Skin Discolouration – An Overview

Overview

Skin discolouration can affect both large and small areas of the skin. It can occur naturally due to the ageing process or indicate an underlying medical condition that requires attention from a healthcare professional. 

Various health conditions can lead to changes in skin colour, such as hypopigmentation, which causes the skin to lighten or whiten, or hyperpigmentation, which causes the skin to darken.

The treatments available for skin discolouration can vary depending on the specific condition. For instance, topical creams commonly address discolouration associated with age spots. 

On the other hand, light-based phototherapy is utilised to treat dermatitis. In some cases, surgeries may be performed to improve the appearance of white patches caused by vitiligo.

Skin discolouration

Skin discolouration is a term used to describe any alteration in your skin’s natural tone. Various factors can contribute to skin discolouration, including birthmarks, infections, skin pigmentation disorders, and even skin cancer. These changes in skin colour can manifest in different shades, such as:

• Red 
• Pink
• Purple
• Tan
• Brown 
• Black
• Blue 

While some instances of skin discolouration are harmless, like birthmarks, others may indicate an underlying medical condition that could require proper diagnosis and treatment. 

Additionally, variations in melanin levels can lead to the development of discoloured patches on specific areas of the body. Melanin is primarily responsible for providing colour to the skin and shielding it from the sun.

 Excessive production of melanin can result in differences in skin tone. It is essential to consult a dermatologist promptly if there are concerns about skin cancer, as early detection and treatment are essential.

Potential causes of skin discolouration

Birthmarks

Birthmarks are pigmented skin spots that can develop at birth or shortly after. They are usually benign and do not necessitate treatment unless they become bothersome or painful.

Various common types of birthmarks include:

Moles: They can be present on the skin from birth and come in different colours.

Deep hemangioma: a purple- or blue-tinted lump under the skin that may require treatment if painful or bleeding.

Dermal melanocytosis: It is also known as Mongolian blue spots, which are bluish patches that typically fade over time.

Strawberry nevus (hemangioma): a red birthmark common in young children and infants that usually fades by age 10.

Salmon patches are salmon, red, or pink-colored patches that often disappear on their own by ages 1 to 3.

Café au lait spots are much darker skin spots that remain for life.

Port-wine marks:  flat patches that can appear red or pink on lighter skin tones and violet-red or dark purple on darker skin tones.

Hypopigmented macule: a lighter spot of skin that tends to fade over time.

Medical conditions

The immune system effectively maintains the body’s health by defending against harmful agents that can lead to infection and disease.

However, individuals with autoimmune diseases experience a malfunction in their immune system, mistakenly identifying healthy cells as foreign and attacks against them. 

This results in inflammation throughout the body, leading to various symptoms, such as swelling and redness.

There are several autoimmune diseases and other medical conditions that can manifest with symptoms of skin discolouration. These include:

Graves’ disease: A type of thyroid disorder that results in excessive production of thyroid hormones. Skin symptoms may include areas of thickened, rough, and red skin.

Psoriasis: A chronic skin condition characterised by itchy patches of red to silvery scales caused by an accelerated turnover of skin cells.

Lupus: Lupus could affect the skin and other body parts, including joints and major organs.

Rosacea: This condition can cause skin flushing and redness. Some forms of rosacea may also lead to acne pimples, ocular symptoms, and thickened skin.

Addison’s disease: This condition, characterised by adrenal insufficiency, can cause hyperpigmentation in some regions of the skin. There is also an increased risk of developing vitiligo.

Scleroderma: A rare autoimmune disorder that can cause thick, discoloured skin patches and problems in connective tissues.

Stasis ulcer: Often associated with varicose veins and venous insufficiency, this condition leads to redness, swelling, and leg pain.

Rashes and allergies

Allergic responses to food, plants, or irritants can lead to discoloured patches on the skin in different parts of the body. These changes may manifest as rashes or raised bumps that cause itching or burning and can occur in the following:

Atopic dermatitis (eczema): Like certain autoimmune conditions, eczema triggers an immune response targeting the skin. This condition can result in scaly patches and red bumps that may ooze or form crusts.

Urticaria (hives): These raised, itchy bumps on the skin are caused by inflammation due to the release of histamine (a compound involved in immune responses) in response to an allergen. While hives are typically acute, some cases can be chronic, lasting for months or years.

Allergic contact dermatitis: This type of allergic skin rash can develop when the skin comes into contact with fragrances, skincare products, metals, or clothing that irritate it. Rashes from allergic contact dermatitis are often itchy and sometimes painful.

Pigmentation disorders

Pigmentation disorders can result in changes in the skin that are either lighter or darker than the natural skin tone. Although generally harmless, more extensive pigmentation changes may prompt individuals to seek aesthetic treatments.

Common pigmentation disorders include:

Vitiligo:  a chronic condition that causes large patches of hypopigmentation on the skin. 

