Melanin is the pigment or chemical that contributes to your natural skin color. Skin disorders that involve too much melanin (hyperpigmentation) darken the skin, while those involving too little melanin (hypopigmentation) lighten the skin.

Common Hyperpigmented Skin Disorders

Common skin disorders that affect many South Asians and involve too much pigment include the following:

• Melasma
• Postinflammatory pigmentation

Melasma involves tan or brown patches primarily over the face. This condition can be seen in pregnancy, but is also common in South Asians and other demographics with darker skin. Sun exposure and skin irritation can worsen melasma. 

Postinflammatory hyperpigmentation (PIH) results in small dark spots or large patches that remain on the skin after a skin injury (such as a burn, cut, scratch or bruise) or inflammation. Virtually any type of rash or even acne can result in this disorder. Common skin procedures such as lasers, dermabrasion and liquid nitrogen therapy can cause PIH. 

Unlike melasma, PIH tends to heal more quickly and can occur anywhere on the body, whereas melasma usually involves the face. Keep in mind that inflammation and injury to the skin can cause hypopigmentation as well. 

Common Hypopigmented Skin Disorders

Vitiligo is equally common in all races, but is more prominent in South Asians due to the contrast of light patches on darker skin. Vitiligo is a condition in which your immune system attacks your skin pigment cells, resulting in smooth white patches that can occur on the skin and mucous membranes (such as the lips or genitals). Although vitiligo may exist alone, it can also be associated with other medical conditions that involve your immune system such as diabetes, thyroid disease, Addison's disease (disease of the adrenal gland) and pernicious anemia (vitamin B12 deficiency).

Apart from vitiligo, there are skin conditions, such as tinea versicolor and pityriasis alba, that can result in hypopigmentation. Inflammation or injury to the skin can cause either hypopigmentation or hyperpigmentation. See your personal physician or dermatologist to confirm the cause, diagnosis and treatment of your skin disorder.

Treatment

The first step is to confirm a diagnosis of a skin disorder is by seeing a physician or dermatologist.

In the case of hyperpigmentary disorders, the physician may prescribe a cream, such as hydroxyquinone, retinoids or azelaic acid, to help lighten the skin. In the case of PIH, it is important to first eliminate the underlying cause of the pigmentation (acne, eczema, etc.) before treating the excess pigmentation.

Vitiligo has no cure. However, the symptoms can be masked with a combination of cosmetic products and treatments that can be discussed with a dermatologist.

Last Reviewed: 2012