Hypopigmentation is the absence of normal amounts of melanin (the chemical that gives skin its color) caused by disease, injury, burns or other trauma to the skin. When the skin cells that produce melanin (melanocytes) reduce their production, the resulting condition is known as hypopigmentation (loss of skin color). Hypopigmentation is also known as skin depigmentation.
Post inflammatory hypopigmentation
The most common cause of hypopigmentation is damage or trauma to the skin. Burns, infections, pimples, blisters, scrapes, and any injuries that result in scarring can all lead to skin discoloration. In situations where hypopigmentation is the result of skin inflammation or damage, the condition may be referred to as post-inflammatory hypopigmentation, or PIH. This can get confusing because PIH is also used to refer to post-inflammatory hyperpigmentation, a skin condition where pigmentation is increased, not decreased.
This hypopigmentation disorder of the skin occurs due to destruction of melanocytes. It is obvious as smooth, white depigmented patches on the skin. According to the distribution of the patches, it is divided into generalized (all over the body), acral / acrofacial (over the face and ends of the limbs), localized (over a smaller surface area) and segmental (affecting one limb or an area supplied by a single nerve, referred to as dermatome).
Affected people should be protected from sunlight. Other forms of treatments used include topical steroids, immune modifiers, phototherapy and surgical grafting techniques. In some cases where the condition is extensive, depigmentation is advised, wherein the patches of normal tissue are lightened out to match the affected tissue and maintain uniformity.
This is another form of hypopigmentation skin disorder with complete absence of the skin pigment. The color of the hair and skin is also lighter than the normal.
Pityriasis alba is a common skin condition that usually affects the face in children. Reddish patches with scaling appear on the face, which subside resulting in hypopigmentation. The skin color returns to normal in due course.
Tinea versicolor is a fungal infection of the skin. The skin shows the presence of multiple white spots that are white and scaly. The spots may increase in size with time. People with oily skin, those who sweat a lot or who have decreased immunity may be more prone to developing tinea versicolor. The condition is treated with antifungal medications.
Hypopigmentation treatment options are often limited. Treating post-inflammatory hypopigmentation may involve the use of topical corticosteroids or tars (topical cream), light or laser treatment, or surgical skin grafting.
Although the numerous lasers and other light-based treatments available today are often perceived as a cosmetic cure-alls, only exicimer lasers will repigment skin. It may be possible to lightening the pigmented areas with lasers so the hypopigented areas are not as pronounced.
If a chronic skin disorder is causing hypopigmentation, then treatment will likely involve topical prescription medications. For hypopigmentation that is unresponsive to medications, camouflaging with cosmetic tattooing or permanent makeup may be the best option.
For patients who experience extreme hypopigmentation on over half of their body (a rare occurrence of vitiligo), overall depigmentation is an option.
Topical medications, such as hydroquinone, TriLuma, and other skin lightening agents, may be used to bleach skin not affected by hypopigmentation so that it can blend in better with hypopigmented skin (think the late, great Michael Jackson).