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Pigmentation

Living in multi-racial Singapore, we are well aware of the different types of skins we all have. But do we really know what gives our skin its colour? Regardless of the colour of our skin, one vital thing we cannot ignore is the importance of sunscreen. It helps prevent skin damage, skin aging, skin cancer, and a change in our pigmentation.

What is pigmentation?

The colour of our skin can also be known as our pigmentation. And what is the pigment that is responsible for the colour of our skin? Melanin. The amount of melanin determines how light or dark our skin is, it also determines the colour of our hair and eyes. Our genetics decides the information that melanin gets which in turn determines our colour. Melanin and our eventual skin colour can also be affected by external factors like sun exposure.

There are two types of melanin:

• Eumelanin: dark brown or black in colour and protects your skin from the harmful ultraviolet (UV) rays of the sun. It ultimately protects you from skin cancer1.

• Pheomelanin: yellow or red in colour and provides little to no protection from UV rays, and hence, does not help protect you from skin cancer, in fact, studies have shown that it may actually contribute to UV-related skin damage2. 

What causes skin pigmentation discolouration?

There are many factors that can cause our pigmentation to be altered, such as acne, sun exposure, skin injury, and hormones. Our pigmentation may darken or lighten due to these factors. In general, there are 3 main types of pigmentation:

• Hyperpigmentation

• Hypopigmentation

• Depigmentation

Hyperpigmentation

As its name suggests, hyperpigmentation means that there is more pigmentation or a high amount of melanin, resulting in a darker skin tone. Other than genetics, patchy areas of hyperpigmentation can be caused by:

• Birth marks

• Bruises

• Acne scars

• Pregnancy (hyperpigmentation during pregnancy is commonly known as melasma)

• Exposure to the sun

• Age spots

• Certain medications like antibiotics and birth control

• Cryotherapy or laser therapy

Hypopigmentation

People with hypopigmentation tend to have lighter skin tones as they have an abnormally low amount of melanin. Other than genetics, patchy incidences of hypopigmentation can be caused by:

• Skin injuries like burns, blisters, ulcers

• Skin conditions such as eczema and psoriasis

• Genetic conditions like albinism

Depigmentation

This happens when there is a complete loss of pigmentation, and your skin turns white. A common cause of depigmentation is vitiligo which is an autoimmune disorder.

What are the treatment options for skin pigmentation discolouration?

The treatment options for skin pigmentation discolouration are dependent on their causes and the type of discolouration. For mild forms of discolouration, over-the-counter creams and ointments might be sufficient, however, a visit to the dermatologist will help in the management of your issue. If these creams and ointments do not work, your dermatologist will be able to come up with a personalised treatment plan that might help.

Hyperpigmentation

Treatment options include:

• Dermabrasion

• Retinol 

• Microneedling

• Chemical peel

• Light or laser therapy

• Cryotherapy

Studies have shown that one of the key things to prevent an exacerbation of your hyperpigmentation and to improve the appearance of hyperpigmentation is, sunscreen3.

Hypopigmentation

If hypopigmentation is caused by albinism, there is no cure, but you should protect yourself daily with a good quality sunscreen. If your hypopigmentation is caused by injuries to your skin, eczema, or psoriasis, only time and patience can help your skin return to its usual colour. If your hypopigmentation was the result of certain skin conditions or laser therapy, the following treatment options might work for you:

• Light-sensitive medication

• Prescription creams

• Using dyes to cover patches

• Light therapy

• Surgery

Depigmentation

Depigmentation is most commonly caused by the autoimmune disorder vitiligo, and treatment may be recommended for individuals with depigmentation in more than 50% of their bodies. It involves applying a lotion to the darker skin to bleach it the same colour as the depigmented skin4. It is also very important to apply sunscreen everyday since the depigmented skin lacks eumelanin to protect it from harmful UV rays.

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