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Hyperpigmentation

February 15, 2024

Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin.

Hyperpigmentation
SpecialtyDermatology
CausesMelanogenesis

Causes edit

Hyperpigmentation can be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris.[1][2][3]: 854  People with darker skin tones are more prone to hyperpigmentation, especially with excess sun exposure.[4]

Many forms of hyperpigmentation are caused by an excess production of melanin.[4] Hyperpigmentation can be diffuse or focal, affecting such areas as the face and the back of the hands. Melanin is produced by melanocytes at the lower layer of the epidermis. Melanin is a class of pigment responsible for producing color in the body in places such as the eyes, skin, and hair. The process of melanin synthesis (melanogenesis) starts with the oxidation of l-tyrosine to l-dopa by the enzyme tyrosine hydroxylase, then to l-dopaquinone and dopachrome, which forms melanin.[5]

As the body ages, melanocyte distribution becomes less diffuse and its regulation less controlled by the body. UV light stimulates melanocyte activity, and where concentration of the cells is greater, hyperpigmentation occurs. Another form of hyperpigmentation is post-inflammatory hyperpigmentation. These are dark and discoloured spots that appear on the skin following acne that has healed.[6]

Diseases and conditions edit

Hyperpigmentation is associated with a number of diseases or conditions, including the following:

Hyperpigmentation can sometimes be induced by dermatological laser procedures.

Diagnosis edit

  • A physical examination including, Wood's lamp examination and a detailed history, usually sufficient for diagnosis.
  • Skin examination.
  • Viewing medical history.

Treatment edit

There are a wide range of depigmenting treatments used for hyperpigmentation conditions, and responses to most are variable.[11]

Most often treatment of hyperpigmentation caused by melanin overproduction (such as melasma, acne scarring, liver spots) includes the use of topical depigmenting agents, which vary in their efficacy and safety, as well as in prescription rules.[12]

Topical treatments edit

Many topical treatments disrupt the synthesis of melanin by inhibiting the enzyme tyrosine hydroxylase.[5]

Several are prescription only in the US, especially in high doses, such as hydroquinone, azelaic acid,[13] and kojic acid.[14] Some are available without prescription, such as niacinamide,[15][16] l-ascorbic acid,[citation needed] retinoids such as tretinoin,[17] or cysteamine hydrochloride.[18][19] Hydroquinone was the most commonly prescribed hyperpigmentation treatment before the long-term safety concerns were raised,[20] and the use of it became more regulated in several countries and discouraged in general by WHO.[21] For the US, only 2% is at present sold over-the-counter, and 4% needs prescription. In the EU hydroquinone was banned from cosmetic applications.[22] According to leading Celebrity Dermatologist Dr. Chytra Anand, active ingredients such as Licorice, Malic acid, Glycolic & Lactic acid, Niacinamide, Vitamin C & Turmeric in a daily skin care routine can also help reduce pigmentation.[23]

Oral edit

Oral medication with procyanidin plus vitamins A, C, and E also shows promise as safe and effective for epidermal melasma. In an 8-week randomized, double-blind, placebo-controlled trial in 56 Filipino women, treatment was associated with significant improvements in the left and right malar regions, and was safe and well tolerated.[24] Other treatments that do not involve topical agents are also available, including fraction lasers[25] and dermabrasion.[12]

Laser treatments edit

Laser toning using YAG lasers[26] and intense pulsed light have been used to treat hyperpigmentation such as melasma and post-inflammatory hyperpigmentation.[27]

