What is hypopigmentation?
Hypopigmentation refers to patches of skin that are lighter than your overall skin tone. Your skin’s pigmentation, or color, is based on the production of a substance called melanin.
If your skin cells don’t produce enough melanin, the skin can lighten. These effects can occur in spots or may cover your entire body.
Genetic and severe environmental conditions can cause melanin disruption. It’s important to identify the root cause before undergoing treatment.
Here’s more on what may be causing your symptoms, what to expect from diagnosis, your options for treatment, and more.
What does hypopigmentation look like?
What causes hypopigmentation?
Problems with melanin production are linked to a variety of causes. Some are genetic conditions that may result in lighter skin throughout the body. Others are related to previous injuries, such as burns.
It’s also possible for hypopigmentation from an injury to develop into an associated condition.
Some of the most common conditions include:
Albinism is best known for extremely pale skin that may have little to no color. This genetic condition can also make your hair white and your eyes light blue in color. People with albinism are born with this condition because of a genetic mutation.
Like albinism, vitiligo is characterized by lighter skin. However, this occurs in patches that cover your skin, rather than a widespread lack of color. The exact cause of vitiligo is unknown. People who have this condition can develop lighter patches of skin anywhere on the body.
Pityriasis alba refers to leftover white spots from previous cases of red, scaly skin patches. This condition tends to heal on its own over time. There’s no definitive cause for pityriasis alba, though it’s thought to be related to eczema. Children with this condition may outgrow it in adulthood.
Tinea (pityriasis) versicolor stems from a fungal infection that occurs from overactive yeast on the skin. Though it doesn’t lead to complications, the resulting scaly spots can become a nuisance.
According to the American Academy of Dermatology (AAD), this is one of the most prevalent skin diseases among people living in tropical or subtropical regions because these environments help fungus thrive. You may also be more prone to tinea versicolor if you sweat a lot or have oily skin.
Lichen sclerosus causes white patches that may eventually enlarge, bleed, and scar. These patches occur in the anal and genital areas. They can also develop on the breasts, arms, and upper body. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), lichen sclerosis is most common in women experiencing menopause.
Widespread hypopigmentation is often genetic. That said, it’s possible for acquired conditions to result in temporary and even long-term discoloration.
- Atopic dermatitis. Also known as eczema, this skin condition causes red patches that are extremely itchy. As the skin heals, the patches may turn white.
- Contact dermatitis. Touching chemicals may lead to this type of eczema and may cause lightened skin.
- Healed blisters. As blisters heal, the affected skin flattens and may turn darker or lighter in color.
- Infections of the skin. As your skin heals, lighter pigments may appear in areas affected by the infection.
- Psoriasis. This autoimmune disorder causes your skin to produce new cells at an accelerated rate. Resulting silver and red patches may eventually heal and look lighter than the rest of your skin.
- Scars and burns. These can lead to scar tissue that’s lighter than the surrounding skin.
How is this condition diagnosed?
Your doctor will rely on results from a physical exam and information about your family history to make a diagnosis.
During your physical, your doctor will assess all areas of skin and make note of any areas where pigmentation is lighter than others. They’ll also make note of any suspicious-looking moles or any other areas of concern.
In some cases, your doctor will perform a biopsy. For this procedure, they’ll scrape a small sample of skin off to send to a laboratory for further analysis. This is most common with suspected cases of lichen sclerosus, pityriasis alba, and tinea versicolor.
Your doctor may also ask you about skin pigmentation in your immediate family. This can help them determine any genetic components.
What treatment options are available?
After making a diagnosis, your doctor will help you develop an appropriate treatment plan for your symptoms.
Your options will depend on:
- the underlying cause
- overall health
- area of coverage
According to DermNet New Zealand, hypopigmentation doesn’t usually require treatment if it’s related to acute inflammation. This includes burns and scarring.
In these cases, the lack of color will resolve on its own as your skin cells in the region heal. The skin cells in the affected area should be able to produce melanin again within the next couple of months.
In the meantime, your doctor can recommend other treatment measures to reduce the appearance of white patches.
Treatment options may include:
- chemical peels
- laser resurfacing or therapy
- lightening gels, such as hydroquinone (Blanche)
If your symptoms are tied to an underlying condition, treating the condition may help ease your symptoms.
For example, prescription anti-inflammatory creams are used to treat lichen sclerosus and pityriasis alba. Moisturizing the skin can also speed up the healing process.
Antifungal medications are used to treat tinea versicolor. These may be taken orally via pills, or applied directly to the patches with a topical cream. The AAD also recommends using a medicated cleaner once every two to four weeks to keep the fungus from coming back.
There are many options for the treatment of vitiligo. According to the AAD, restorative light treatments have a 70 percent success rate. Depigmentation, laser therapy, and surgery are also options. However, their effects may wear off over time.
Some conditions, like albinism, are life-long. If your hypopigmentation is long-lasting, talk to your doctor about what to expect in the short- and long-term. You may need to take certain precautions to prevent additional complications.
Can hypopigmentation lead to complications?
Lichen sclerosus doesn’t cause skin cancer itself. But severe scars related to the condition may become cancerous.
Social concerns should also be considered as complications of hypopigmentation. For example, many people who have vitiligo and albinism also experience social anxiety because of their skin’s appearance and how others interact with them.
What’s the outlook?
Your individual outlook depends on what’s causing your hypopigmentation. Skin cell damage from wounds, burns, and infections will likely heal over time and then be able to give your skin color again. Pityriasis alba also goes away on its own.
Tinea versicolor tends to clear up once you’ve taken antifungals. While the condition might return, it’s still treatable.
Other long-term skin disorders require follow-ups with your doctor. For lichen sclerosis, the NIAMS recommends a skin checkup every six months to a year.
On the flipside, certain genetic disorders, like albinism, aren’t curable. In these cases, your doctor will work with you on symptom management and ways to reduce your risk of added complications.