Hyperpigmentation of the skin is when a portion of the skin is darker than the other surrounding areas. This occurs due to melanin. Melanin is the pigment that is produced by cells called melanocytes. Melanin gives the skin its color. When the skin produces more melanin, it leads to hyperpigmentation.
Where is hyperpigmentation mostly seen?
Hyperpigmentation is mostly seen in either exposed area, for example, skin of the face. However, areas that are closed off and subject to greater amount of friction also experience hyperpigmentation. These areas include the neck, elbows, knees and the axillae (armpits).
What causes hyperpigmentation in these areas?
Hyperpigmentation seen in closed areas is mostly due to a skin condition called acanthosis nigricans (AN) where patches of velvety texture that are darker than ideal are seen on the skin. Other causes of hyperpigmentation of skin include:
1. Accumulated dead skin:
The skin needs to be exfoliated to remove the debris and reveal soft, supple skin.
2. UV ray exposure:
Ultraviolet rays that may damage the skin if overexposure. A good sunscreen with sufficient SPF is essential.
3. Birth control pills:
These magic pills are hormones that prevent from a potential pregnancy. An imbalance of hormones occurs and that can have varying effects on the body, one of them is hyperpigmentation.
The body works at super speed to accommodate the existence of an entire growing being inside it. This includes a surge in various hormones. Such a hormone imbalance tends to cause hyperpigmentation in various areas of the body which often remain for a lifetime if not deal with it.
Diabetics are more likely to experience hyperpigmentation and acanthosis nigricans. The relation is still unknown. Even teenagers who suffer from hyperpigmentation in axillary regions and joints are more likely to suffer from diabetes later in life.
Due to obesity, the skin becomes stretched and can rub against itself more often, owing to an increase in bulk. This can even cause inflammation. Areas that keep coming in contact with one another are more likely to be hyperpigmented.
7. Freckles and spots:
These are acquired hyperpigmentations that appear with age. These are mostly evident either during puberty or the aging slump that occurs after. Most women experience these after menopause. However, as a general rule, the skin starts experiencing detrimental changes after the age of 25 years.
8. Race (Ethnicity):
Hyperpigmentation is more likely to be seen in those with a darker skin. Africans and Latinos who have darker skin have a greater incidence of hyperpigmentation.
9. Fungal infections:
Fungal infections are common in areas of excess friction or where there is more sweat, e.g. the axillary region, beneath the breasts, leg folds, etcetera. Intertrigo is a condition where a candida infection can lead to hyperpigmentation of the skin in these areas. It can be a deal of great stress to the patient, especially because it is accompanied by itching and foul odor.
10. Certain skin conditions:
Patients who have preexisting skin conditions like psoriasis or eczema are more likely to experience hyperpigmentation.
11. Post acne hyperpigmentation:
Acne marks or past injuries can cause hyperpigmentation of skin that are quite difficult to get rid of.