See also edit

References edit

  1. ^ "Hyperpigmentation". Dermatalogic Disease Database. American Osteopathic College of Dermatology. Retrieved 2006-03-08.
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  3. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  4. ^ a b Chandra, M; Levitt, J; Pensabene, CA (May 2012). "Hydroquinone therapy for post-inflammatory hyperpigmentation secondary to acne: not just prescribable by dermatologists". Acta Dermato-Venerologica. 92 (3): 232–5. doi:10.2340/00015555-1225. PMID 22002814.
  5. ^ a b Kim, Ji Hye; Kang, Nam Joo (2015-07-14). "Potent whitening effects of rutin metabolites". Korean Journal of Food Preservation (in Latin). 22 (4): 607–612. doi:10.11002/kjfp.2015.22.4.607. ISSN 2287-7428. Retrieved 2022-03-15.
  6. ^ Hyperpigmentation on Face (Acne Scars) Hyperpigmentation, Dark Spots, Acne Scars, Meladerm.
  7. ^ "Melasma". American Academy of Dermatology, Inc.
  8. ^ "Schimke immunoosseous dysplasia | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Retrieved 2019-03-13.
  9. ^ Kannan, R.; Ng, M. J. (2008). "Cutaneous lesions and vitamin B12 deficiency: An often-forgotten link, Rajendran Kannan, MB BS MD". Canadian Family Physician. 54 (4): 529–532. PMC 2294086. PMID 18413300.
  10. ^ Lawrence, Elizabeth; Al Aboud, Khalid M. (2022), "Postinflammatory Hyperpigmentation", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 32644576, retrieved 2022-03-27
  11. ^ Gupta, AK; Gover, MD; Nouri, K; Taylor, S (December 2006). "The treatment of melasma: a review of clinical trials". Journal of the American Academy of Dermatology. 55 (6): 1048–65. doi:10.1016/j.jaad.2006.02.009. PMID 17097400.
  12. ^ a b "Variety of options available to treat pigmentation problems | American Academy of Dermatology". www.aad.org. Retrieved 2017-02-12.
  13. ^ Mazurek, Klaudia; Pierzchała, Ewa (2016-09-01). "Comparison of efficacy of products containing azelaic acid in melasma treatment". Journal of Cosmetic Dermatology. 15 (3): 269–282. doi:10.1111/jocd.12217. ISSN 1473-2165. PMID 27028014. S2CID 25303091.
  14. ^ Monteiro, Rochelle C.; Kishore, B. Nanda; Bhat, Ramesh M.; Sukumar, D.; Martis, Jacintha; Ganesh, H. Kamath (2013-03-01). "A Comparative Study of the Efficacy of 4% Hydroquinone vs 0.75% Kojic Acid Cream in the Treatment of Facial Melasma". Indian Journal of Dermatology. 58 (2): 157. doi:10.4103/0019-5154.108070. ISSN 1998-3611. PMC 3657227. PMID 23716817.
  15. ^ Hakozaki, T.; Minwalla, L.; Zhuang, J.; Chhoa, M.; Matsubara, A.; Miyamoto, K.; Greatens, A.; Hillebrand, G.G.; Bissett, D.L. (2002-07-01). "The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer". British Journal of Dermatology. 147 (1): 20–31. doi:10.1046/j.1365-2133.2002.04834.x. PMID 12100180. S2CID 39489580.
  16. ^ "Spotlight On: Niacinamide - FutureDerm". FutureDerm. 2007-10-30. Retrieved 2017-02-12.
  17. ^ Callender, Valerie D.; Baldwin, Hilary; Cook-Bolden, Fran E.; Alexis, Andrew F.; Stein Gold, Linda; Guenin, Eric (2021-11-09). "Effects of Topical Retinoids on Acne and Post-inflammatory Hyperpigmentation in Patients with Skin of Color: A Clinical Review and Implications for Practice". American Journal of Clinical Dermatology. Springer Science and Business Media LLC. 23 (1): 69–81. doi:10.1007/s40257-021-00643-2. ISSN 1175-0561. PMC 8776661. PMID 34751927.
  18. ^ Mansouri, P.; Farshi, S.; Hashemi, Z.; Kasraee, B. (2015-07-01). "Evaluation of the efficacy of cysteamine 5% cream in the treatment of epidermal melasma: a randomized double-blind placebo-controlled trial". The British Journal of Dermatology. 173 (1): 209–217. doi:10.1111/bjd.13424. ISSN 1365-2133. PMID 25251767. S2CID 21618233.
  19. ^ "Cysteamine Cream® -- New Hyper Intensive Depigmenting Treatment". Scientis Pharma. Retrieved 2017-02-12.
  20. ^ Draelos, Zoe Diana (2007-09-01). "Skin lightening preparations and the hydroquinone controversy". Dermatologic Therapy. 20 (5): 308–313. doi:10.1111/j.1529-8019.2007.00144.x. ISSN 1529-8019. PMID 18045355. S2CID 24913995.
  21. ^ Hyrdoquinone Guidance published under the joint sponsorship of the United Nations Environment Programme, the International Labour Organisation, and the World Health Organization. World Health Organization. 1994. hdl:10665/39218. ISBN 9789241571579.
  22. ^ "Hydroquinone - Substance evaluation - CoRAP - ECHA". echa.europa.eu. Retrieved 2017-02-12.
  23. ^ "Glow Brite Beauty Box - Best Kit for Pigmentation". skinq.com. Retrieved 2022-12-26.
  24. ^ Handog, Evangeline (2009-07-20). "A randomized, double-blind, placebo-controlled trial of oral procyanidin with Vitamins A, C, E for melasma among Filipino women". International Journal of Dermatology. 48 (8): 896–901. doi:10.1111/j.1365-4632.2009.04130.x. PMID 19659873. S2CID 28886093.
  25. ^ "Laser Skin Whitening - Advantages and Disadvantages | Skin Whitening News". skinwhiteningnews.org. 2014-04-05. Retrieved 2017-02-12.
  26. ^ Kim, Young Jae; Suh, Hyun Yi; Choi, Myoung Eun; Jung, Chang Jin; Chang, Sung Eun (2020-04-17). "Clinical improvement of photoaging-associated facial hyperpigmentation in Korean skin with a picosecond 1064-nm neodymium-doped yttrium aluminum garnet laser". Lasers in Medical Science. Springer Science and Business Media LLC. 35 (7): 1599–1606. doi:10.1007/s10103-020-03008-z. ISSN 0268-8921. PMID 32300974. S2CID 215794622.
  27. ^ Arora, Pooja; Sarkar, Rashmi; Garg, Vijay K; Arya, Latika (2022-01-27). "Lasers for Treatment of Melasma and Post-Inflammatory Hyperpigmentation". Journal of Cutaneous and Aesthetic Surgery. 5 (2): 93–103. doi:10.4103/0974-2077.99436. PMC 3461803. PMID 23060704.

