Pigmentation and Blemishes

Do you suffer from uneven skin tone or discoloration? There are many conditions that can lead to discoloration. Discoloration can take many forms depending on your skin color or ethnic background. Some people suffer from hyperpigmentation which is a darkening or increase in brown discoloration of the skin. Other people can have hypopigmentation or lightening of the skin. Some discoloration can be redness that does not seem to go away. A common term that patients often use for discoloration is "blemishes." While this is not a medical term, it does encompass many different meanings depending on the patient and the cause of the discoloration. The good news is that the majority of causes of discoloration can be treated.

There are many causes of skin pigmentation and blemishes:

Hyperpigmented scarring: brown discoloration that can occur as a result of any trauma or inflammation or irritation to the skin. This condition is also called post-inflammatory hyperpigmentation. Causes of hyperpigmentation include acne, rashes, dermatitis, eczema, chemicals applied to the skin, picking, scratching, and other injuries from outside sources like bug bites or burns. Often, the underlying cause of the discoloration must be addressed before the pigmentation can be addressed. There are ways to speed up the treatment of the discoloration with procedures like SilkPeel and chemical peels.

Melasma: This is a brown discoloration, more common in females and worsened by sun exposure. It can occur in pregnancy or when a patient is on hormonal treatments like birth control. However, it can occur without any hormonal change and can occur in men as well. It will often appear as brown patches on the forehead, cheeks, and upper lip. Waxing and hair removal methods that rip out the hair seem to worsen this condition.

Post-folliculitis: Brown bumps can be seen in both males in females. Pseudofolliculitis barbae is a condition seen most commonly in African-American men which results in severe scarring and pigmentation in the beard area of the face. Women who pluck and tweeze hairs can suffer with brown pigmentation on the face as well. This condition is treatable but often requires a combination of topical skincare, changes in hair removal techniques, and often laser treatment to reduce the thickness and number of hairs causing the folliculitis.

Hypopigmentation: Just like hyperpigmented scarring, lightening of the skin can occur from acne, rashes, dermatitis, eczema, chemicals applied to the skin, picking, scratching, and other injuries from outside sources like bug bites or burns. It is called post-inflammatory hypopigmentation. Vitiligo is a complete loss of pigmentation of the skin but is much less common than scarring from inflammation or trauma. Vitiligo is often seen at sites of past skin injury.

Redness: There are many causes of red discoloration like sun (actinic) damage, rosacea, acne, seborrheic dermatitis (dandruff), and stretch marks. Many of these respond to topical treatment and skincare specific to the patient's condition. Others may require further treatment with a laser or light based therapy.

While pigmentation and blemishes can occur in all skin types, it is more prevalent in darker skin types, including African-Americans, Caribbean-Americans, Hispanics/Latinos, Asians, Native Americans, Pacific Islanders, people of Middle Eastern descent.

The most important first step in addressing pigmentation and blemishes is sun protection and skin care to address the specific condition causing the pigmentation. We at the Lupo Center have a special interest in treating skin discoloration and we have options for all skin types and ethnic backgrounds.

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