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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Skin - abnormally dark or light

Hyperpigmentation; Hypopigmentation

Last reviewed: May 15, 2013.

Skin that has turned darker or lighter than normal is usually not a sign of a serious medical condition.

Considerations

Normal skin contains cells called melanocytes. These cells produce melanin, the substance that gives skin its color.

Skin with too much melanin is called hyperpigmented skin.

Skin with too little melanin is called hypopigmented skin.

Pale skin areas are due to too little melanin or underactive melanocytes. Darker areas of skin (or an area that tans more easily) occurs when you have more melanin or overactive melanocytes.

Bronzing of the skin may sometimes be mistaken for a suntan. This skin discoloration often develops slowly, starting at the elbows, knuckles, and knees and spreading from there. Bronzing may also be seen on the soles of the feet and the palms of the hands. The bronze color can range from light to dark (in fair-skinned people) with the degree of darkness due to the underlying cause.

Causes

Causes of hyperpigmentation include:

Causes of hypopigmentation include:

Home Care

Over-the-counter and prescription creams are available for lightening the skin. If you use these creams, follow instructions carefully, and don't use one for more than 3 weeks at a time. Darker skin requires greater care when using these preparations. Cosmetics may also help cover a discoloration.

Avoid too much sun exposure. Always use sunscreen with an SPF of 30 or higher.

Abnormally dark skin may continue even after treatment. Experts recommend emotional support or counseling.

When to Contact a Medical Professional

Call your doctor for an appointment if you have:

  • Skin discoloration that causes significant concern
  • Persistent, unexplained darkening or lightening of the skin
  • Any skin sore or lesion that changes shape, size, or color may be a sign of skin cancer

What to Expect at Your Office Visit

Your doctor will perform a physical exam and ask about your symptoms, including:

  • When did the discoloration develop?
  • Did it develop suddenly?
  • Is it getting worse? How fast?
  • Has it spread to other parts of the body?
  • What medicines do you take?
  • Has anyone else in your family had a similar problem?
  • How often are you in the sun? Do you use a sun lamp or go to tanning salons?
  • What is your diet like?
  • What other symptoms do you have? For example, are there any rashes or skin lesions?

Tests that may be done include:

Your doctor may recommend creams, ointments, surgery, or phototherapy, depending on the type of skin condition you have. Bleaching creams can help lighten dark areas of skin. 

Some skin color changes may return to normal without treatment.

References

  1. Ortonne JP, Passeron T. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 66.
  2. Chang MW. Disorders of hyperpigmentation. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 67.

Review Date: 5/15/2013.

Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial Team.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Comparison of a light‐emitting diode with conventional light sources for providing phototherapy to jaundiced newborn infantsComparison of a light‐emitting diode with conventional light sources for providing phototherapy to jaundiced newborn infants
    Jaundice, or yellowish discolouration of the skin, can occur due to increased amounts of bilirubin pigment in the blood. It is a commonly observed, usually harmless condition in newborn infants during the first week after birth. However, in some babies the amount of bilirubin pigment can increase to dangerous levels and require treatment. Treatment of jaundice in newborn infants is done by placing them under phototherapy, a process of exposing their skin to light of a specific wavelength band. Fluorescent tubes or halogen lamps have been used as light sources for phototherapy for many years. A light‐emitting diode (LED) is a newer type of light source which is power efficient, has a longer life and is portable with low heat production. In this systematic review, the efficacy of LED phototherapy was compared with conventional (non‐LED) phototherapy. LED phototherapy was observed to be efficacious in bringing down the levels of serum total bilirubin, at rates similar to phototherapy with conventional light sources.
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Figures

  • Vitiligo, drug induced.
    Vitiligo on the face.
    Incontinentia pigmenti on the leg.
    Incontinentia pigmenti on the leg.
    Hyperpigmentation 2.
    Post-inflammatory hyperpigmentation - calf.
    Hyperpigmentation w/malignancy.
    Post-inflammatory hyperpigmentation 2.

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