Age or “liver” spots (lentigo) are common hyperpigmentation spots caused by sun damage. These spots could appear anywhere on the body but are more common on sun-exposed areas like the hands, chest, and face.

Albinism: an inherited condition that leads to highly light eyes, skin, and hair due to a lack of melanin.

Melasma: It is also known as “the mask of pregnancy” due to the involvement of progesterone and estrogen. It is a type of hyperpigmentation that causes darker spots on the face and abdomen. Melasma usually fades and lightens once birth control pills are stopped or after pregnancy. Sun exposure can trigger its return.

Skin cancer

Skin cancer can alter the colour or texture of the skin. This condition typically arises when the genetic material within skin cells becomes damaged, often due to continuous exposure to the sun or certain chemicals. The damage can lead to uncontrolled cell growth, which results in the formation of a cancerous mass.

Various types of skin cancer necessitate treatment:

Actinic keratosis: A precancerous skin condition characterised by scaly, crusty patches on the hands, arms, or face. These patches are usually brown, grey, or pink and may cause itching or burning.

Squamous cell carcinoma is a form of skin cancer originating in the squamous cells, which comprise the outermost skin layer. This condition manifests as scaly, red patches and raised sores, commonly found on sun-exposed skin areas.

Basal cell carcinoma: The most common type of skin cancer that affects the top layer of the skin, often appearing in sun-exposed areas. In its early stages, it can cause bleeding lesions with discoloured, shiny, pearly, or scar-like bumps that resemble open sores.

Melanoma: The least common yet most severe type of skin cancer that typically begins as an atypical mole. Cancerous moles are often multicoloured, asymmetrical, and large, appearing anywhere on the body but are usually first seen on the chest or back in cis males and on the legs in individuals assigned female at birth.

While most discoloured skin patches are not indicative of skin cancer, it is recommended to consult a healthcare professional if you notice any irregular moles or rapidly changing skin lesions.

Other factors that can contribute to skin discolouration are as follows:

1. Hemorrhaging beneath the skin: It occurs when blood vessels rupture due to injury, bruising, or an allergic response.
2. Radiation therapy: A cancer treatment that can result in blistering, itching, and peeling of the skin.
3. Spider veins: Damaged veins can manifest as clusters of red, blue, or purple lines beneath the skin, particularly in the legs.
4. Hormonal fluctuations: Changes in hormones can lead to the development of melasma hyperpigmentation.
5. Thermal injuries: Skin discolouration can occur during the healing process following burns caused by frostbite, sunburn, fire, or electrical accidents.
6. Exposure to toxins: Prolonged use or ingestion of silver compounds (argyria) and heavy metals can cause the deposition of metallic compounds in the skin and stimulate excessive melanin production.
7. Side effects of medication: Some individuals may experience drug-induced hyperpigmentation when taking antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and other medications.

Treating skin discolouration

The approach to treating discoloured skin patches varies depending on the underlying cause. If a healthcare professional identifies an underlying health condition, their initial focus will be treating it.

The appropriate class of drugs must be administered in cases of an active infection.

 For instance, bacterial infections can be effectively treated with antibiotics, while antifungal medications are used to address fungal infections.

If you are seeking treatment for cosmetic purposes, a dermatologist may suggest over-the-counter or prescription topical treatments to minimise the appearance of skin discolouration. 

Additionally, professional treatments like microdermabrasion or chemical peels may be employed to help reduce hyperpigmentation, although insurance does not cover these methods.

Before attempting any topical treatments or home remedies that claim to address skin discolouration, it is crucial to get advice from your doctor and obtain an accurate diagnosis.

Home remedies for skin discolouration

Treating and healing skin discolouration varies in duration depending on the underlying cause. For instance, changes caused by tinea versicolor may require several months to resolve fully. At the same time, treatments such as laser therapy and prescription creams may take weeks before noticeable improvements in skin tone are observed.

Individuals seeking quick solutions for skin discolouration may find relief in some instances, such as sunburn, which can clear up in a few days.

However, it is essential to note that progress may be gradual. Using cosmetics to conceal blemishes or even uneven skin tone can be a helpful interim solution to achieve desired results.

Additional home remedies for addressing skin discolouration or its root causes include:

1. Utilising vinegar, which possesses antioxidant and antimicrobial properties when applied cautiously.
2. Taking oatmeal baths.
3. Avoiding sun exposure during midday hours.
4. Managing stress levels.
5. Making dietary changes if certain foods are exacerbating skin issues.

It is necessary to consult a physician regarding any abnormal or bothersome changes in your skin, mainly if you observe sudden symptoms or rapid alterations in your skin tone.

Many skin discolourations are benign, but any unusual changes should be taken seriously. Specific discoloured skin patches may stem from minor conditions that can be easily treated, while others may indicate more serious issues that necessitate continuous treatment.

FAQs