According to the Cleveland Clinic, there are a number of conditions considered to be abnormal pigmentations of the skin. These conditions range from a variety of types of birth marks to moles and freckles to melasma and vitiligo. Treatment for the conditions vary, with some responding to medicated creams and others requiring laser treatment or removal.
Consult your health care provider with your concerns about abnormal skin pigmentation.
Types
Birth marks are areas of abnormal pigmentation that are present at birth or develop during the first few weeks of life.
Melasma, also known as cholasma, causes brown patches on the skin and is often referred to as the "mask of pregnancy" because it often develops on the face and is more common in pregnant women. Some women also may develop this condition with the use of birth control pills or estrogen in post-menopause. Men may also develop melasma.
Vitiligo is a loss of skin pigment. No cure exists for this condition, but some treatments are available.
Treatment
Most birth marks do not require treatment. Port wine stains, which are birth marks that present as flat pink to purple areas on the face or other body parts, are treated with laser therapy.
Hemangiomas often go away by themselves, but if they interfere with functions such as eating or seeing, you may need treatment. Treatments may be with corticosteroid medications or laser therapy, as reported by the Cleveland Clinic.
Melasma often responds to prescription medications and some skin care products. The Cleveland Clinic advises that you consult your health care provider for diagnosis of your condition before attempting self-treatment.
Vitiligo may be treated with the combination of light-sensitive medications and ultraviolet light, dyes or an excimer laser.
Expert Insight
DermNet NZ explains that fractional laser treatment is useful in skin pigmentation abnormalities due to surgical or acne scarring, changes from sun exposure and melasma. While fractional laser treatment may be used on any part of the body, it is particularly effective on the chest, neck and hands as compared to other ablative treatments.
According to DermNet NZ, areas of abnormal pigmentation are slow to respond to treatment. Fractional laser treatment may require four to five applications one month apart before the abnormal pigmentation area is eliminated.
Considerations
A review titled "Management of Facial Hyperpigmentation" published by the "American Journal of Clinical Dermatology" reports that melasma is the most common cause of facial hyperpigmentation. The study discusses the success of various treatment modalities for facial pigmentation problems, including the use of hypopigmenting agents and chemical peels.
Topical hydroquinone and topical azelaic acid are reported to be effective, with the latter being less irritating to the skin. Tretinoin topically is reported to be effective in treating abnormal skin pigmentation related to aging. Chemical peels made wtih salicylic acid, alpha-hydroxy acid, kojic acid and others are reported to be effective treatments for melasma when used alone or in combination.
Moles
Moles, or nevi, are growths on the skin that develop because skin cells grow in a cluster rather than being spread across the skin, usually developing into brown or black spots, according to the Cleveland Clinic. Most moles are benign but should be watched for signs of possible cancer: asymmetry, size, color, elevation and border. Consult your health care provider if you notice changes in a mole or if it begins to bleed or itch.
Treatment for moles that your physician believes may be cancerous will involve a biopsy, where a small sample of skin tissue will be examined. If the mole is cancerous, the physician will remove the entire mole and skin from the circumference of the mole, then stitch the area closed.
Precaution
Dermatologists recommend that you use sunscreen on your face both before and after treatment of facial hyperpigmentation.
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