Facial skin pigmentation is a very common problem that Indians face and, believe it or not, it can have a considerable psychological impact. But you should know about the types of pigmentation and how to solve them.
Causes of skin pigmentation
Some of the most common causes of pigmentation on the face are conditions like melasma, freckles, lentigines, Riehl’s melanosis, Ashy’s dermatitis, and more. These can cause light brown to dark brown and even gray or bluish discoloration.
Its treatment requires clinical expertise and also skin biopsy in some cases to accurately diagnose the clinical condition causing the pigmentation.
Another common cause of pigmented spots on the face in India is freckles. These are seen as small light brown spots on areas exposed to the sun. Sun exposure and genetics are the two main causes.
Lentiges are also small brown spots that appear in areas exposed to the sun, but are usually darker in color.
Acanthosis nigricans is also an extremely common cause of pigmentation on the face and neck. It is characterized by dark skin, velvety and thickened in the folds of the face and body. It is usually a symptom of obesity, diabetes, nutritional deficiency and, in some cases, even tumors.
Different types of pigmentation
Melasma, the most common cause of pigmentation in India, has been classified as epidermal, dermal, and dermal-epidermal, depending on the depth of pigmentation. In the epidermal type, the pigment is brown while in the dermal type, the pigment is grayish-brown.
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After identifying the type of pigment, the treatment plan is formulated. UV rays, hormonal changes, thyroid disorders, oral contraceptives, genetic history, pregnancy and oral medications like phenytoin, griseofulvin, NSAIDs are some of the common causes of melasma.
The diagnosis of pigmented patches on the face is challenging as most of these conditions have overlapping clinical features.
How to treat skin pigmentation?
The most important part of treating these clinical entities is the removal of triggering factors, rigorous photoprotection and pigment reduction.
Photoprotection in the form of sunscreen, both topical and oral; wearing a hat or umbrella outdoors, and wearing sunglasses is of paramount importance.
Lifestyle modifications, such as avoiding outdoor activities between 11 am and 4 pm, can be helpful.
Topical skin lightening agents after correct diagnosis can be started.
Some of the skin lightening agents are azelaic acid, hydroquinone, glycolic acid, lactic acid, mandelic acid, alpha arbutin, licorice extract and kojic acid. They must be used together with sunscreens. If you experience redness and irritation, talk to your doctor.