What is hyperpigmentation?
Hyperpigmentation is a skin condition in which there is too much pigment in the human skin. The most important pigment is melanin in the human skin; a so-called organic pigment. Also plays a role as an iron pigment.
Melanin
Melanin is a so-called organic pigment. Melanin is produced by melanocytes with the aid of the amino acid tyrosine. Melanin may be located in the basal layer of the epidermis, by the melanocytes produce more pigment (freckle), or because there are more pigment cells are present (mole). The pigment may also be present in the dermis. A build up of pigment-producing melanocytes creates a blue or black colored birthmark (blue nevus). In certain inflammatory conditions may also pigment in macrophages (blow-out cells) to penetrate; this pigment is usually derived from keratinocytes, such as by inflammation (especially in a grensvlakdermatitis) perish. This is especially in darker skin types. Macrophages filled with pigment are often called melanofagen.
Iron
Iron can also cause hyperpigmentation of the skin, especially in the form of stacked hemosiderin in macrophages. An important example is the brown discoloration of the lower legs that occurs with venous insufficiency. But this can occur after inflammation of the capillaries (Schammberg disease), or iron overload caused by hemochromatosis. Pigment may also be made from the outside into the dermis or remain after an injury. In both cases, it is called tattoo.
Skin conditions
Hyperpigmentation is the symptom of these disorders or diseases with skin disorder symptom:
- Melasma (also called mask of pregnancy) is a form of hyper-pigmentation under the influence of hormone fluctuations.
- Addison's disease is a form of hyperpigmentation wherein the increased production of pigment is the cause.
- Linea nigra - is a dark vertical line that appears in three-quarters of the pregnancies in the abdomen.
- Damage to allspice by exposure to chemicals such as salicylic acid, bleomycin and cisplatin.
- Peutz-Jeghers syndrome - a rare hereditary syndrome characterized by small brown pigment spots on the lining of the oral cavity, around the lips, on the face, genitals, and palms.
- Celiac disease In some cases, there exists a characteristic blistering skin (dermatitis herpetiformis) in addition to the intestinal disease.
- Porphyria in medicine is the name for a number of inherited diseases in which the enzymes involved do not work well in the synthesis of the heme molecule or absent. This leads to the accumulation of intermediates such as in the skin. These disorders are characterized by skin disorders such as porphyria cutanea tarda.
- Ringworm is a contagious fungal infection of the skin. The infection causes itching and red, scaly skin.
- Hemochromatosis - is a metabolic disorder in which the absorption of iron can not be properly regulated in the intestine, which sometimes leads to iron accumulation in organs and skin, causing a long time (sometimes severe) symptoms.
- Mercury poisoning Affected people may exhibit erythematous (red), cheeks, nose and lips and transient rashes.
Also, a Acanthosis nigricans is a skin condition which is characterized by discoloration. However, it is not a hyperpigmentation. Acanthosis nigricans is a dark discolouration due to the thickening of the horny layer, instead of by pigment.
Treatment for hyperpigmentation
Hyperpigmentation can sometimes be treated, especially if it is localized in the epidermis.
- Bleaching creams: mainly contain hydroquinone or azelaic acid.
- Peeling: The peeling of the upper skin layers, especially with chemicals. Examples are fruit peeling with acid, or with trichloroacetic acid.
- Laser therapy: by the wavelength of the light so that it is mainly to choose pigment absorbs the energy, the pigment can be burnt, without damaging the remaining skin constituents. This process is never quite selective. This is less suitable for darker skin types because then even ordinary skin bleached.
In all treatments, there is a considerable risk of too much bleach, so light stains. There is also a risk of damage to the normal skin, causing hyperpigmentation may exacerbate or (even) scars.