External links edit

 
Wikimedia Commons has media related to Hyperpigmentation.

February 15, 2024
hyperpigmentation, darkening, area, skin, nails, caused, increased, melanin, specialtydermatologycausesmelanogenesis, contents, causes, diseases, conditions, diagnosis, treatment, topical, treatments, oral, laser, treatments, also, references, external, linksc. Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin HyperpigmentationSpecialtyDermatologyCausesMelanogenesis Contents 1 Causes 1 1 Diseases and conditions 2 Diagnosis 3 Treatment 3 1 Topical treatments 3 2 Oral 3 3 Laser treatments 4 See also 5 References 6 External linksCauses editHyperpigmentation can be caused by sun damage inflammation or other skin injuries including those related to acne vulgaris 1 2 3 854 People with darker skin tones are more prone to hyperpigmentation especially with excess sun exposure 4 Many forms of hyperpigmentation are caused by an excess production of melanin 4 Hyperpigmentation can be diffuse or focal affecting such areas as the face and the back of the hands Melanin is produced by melanocytes at the lower layer of the epidermis Melanin is a class of pigment responsible for producing color in the body in places such as the eyes skin and hair The process of melanin synthesis melanogenesis starts with the oxidation of l tyrosine to l dopa by the enzyme tyrosine hydroxylase then to l dopaquinone and dopachrome which forms melanin 5 As the body ages melanocyte distribution becomes less diffuse and its regulation less controlled by the body UV light stimulates melanocyte activity and where concentration of the cells is greater hyperpigmentation occurs Another form of hyperpigmentation is post inflammatory hyperpigmentation These are dark and discoloured spots that appear on the skin following acne that has healed 6 Diseases and conditions edit Hyperpigmentation is associated with a number of diseases or conditions including the following Addison s disease and other sources of adrenal insufficiency in which hormones that stimulate melanin synthesis such as melanocyte stimulating hormone MSH are frequently elevated Cushing s disease or other excessive adrenocorticotropic hormone ACTH production because MSH production is a byproduct of ACTH synthesis from proopiomelanocortin POMC Acanthosis nigricans hyperpigmentation of intertriginous areas associated with insulin resistance Melasma also known as chloasma or the mask of pregnancy when it occurs in pregnant women It is a common skin problem that causes dark discolored patchy hyperpigmentation It typically occurs on the face and is symmetrical with matching marks on both sides of the face The condition is much more common in women than men though men can get it too According to the American Academy of Dermatology 90 percent of people who develop melasma are women 7 Post Acne marks from post inflammatory hyperpigmentation Linea nigra a hyperpigmented line found on the abdomen during pregnancy Peutz Jeghers syndrome an autosomal dominant disorder characterized by hyperpigmented macules on the lips and oral mucosa and gastrointestinal polyps Exposure to certain chemicals such as salicylic acid bleomycin and cisplatin Smoker s melanosis Coeliac disease Cronkhite Canada syndrome Porphyria Tinea fungal infections such as ringworm Haemochromatosis a common but debilitating genetic disorder characterized by the chronic accumulation of iron in the body Mercury poisoning particularly cases of cutaneous exposure resulting from the topical application of mercurial ointments or skin whitening creams Aromatase deficiency Nelson s syndrome Graves disease Schimke immunoosseous dysplasia SOID 8 As a result of tinea cruris Due to B12 deficiency 9 Atopic dermatitis as a result of inflammation 10 Hyperpigmentation can sometimes be induced by dermatological laser procedures Diagnosis