Types of Pigmentation on Face: Understanding Your Skin Discoloration

Nobody enjoys seeing a pigmented patch on their face. While benign, it feels disheartening and has you running around searching for a quick fix.

Skin pigmentation generally refers to the natural hue of one’s skin, the color that is passed down based on genetics and geographical location. Over time, an interplay of factors can cause an uneven distribution of pigmentation, resulting in spots and patches different than your skin color.

This article will explore different types of pigmentation that appear on the face and ways to identify them for better skin health.

Keynotes:

• Skin pigmentation is a natural process in which the body releases melanin (pigment) to protect it from stressors such as inflammation, injury and sun exposure.
• Some types of pigmentation are hyperpigmentation, freckles, age spots, post-inflammatory hyperpigmentation, melasma and hypopigmentation.
• Identifying the pigmentation type and its causes can help in easier diagnosis and efficient use of targeted skin care and sunscreen.
• Be sure to consult a dermatologist in case of persistent hyperpigmentation or worsening of symptoms.

Have you noticed your arms and legs gradually getting tanned with extended sun exposure, while you lounge by the pool? The mechanism that causes this change is called as skin pigmentation. It is a natural process and an efficient way in which the body protects you against external stressors.

Definition of Pigmentation

Our skin is an interesting mix of cells, hair follicles, blood vessels, tissues, and pigments. One pigment in particular, melanin, dictates the type of color of our skin.

This process is triggered by the oxidation of tyrosine in the melanocyte cells as a response to stressors.
The result: a reaction leading to the generation of melanin. This pigment is then sent outwards towards the basal layer, manifesting as skin pigmentation.

The pigmentation color may differ based on the type of melanin deposited onto the skin. While eumelanin produces brown and black patches, pheomelanin results in red and yellow spots (often seen on light skin).

Fitzpatrick’s scale is a well-accepted classification system that categorizes skin types from I to VI based on how diverse skin tones respond to UV radiation. At the extreme ends of the spectrum are type I (white skin). which burns but doesn’t tan, and type VI (black skin), which tans yet seldom burns. Indian skin tones fall between types III to VI, that slightly burns and tans easy.

Causes of Skin Pigmentation Changes

Normal pigmentation is genetically inherited; in contrast, abnormal pigmentation (darkening or lightening) can point towards various different causes. Let’s explore this in detail:

1. Sun Exposure

   UV radiation from the prolonged accounts of sun exposure is a substantial aggressor on the skin. It triggers a surge of melanin production in the body to combat the photodamage. This leads to tanning, spots, and other types of localized hyperpigmentation.

2. Hormonal fluctuations

   A significant shift in estrogen and progesterone hormones in the body can influence melanogenesis. Such fluctuations are quite common and can be seen during puberty, pregnancy, and conditions such as PCOS.

3. Inflammation

   Irritation, trauma (to the skin), and internal inflammatory conditions, like acne and eczema, result in excess deposit of melanin in the skin. This is commonly called post-inflammatory hyperpigmentation, which acts as a way to heal the skin.

4. Genetics

   As explored before, genetic background as well as history of hyperpigmentation and acne in the family can trigger certain pigmentation disorders.

5. Medication

   Some medications, such as antibiotics, birth control pills, antimalarials, antidepressants, etc., are known to increase the melanocyte reactivity in the skin, leading to skin pigmentation.

6. Medical conditions

   Just like medicines, several medical conditions, like Addison’s disease or hemochromatosis, can cause a change in hormones and bronzing of skin tone.

Here is a list of various types of pigmentation disorders that one can potentially encounter:

1. Hyperpigmentation

   Hyperpigmentation is a cosmetic disorder in which the skin gradually darkens in spots or lesions due to UV exposure and other factors. It can occur across all skin types and affect larger surface areas.

2. Melasma

   Melasma is a skin condition that is frequent in pregnant women and individuals on contraceptives. It can be identified by its symmetrical gray-brown patches that appear on cheeks, nose or forehead.

3. Freckles

   Ephelides are common freckles caused by sun exposure, often seen in fair-skinned young adults and children. These can be identified by tiny, tan-brown spots along the face, arms and shoulders.

4. Post-Inflammatory Hyperpigmentation

   Trauma to the skin (external) and inflammation (internal) trigger an immune response leading to discoloration of the skin called post-inflammatory hyperpigmentation. The condition is potentially prevalent in darker skin tones (i.e. Fitzpatrick skin types III to VI).

5. Age Spots

   Solar Lentigines or Age spots are flat, darkened spots that appear on surfaces of the skin exposed to the sun, like the face, hands and arms. While these are similar to freckles in their features, solar lentigines can be seen as a sign of cumulative sun damage over ages.

