Hypopigmentation in skin is defined as appearance of light colored or white patches on the body as a result of a reduction in melanin production. Examples of hypopigmentation include:
- Hypopigmentation due to fungal infection( P.Versicolor): Appearance of white patches can be due to superficial fungal infection which is usually seasonal due to excess sweating. This can be treated effectively with oral and topical antifungal creams and lotions. Improvement is seen in 2 to 3 months.
Sunburn: Sun damage and sensitivity can give rise to light colored patches on the sunexposed areas of the skin mainly the face, neck and the outer aspect of the hands. This is treated effective with use of sunscreens and mild steroid creams for short duration.Vitiligo: Vitiligo causes smooth well demarcated, milky white patches on the skin. In some people, these patches can appear all over the body or remain localised to a particular area of the body. It is an autoimmune disorder in which the pigment-producing cells are damaged or deficient. However this disease is not contagious to others through direct skin contact but has a genetic predisposition in few patients. There is no 100% cure for vitiligo, but there are several treatments, including cosmetic cover-ups, corticosteroid creams, or ultraviolet light treatments and vitiligo surgeries which improve the visibility of patches or give complete recovery from the disease.
- Albinism:Albinism is a rare inherited disorder caused by the absence of an enzyme that produces melanin. This results in a complete lack of pigmentation in skin, hair, or eyes. Albinos have an abnormal gene that restricts the body from producing melanin. There is no cure for albinism. People with albinism should use a sunscreen at all times because they are much more likely to get sun damage and skin cancer. This disorder can occur in any race, but is most common among whites.
- Post inflammatory hypopigmenation(Pigmentation loss as a result of skin damage):Many a times any skin infection, blisters, burns, or other trauma to the skin, may result in loss of pigmentation in the affected area. However the type of pigment loss in this situation may frequently not be permanent, but it may take a long time to regain the color. Cosmetic camouflage can be used to cover the area, while the body regenerates the pigment.
Various treatments for Vitiligo:
Excimer laser: This treatment uses exposure to 308wavelength UVB light which induces pigment cells to increase and repigment the white patches. The sessions are done twice or thrice in a week upto 20 to 30 sessions depending on the improvement.
Fractional laser: Fractional Co2 or Erbium Yag is used on the patches which gives a stimulus to the skin to repigment. This can be repeated every 3 weekly for 4 to 6 sessions alone or with combination treatment.
Chemical phenolisation: Chemical like 88% phenol is applied on the skin which causes superficial erosion of the vitiligenous skin and stimulation of the melanocytes. This is repeated at the interval of 15-20 days till results seen.
Needling: This technique pushes the pigment cells from the border of the vitiligo patch in to the patch helping in spread of the color into the white skin. It is a slower but effective treatment in smaller patches.
Spot Dermabrasion: The vitiligenous skin is eroded with the dermabrader leading to wounding of the area and resultant healing with hyper pigmentation.
Vitiligo surgeries: Mini punch grafting, suction blister grafting, split thickness grafting, melanocyte culture etc .
Vitiligo surgeries are preferred in patients having stable and lesser number of patches on the cosmetically visible areas. This giver better chances of improvement and recovery from the disease.
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