editA physical examination including Wood s lamp examination and a detailed history usually sufficient for diagnosis Skin examination Viewing medical history Treatment editThere are a wide range of depigmenting treatments used for hyperpigmentation conditions and responses to most are variable 11 Most often treatment of hyperpigmentation caused by melanin overproduction such as melasma acne scarring liver spots includes the use of topical depigmenting agents which vary in their efficacy and safety as well as in prescription rules 12 Topical treatments edit Many topical treatments disrupt the synthesis of melanin by inhibiting the enzyme tyrosine hydroxylase 5 Several are prescription only in the US especially in high doses such as hydroquinone azelaic acid 13 and kojic acid 14 Some are available without prescription such as niacinamide 15 16 l ascorbic acid citation needed retinoids such as tretinoin 17 or cysteamine hydrochloride 18 19 Hydroquinone was the most commonly prescribed hyperpigmentation treatment before the long term safety concerns were raised 20 and the use of it became more regulated in several countries and discouraged in general by WHO 21 For the US only 2 is at present sold over the counter and 4 needs prescription In the EU hydroquinone was banned from cosmetic applications 22 According to leading Celebrity Dermatologist Dr Chytra Anand active ingredients such as Licorice Malic acid Glycolic amp Lactic acid Niacinamide Vitamin C amp Turmeric in a daily skin care routine can also help reduce pigmentation 23 Oral edit Oral medication with procyanidin plus vitamins A C and E also shows promise as safe and effective for epidermal melasma In an 8 week randomized double blind placebo controlled trial in 56 Filipino women treatment was associated with significant improvements in the left and right malar regions and was safe and well tolerated 24 Other treatments that do not involve topical agents are also available including fraction lasers 25 and dermabrasion 12 Laser treatments edit Laser toning using YAG lasers 26 and intense pulsed light have been used to treat hyperpigmentation such as melasma and post inflammatory hyperpigmentation 27 See also editDrug induced pigmentation Hypopigmentation List of skin conditionsReferences edit Hyperpigmentation Dermatalogic Disease Database American Osteopathic College of Dermatology Retrieved 2006 03 08 Rapini Ronald P Bolognia Jean L Jorizzo Joseph L 2007 Dermatology 2 Volume Set St Louis Mosby ISBN 978 1 4160 2999 1 James William Berger Timothy Elston Dirk 2005 Andrews Diseases of the Skin Clinical Dermatology 10th ed Saunders ISBN 0 7216 2921 0 a b Chandra M Levitt J Pensabene CA May 2012 Hydroquinone therapy for post inflammatory hyperpigmentation secondary to acne not just prescribable by dermatologists Acta Dermato Venerologica 92 3 232 5 doi 10 2340 00015555 1225 PMID 22002814 a b Kim Ji Hye Kang Nam Joo 2015 07 14 Potent whitening effects of rutin metabolites Korean Journal of Food Preservation in Latin 22 4 607 612 doi 10 11002 kjfp 2015 22 4 607 ISSN 2287 7428 Retrieved 2022 03 15 Hyperpigmentation on Face Acne Scars Hyperpigmentation Dark Spots Acne Scars Meladerm Melasma American Academy of Dermatology Inc Schimke immunoosseous dysplasia Genetic and Rare Diseases Information Center GARD an NCATS Program rarediseases info nih gov Retrieved 2019 03 13 Kannan R Ng M J 2008 Cutaneous lesions and vitamin B12 deficiency An often forgotten link Rajendran Kannan MB BS MD Canadian Family Physician 54 4 529 532 PMC 2294086 PMID 18413300 Lawrence Elizabeth Al Aboud Khalid M 2022 Postinflammatory Hyperpigmentation StatPearls Treasure Island FL StatPearls Publishing PMID 32644576 retrieved 2022 03 27 Gupta AK Gover MD Nouri K Taylor S December 2006 The treatment of melasma a review of clinical trials Journal of the American Academy