6. Hypopigmentation

   Hypopigmentation, on the other hand, is sudden lack of pigment in a specific patch on the skin, turning it lighter than the rest. It often results in light or white patches due to the impact on the melanocytes in the skin. Common types of hypopigmentation are vitiligo, post-inflammatory hypopigmentation, pityriasis alba, etc.

Skin pigmentation is a complex condition that can manifest all around the body. Hence, having a keen understanding of its characteristics can help you identify it better.

Common Facial Pigmentation Types and Their Triggers

Let’s understand which among these types of pigmentation actually appears on the face:

1. Melasma: Symmetrical, blotchy patches of colors from light brown to gray, predominantly appearing on the face. Trigger: Sun exposure.
2. Freckles: Small spots (1-2 mm) on children’s faces, necks, chest and arms. Trigger: Sun exposure.
3. Post-Inflammatory Hyperpigmentation: Dark, irregular patches or lesions that manifest after injuries. Trigger: Inflammation.
4. Age Spots: Flat and small brown spots (1-3 mm), often seen in older adults. Trigger: Cumulative sun exposure.
5. Periorbital Hyperpigmentation: Dark pigmentation around the eyes and eyelids. Trigger: Genetics, poor diet and sun exposure.
6. Hypopigmentation: Light or white patches on the skin. Trigger: Immunity issues, sun exposure, inflammation or infection.

How to Differentiate Between Melasma, Freckles, and PIH

Once you are familiar with the types of skin pigmentation, you can seamlessly differentiate between common conditions. Here are some ways you can identify the pigmentation on face or other parts of the body:

• Pattern
  Look for a set pattern; if it is a cluster of small spots based on age, it could be solar lentigines or freckles. On the other hand, if the patches are symmetrical, then it may indicate melasma, while PIH is more localized and corresponds with an injury.
• Color
  In terms of color, melasma may appear as brown to gray patches, freckles as tan to red, and PIH as brown to black.
• Seasonality
  Similar to other types of pigmentation caused by UV radiation, melasma and post-inflammatory hyperpigmentation may persist year-round depending on sun exposure and hormonal issues. While freckles darken during seasons of heat (summer) and reduce during winter.
  
  Read more: How to Treat Skin Pigmentation.

Some types of pigmentation on the face can be managed with hyperpigmentation-centered skincare products and lifestyle changes. However, here are a few instances when to consult your dermatologist for your skin condition:

• If you notice rapid changes in the color, size and shape of your pigmented patches or lesions, they have to be diagnosed by a professional to rule out melanoma.
• Persistent or worsening pigmentation despite sun protection and supporting skin care routines also requires a screening.
• If you suspect a surge of pigmentation due to an underlying medical condition, like injury, hormonal imbalance or autoimmune issue.

Being proactive about any pigmentation changes is essential to not only prevent worsening of the condition but also rule out major health-related issues as well. Early intervention can help you manage the condition and sport radiant, even-toned skin with ease.

Be it a patch of pigmentation on your face or a cluster of spots on your arms, understanding its types is integral in making informed decisions about your skin health. Pay attention to your skin, follow up with dermatologically proven skincare products , apply sunscreen, and when in doubt, head to your dermatologist. Early intervention and efficient care are key to even-toned, plump skin.

1. What is the most common type of pigmentation on the face?

   Common hyperpigmentation caused by sun exposure, melasma, freckles, and post-inflammatory hyperpigmentation (PIH) are some of the most common types of pigmentation on the face. Their effects and length of resolution, however, depend on pigmentation types.

2. Can pigmentation be completely removed?

   Skin pigmentation is an ongoing process carried out to safeguard our body from the stringent effects of UV exposure. Hence, skin pigmentation on the face and other parts of the body cannot be removed completely. However, targeted skincare, topical agents and professional treatments can reduce its effects on the skin.

3. How can I identify the type of pigmentation I have?

   To identify the type of pigmentation, look for factors like color, shape, seasonality, and your personal medical history. For instance, freckles darken during summers, melasma is usually symmetrical, and a predisposition for acne may result in post-inflammatory hyperpigmentation (depending on severity). However, in times of confusion, it is best to consult a dermatologist for a professional assessment and a personalized treatment plan.

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• Sciencedirect - The main causes and corresponding solutions of skin pigmentation in the body
• NIH - Cutaneous Melanoma: Etiology and Therapy.
• Dermnetnz.org - Pigmentation disorders
• Aafp.org - Pigmentation Disorders: Diagnosis and Management
• Skincancer.org - Melanoma Warning Signs
• Health.harvard.edu - Polycystic ovarian syndrome and the skin