation changes, the prognosis worsens.In these cases, there is a development of a disease for which there is a need for timely treatment and therapy. The further prospects must be assessed individually and according to the existing underlying disease. The risk of a malignant and thus potentially life-threatening disease increases the later a physician is consulted. If the hyperpigmentation causes mental or emotional stress to the affected person, the risk of side effects or the development of a secondary disease increases. Feelings of inferiority, fear, shame or withdrawal from social life may occur and contribute to a deterioration in general well-being. In severe cases, the patient is at risk of psychological disorders. Without medical care or psychotherapeutic treatment, there may be widespread problems. Although there are no physical impairments, the disease of the psyche due to hyperpigmentation can lead to severe life-impairing disorders that threaten the patient’s overall health.
Prevention
The most efficient prevention of hyperpigmentation is to avoid direct sun exposure by covering the affected areas of the body or using creams and skin care products with a sun protection factor. If hyperpigmentation has already appeared, special creams and cosmetic treatments can prevent pigmentation spots from spreading further or becoming more visible.
Aftercare
In most cases, no special aftercare measures are available to the person affected by hyperpigmentation. They are not necessary in every case, because hyperpigmentation does not always need to be treated immediately by a doctor. Nevertheless, it is advisable to consult a doctor in case of this disease, so that there are no further complaints or complications on the skin of the affected person. As a rule, the life expectancy of the affected person is not reduced or otherwise limited by this disease. In many cases, patients are dependent on psychological treatment. Children in particular often need the support of their parents to avoid psychological upsets or depression. In the case of scars, a correction can also be carried out to restore the aesthetics of the affected person. Furthermore, in case of hyperpigmentation, the patient should protect himself from direct sunlight and avoid it. When sunbathing, always use sufficient sunscreen to avoid complications. Contact with other affected persons can also be very useful in the case of hyperpigmentation, as this often leads to an exchange of information, which can make the life of the affected person easier.
What you can do yourself
As a rule, no treatment is necessary for hyperpigmentation. Self-help measures are also not absolutely necessary for this condition. However, further complications and discomfort can be prevented relatively easily. In case of hyperpigmentation, the affected person should in any case avoid direct sunlight and always wear sunscreen when in the sun. Especially children must be informed about the risks of direct sunlight. The use of various creams or ointments can soothe irritated skin. It may also prevent the formation of scars. When using cosmetic products, the patient should always make sure that the cosmetics are based on natural ingredients. When spending a long time in the sun, the patient should protect all parts of the body from the sun if possible. Hyperpigmentation can also lead to psychological complaints. In this case, informative discussions with other affected persons or with one’s own partner and family are very helpful. In severe cases, however, a therapist should be consulted, as hyperpigmentation can lead to bullying or teasing in children.
