By DR. MIRIAM LAKER-OKETTA
As a child, I struggled with a skin condition called eczema, which included very itchy rashes in the fold of the arms and legs and after healing would leave the area darkened for a long time. Many years later, as a medical doctor, I have experienced severe allergies to rubber gloves, causing both my hands to be covered in rashes and eventually healing, leaving dark spotty scars. The Skin is a canvas; the largest organ of our bodies, protecting our internal organs from exposure to the environment and helping us regulate our inner body temperature. In addition, the skin reflects our health, heritage and unique stories. Skin colouring (skin pigmentation) adds to the beauty and uniqueness of each individual. In this article, we will explore conditions that cause the skin to change in ways that normal skin should not- pigmentation disorders.
Pigmentation disorders affect the skin’s colour, often due to changes in melanin, the pigment responsible for skin tone. When melanin production is disrupted, it can lead to noticeable changes. The disruption may lead to over or underproduction of melanin, leading to darkening (hyperpigmentation) or lightening (hypopigmentation).
Hyperpigmentation: when skin darkens Post-injury hyperpigmentation: This happens after healing from acne, eczema and any other form of skin rash or burn, only to find stubborn dark spots lingering. The darkening often lasts a long time and may take months to years before returning to normal tone. However, the skin feels normal like the rest of the unaffected skin.
Melasma: It is often called the “mask of pregnancy” because it frequently occurs in pregnant women. Melasma presents as symmetrical, dark patches on the face, particularly on the cheeks, forehead and upper lip. Triggered by sun exposure, hormonal changes, or medications like birth control pills, melasma can affect anyone but is more common in women.
Managing melasma involves diligent sun protection and sometimes topical treatments to lighten the patches.
Hypopigmentation: when skin lightens Vitiligo is a long-standing condition, characterized by the appearance of pink patches on the skin. It may be limited to a small area of the skin or extend to include most parts of the body. The hairs in the affected patch also grow completely white. It occurs when melanocytes, the cells responsible for producing skin pigment are destroyed. This loss is thought to result from an autoimmune response, where the body’s immune system mistakenly attacks these cells. Some medications can trigger vitiligo as a side effect, particularly.
those that affect the immune system or skin. Non-genetic factors like stress, sunburn and exposure to certain chemicals like those found in hair dyes and skin-lightening creams can also contribute to its development. While not harmful or contagious, vitiligo can have significant psychological and social effects due to its visible nature.
Pityriasis Alba is a common but not serious skin condition primarily affecting children and adolescents. A person with it has pale, slightly scaly patches on the skin, most often on the face. The patches are usually round or oval and in very light-skinned people it might be more noticeable after sun exposure, as the surrounding skin tans while the patches remain light. The exact cause is unknown, but it is associated with eczema and dry skin conditions. Pityriasis Alba often resolves on its own, however, moisturizers and gentle skin care like avoiding harsh soaps like washing soap for bathing can help improve the appearance and manage dryness. In some cases, mild topical steroids are used to reduce inflammation.
Managing Pigmentation Disorders Some conditions for instance vitiligo may have no cure. For others, treatment takes time and response to treatment takes months to years. If not causing psychological distress, there may be no need to treat, for instance, the pregnancy mask in pregnancy and hyperpigmentation following the healing of rashes and other injuries. Consistency in your skincare routine
and patience are key. Improvements may take months but perseverance usually pays off.
It is important to remember that for the good health of skin, sun protection is a priority. Either wear a hat and long clothes when you are going to be exposed to the sun for long or use a good sunscreen. Opt for a broad-spectrum SPF 30 or higher to prevent further darkening and protect against new pigmentation issues.
Creams and ointments only prescribed by a skin specialist can be used to help lighten dark spots. Some examples include: hydroquinone, retinoids and vitamin C. There are other procedures for instance: chemical peels, laser therapy and microdermabrasion for persistent pigmentation problems. Ensure these are performed by dermatologists; doctors who are skin experts. Some natural remedies have also been reported to work. They include aloe vera, liquorice extract and green tea, which offer gentle safe lightening to darkened areas.
In general, skin disorders affecting pigmentations are related to extra exposure to sunlight. It may be due to changes in hormones for instance, from pregnancy and use of hormonal contraception, or for other forms of treatment, from injury to the skin. Sometimes, it is a genetic predisposition, meaning that a family history for instance of vitiligo and eczema can increase one’s risk of experiencing these disorders in their lifetime.
Above all, consult a dermatologist if you notice sudden changes or worsening of your skin condition. They can provide an accurate diagnosis and personalized treatment plan.
“skin disorders affecting pigmentations
are related to extra exposure to
sunlight. It may be due to changes in
hormones for instance, from pregnancy
and use of hormonal contraception,
or for other forms of treatment, from
injury to the skin”
The Author has an advanced training in Epidemology and Biostatistcs. Her current research focus is HIV-associated mailgancies,
specifically Kaposi’s sarcoma and cervical cancer epidemiology, early detection, diagnosis and treatment. She is also co-
founder of the Hub for African Women in Science (AWiSH)
