Skin pigmentation on the face is a very common problem that Indians face, and believe it or not, it can cause a considerable psychological impact. But you must know about the types of pigmentation and how to solve them.
Some of the most common causes of pigmentation on the face are conditions like melasma, freckles, lentigens, Riehl’s melanosis, Ashy’s dermatosis, and many more. These can cause light brown to dark brown and even grey or bluish discoloration.
Its treatment requires clinical expertise and also skin biopsy in some cases to accurately diagnose the clinical condition causing the pigmentation.
Another common cause of pigmented spots on the face in India is freckles. These are seen as light small brown spots on sun-exposed areas. Sun exposure and genetics are the two main causes.
Lentigens are also small brown spots that appear in sun-exposed areas but they are usually darker in colour.
Acanthosis nigricans is also an extremely common cause of pigmentation on the face and neck. It is characterized by dark, velvety, and thickened skin on the face and body folds. It is usually a symptom of obesity, diabetes, nutritional deficiency, and in some cases even tumors.
Melasma, the most common cause of pigmentation in India has been classified as epidermal, dermal, and dermo-epidermal, depending on the depth of pigmentation. In the epidermal type, the pigment is brown whereas, in the dermal type, the pigment is grey-brown.
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After we identify the type of pigment, the treatment plan is formulated. UV rays, hormonal changes, thyroid disorders, oral contraceptives, genetic history, pregnancy, and oral medications like phenytoin, griseofulvin, NSAIDS are some of the common causes of melasma.
Diagnosing pigmented spots on the face is challenging, since most of these conditions have overlapping clinical features.
The most important part in the treatment of these clinical entities is the removal of the provoking factors, strict photoprotection, and pigment reduction.
Photoprotection in the form of sunscreen, both topical and oral; wearing hats or using an umbrella outdoors, and wearing shades is of paramount importance.
Lifestyle modifications like avoiding outdoor activities between 11 AM – 4 PM can be helpful.
Topical skin lightening agents after correct diagnosis can be started.
Some of the skin-lightening agents are azelaic acid, hydroquinone, glycolic acid, lactic acid, mandelic acid, alpha arbutin, licorice extract, and kojic acid. They have to be used along with sunscreens. If you experience redness and irritation, talk to your doctor.