Changes in skin color can be frustrating, especially when you’re not sure what is causing them or how to treat them. Pigmentation disorders can make areas of skin appear darker or lighter than the surrounding skin, or completely white.
At Advanced Dermatology, P.C., our dermatologists can help identify the cause of a pigmentation change and recommend treatment based on your condition. Understanding the different types of pigmentation disorders can help you know what you may be seeing and when to have it checked.
What are pigmentation disorders?
Pigmentation disorders develop when the skin produces too much, too little or no melanin in a specific area. Melanin is the pigment that gives your skin, hair and eyes their color.
Pigmentation changes are generally described as:
- Hyperpigmentation: Skin becomes darker because there is more melanin or pigment in an area.
- Hypopigmentation: Skin becomes lighter because there is less melanin than usual.
- Depigmentation: Skin loses its pigment completely, causing the area to appear white or nearly white.
These changes can have many causes. Sun exposure, hormonal changes, inflammation, injury, medications, infections, genetics and certain skin conditions can all affect pigmentation.
Because different conditions can look alike, identifying the cause of a pigmentation change is an important first step in choosing treatment.
What causes pigmentation changes?
Several factors can affect how much pigment your skin produces or how pigment is distributed.
Common causes include:
- Sun and UV exposure: Repeated UV exposure can increase melanin production and contribute to sunspots, age spots and other forms of hyperpigmentation.
- Hormonal changes: Pregnancy, hormonal birth control and other hormonal changes can contribute to melasma.
- Inflammation or injury: Acne, eczema, cuts and other skin irritation can leave darker marks after the skin heals. This is called post-inflammatory hyperpigmentation.
- Skin conditions and infections: Some skin conditions can cause areas of skin to become darker or lighter.
- Medications: Certain medications can cause changes in skin color.
- Genetics: Some people are more likely to develop certain pigmentation disorders based on their genetics.
- Aging: Years of sun exposure and other changes in the skin can make uneven pigmentation more noticeable over time.
Treating the underlying cause may help prevent new pigmentation changes. If you’re not sure why a spot or patch has appeared, a dermatologist can help determine what is causing it.
Types of pigmentation disorders we treat
Pigmentation disorders can affect skin in different ways. Some cause isolated dark spots, while others create larger patches or areas of lighter or completely depigmented skin.
The type of pigmentation change matters because treatment depends on the cause. Advanced Dermatology, P.C. treats a range of pigmentation concerns, including:
Hyperpigmentation
Hyperpigmentation causes areas of skin to appear darker than the surrounding skin. It can have many causes, including sun exposure, hormonal changes and inflammation.
Common examples include:
- Irregular brown spots: Brown spots can have several causes. Because “brown spot” describes how an area looks rather than a specific diagnosis, new or changing spots should be evaluated by a dermatologist.
- Sunspots: Also called solar lentigines, these are flat, brown areas that commonly develop on skin with repeated sun exposure. They often appear on the face, hands, shoulders and chest.
- Age spots: These flat areas of increased pigmentation often develop on parts of the body that receive frequent sun exposure and may become more noticeable with age.
- Melasma: Melasma causes flat brown or gray-brown patches, most often on the face. Hormonal changes can contribute to melasma, while sun exposure can make it darker or more noticeable.
Hyperpigmentation can also develop after inflammation or injury, including acne or other skin irritation.
Hypopigmentation and depigmentation
Some pigmentation disorders cause areas of skin to become lighter instead of darker.
Hypopigmentation occurs when an area has less melanin than usual. Depigmentation occurs when pigment is completely lost from an area of skin.
These changes can have different causes, including certain skin conditions, infections, inflammation and autoimmune conditions. Because treatment depends on the cause, a dermatologist should evaluate persistent or unexplained light patches.
Skin discoloration
Skin discoloration is a broad term that describes a change in the usual color of the skin. It is not a specific diagnosis.
Discoloration can result from pigmentation disorders, inflammation, injury, medications, infections and other causes. If you notice a new or persistent change in your skin color and aren’t sure what is causing it, a dermatologist can help determine the next step.
When should pigmentation changes be checked?
Not every pigmentation change is a sign of a serious problem. However, some skin cancers can look like dark spots or other pigmented areas, so it is important to pay attention to changes in your skin.
You should have a new, changing or unusual pigmented spot evaluated by a dermatologist, particularly if you notice changes in its:
- A — Asymmetry: One half of the spot does not look like the other half.
- B — Border: The edges are uneven, jagged or poorly defined.
- C — Color: The spot has multiple colors or uneven coloring.
- D — Diameter: A spot may be concerning if it is larger than about 6 millimeters, although melanomas can be smaller.