of Dermatology 55 6 1048 65 doi 10 1016 j jaad 2006 02 009 PMID 17097400 a b Variety of options available to treat pigmentation problems American Academy of Dermatology www aad org Retrieved 2017 02 12 Mazurek Klaudia Pierzchala Ewa 2016 09 01 Comparison of efficacy of products containing azelaic acid in melasma treatment Journal of Cosmetic Dermatology 15 3 269 282 doi 10 1111 jocd 12217 ISSN 1473 2165 PMID 27028014 S2CID 25303091 Monteiro Rochelle C Kishore B Nanda Bhat Ramesh M Sukumar D Martis Jacintha Ganesh H Kamath 2013 03 01 A Comparative Study of the Efficacy of 4 Hydroquinone vs 0 75 Kojic Acid Cream in the Treatment of Facial Melasma Indian Journal of Dermatology 58 2 157 doi 10 4103 0019 5154 108070 ISSN 1998 3611 PMC 3657227 PMID 23716817 Hakozaki T Minwalla L Zhuang J Chhoa M Matsubara A Miyamoto K Greatens A Hillebrand G G Bissett D L 2002 07 01 The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer British Journal of Dermatology 147 1 20 31 doi 10 1046 j 1365 2133 2002 04834 x PMID 12100180 S2CID 39489580 Spotlight On Niacinamide FutureDerm FutureDerm 2007 10 30 Retrieved 2017 02 12 Callender Valerie D Baldwin Hilary Cook Bolden Fran E Alexis Andrew F Stein Gold Linda Guenin Eric 2021 11 09 Effects of Topical Retinoids on Acne and Post inflammatory Hyperpigmentation in Patients with Skin of Color A Clinical Review and Implications for Practice American Journal of Clinical Dermatology Springer Science and Business Media LLC 23 1 69 81 doi 10 1007 s40257 021 00643 2 ISSN 1175 0561 PMC 8776661 PMID 34751927 Mansouri P Farshi S Hashemi Z Kasraee B 2015 07 01 Evaluation of the efficacy of cysteamine 5 cream in the treatment of epidermal melasma a randomized double blind placebo controlled trial The British Journal of Dermatology 173 1 209 217 doi 10 1111 bjd 13424 ISSN 1365 2133 PMID 25251767 S2CID 21618233 Cysteamine Cream New Hyper Intensive Depigmenting Treatment Scientis Pharma Retrieved 2017 02 12 Draelos Zoe Diana 2007 09 01 Skin lightening preparations and the hydroquinone controversy Dermatologic Therapy 20 5 308 313 doi 10 1111 j 1529 8019 2007 00144 x ISSN 1529 8019 PMID 18045355 S2CID 24913995 Hyrdoquinone Guidance published under the joint sponsorship of the United Nations Environment Programme the International Labour Organisation and the World Health Organization World Health Organization 1994 hdl 10665 39218 ISBN 9789241571579 Hydroquinone Substance evaluation CoRAP ECHA echa europa eu Retrieved 2017 02 12 Glow Brite Beauty Box Best Kit for Pigmentation skinq com Retrieved 2022 12 26 Handog Evangeline 2009 07 20 A randomized double blind placebo controlled trial of oral procyanidin with Vitamins A C E for melasma among Filipino women International Journal of Dermatology 48 8 896 901 doi 10 1111 j 1365 4632 2009 04130 x PMID 19659873 S2CID 28886093 Laser Skin Whitening Advantages and Disadvantages Skin Whitening News skinwhiteningnews org 2014 04 05 Retrieved 2017 02 12 Kim Young Jae Suh Hyun Yi Choi Myoung Eun Jung Chang Jin Chang Sung Eun 2020 04 17 Clinical improvement of photoaging associated facial hyperpigmentation in Korean skin with a picosecond 1064 nm neodymium doped yttrium aluminum garnet laser Lasers in Medical Science Springer Science and Business Media LLC 35 7 1599 1606 doi 10 1007 s10103 020 03008 z ISSN 0268 8921 PMID 32300974 S2CID 215794622 Arora Pooja Sarkar Rashmi Garg Vijay K Arya Latika 2022 01 27 Lasers for Treatment of Melasma and Post Inflammatory Hyperpigmentation Journal of Cutaneous and Aesthetic Surgery 5 2 93 103 doi 10 4103 0974 2077 99436 PMC 3461803 PMID 23060704 External links edit nbsp Wikimedia Commons has media related to Hyperpigmentation Retrieved from https en wikipedia org w index php title Hyperpigmentation amp oldid 1181576069, wikipedia, wiki, book, books, library,

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