- E — Evolving: The spot changes in size, shape, color or appearance.
The ABCDE guide can help you recognize possible warning signs, but it cannot diagnose skin cancer. A spot that looks different from others around it or changes over time should be checked.
The Skin Cancer Foundation provides additional information about melanoma warning signs. If a spot concerns you, don’t try to diagnose it based on appearance alone. A dermatologist can examine it and determine whether additional evaluation is needed.
How are pigmentation disorders treated?
Treatment depends on the type of pigmentation disorder, what caused it and other factors related to your skin. There is no single treatment that works for every type of pigmentation change.
Depending on the condition, treatment may include:
- Topical medications: Prescription or over-the-counter treatments may help reduce excess pigmentation or treat an underlying skin condition.
- Chemical peels: Chemical peels remove controlled layers of skin and may improve certain types of uneven pigmentation.
- Laser procedures: Laser procedures use focused energy to target specific areas of pigmentation. The type of laser and treatment approach depend on the condition and your individual needs.
- Treatment for an underlying condition: If a skin condition, infection or inflammation is causing the pigmentation change, treating that condition may be an important part of care.
- Cryotherapy: In some cases, controlled freezing may be used to treat certain pigmented spots.
Your dermatologist can recommend an approach based on the cause and type of pigmentation change.
Can sun protection help?
Sun protection is an important part of managing many pigmentation disorders. UV exposure can worsen existing discoloration and contribute to new pigmentation changes.
Helpful habits include:
- Apply a broad-spectrum sunscreen with SPF 30 or higher.
- Reapply sunscreen as directed, especially when spending time outdoors.
- Seek shade and wear protective clothing when possible.
- Avoid picking at acne or irritating your skin.
- Use gentle skin care products if your skin is sensitive or prone to discoloration.
- Treat inflammatory skin conditions as recommended by your dermatologist.
For some types of hyperpigmentation, including melasma, visible light can also contribute to discoloration. Your dermatologist can recommend the type of sun protection that is appropriate for your skin and condition.
The American Academy of Dermatology recommends determining the cause of dark spots before choosing treatment. Some treatments can cause irritation or additional changes in pigmentation when used incorrectly, so an accurate diagnosis is important.
Frequently asked questions
Can hyperpigmentation be fully treated?
Hyperpigmentation can often be improved, but results depend on its cause, type and depth. Some dark spots fade on their own, while others may need treatment with topical medications, chemical peels, laser procedures or other approaches.
New pigmentation can also develop after treatment, particularly if the underlying cause continues. Your dermatologist can help set realistic expectations and create a treatment plan based on your skin and the cause of the discoloration.
What is the difference between melasma and sunspots?
Melasma and sunspots both cause darker areas of skin, but they have different patterns and causes.
Melasma often appears as larger, symmetrical patches on the face and can be influenced by hormonal changes and sun exposure. Sunspots are usually smaller, flat brown spots that develop after repeated sun exposure.
Because different pigmentation conditions can look alike, a dermatologist can help determine which one you have before treatment begins.
Are dark spots a sign of skin cancer?
Most dark spots are harmless, but some skin cancers can resemble pigmented spots. A spot that is new, changing or unusual should be evaluated by a dermatologist.
The ABCDE guide can help you recognize possible warning signs, but it should not be used to diagnose skin cancer. If a spot looks different from the others around it or changes over time, have it checked.
Why do some areas of skin become lighter?
Light patches can develop when the skin produces less melanin or loses pigment. Causes can include certain skin conditions, infections, inflammation, medications and autoimmune conditions.
Because many conditions can cause lighter skin, a dermatologist can help determine the cause and recommend appropriate treatment.
How can I prevent pigmentation problems?
You may be able to reduce some pigmentation changes by protecting your skin from the sun and avoiding unnecessary irritation.
Helpful habits include:
- Apply a broad-spectrum sunscreen with SPF 30 or higher
- Reapply sunscreen as directed, especially when spending time outdoors
- Seek shade and wear protective clothing when possible
- Avoid picking at acne or irritating your skin
- Use gentle skin care products if your skin is sensitive or prone to discoloration
- Treat inflammatory skin conditions as recommended by your dermatologist
These steps can help protect your skin, but they cannot prevent every type of pigmentation disorder.
Get help for changes in skin pigmentation
When you’re not sure why your skin has become darker, lighter or uneven in color, it can be difficult to know what to do next. A dermatologist can help identify the cause and guide you toward the right treatment.
At Advanced Dermatology, P.C., our dermatologists can evaluate pigmentation changes and recommend care based on your condition.
With 40+ locations conveniently located throughout New York and New Jersey, finding a dermatologist near you is easy. Schedule an appointment today.