Discolourations are smaller or larger spots, visible to the naked eye, darker than the surrounding healthy skin. In terms of colour, they can be anything from light russet, through all shades of brown, to grey. Discolourations frequently develop with the participation of sunlight and in many cases they are just an accumulation of melanin – skin pigment produced in reply to ultraviolet rays. Sometimes, however, a little spot on the skin may result not only from increased quantity of the pigment itself, but also of cells which produce it – melanocytes.
Considering their frequent location on uncovered skin (face, cleavage, hand tops), they constitute a major psychological and aesthetic problem. This deficiency concerns 30% of women after the age of thirty and 90% of women after the age of fifty. Luckily, there are a number of treatments aimed at systematic removal of discolourations.
Reasons of development:
- Under the influence of sunlight radiation (UV)
- Inflammatory skin lesions (including acne)
- Hormonal changes:
- Use of oral contraceptives,
- Use of hormone replacement therapy,
- Menopause period,
- Other hormone treatments,
- Liver diseases,
- Adrenal gland hypofunction,
- Effect of phytotoxic or photoallergic substances contained in medicines, cosmetics, soaps.
Discolourations may be divided into:
- Epidermal discolourations
- Connected with an excessive quantity of melanocytes in the epidermis,
- Connected with overproduction of melanin by a correct number of melanocytes.
- Freckles – numerous, small, irregular, light or dark brown spots, located mainly on the face, but also on the arms, cleavage and back. Freckles develop in persons with a fair skin, becoming more intensive in case of sunbathing. Development of freckles is genetically conditioned and is inherited as a dominant feature. Freckles appear equally frequently in women and men, and they appear particularly often in people with fair or red hair. Under the influence of sunlight, freckles become darker and more visible.
- Melasma – one of the most common kinds of discolouration, occurring mainly in women. It usually appears after the age of 30. The role of factors causing this condition is not thoroughly explained. These are irregular discolourations, with sharp borders, brown spots without signs of inflammation, located on the face (forehead, cheeks, upper lip). The symmetry of foci gives them a mask-like appearance. Their most common symptomatic form appears during pregnancy, while taking hormone contraceptives (chloasma uterinum) – in 10-20% of women, while taking medicines (e.g. hydantoin) and during endocrine disorders (hyperthyroidism, ovary diseases). Efflorescences become augmented during intensive exposition to ultraviolet (also on a tanning bed).
- Old age lentigines – round or oval spots, clearly separated from healthy skin, small spots from light brown to nearly black. They develop in areas not protected against the impact of ultraviolet radiation (also from a tanning bed), mainly on the face, hand top sides and on the neck, as well as on forearms and calves. They usually develop between the ages of 30 and 50. With the passage of time, the spots may enlarge and become darker in colour.
- Post-inflammatory discolourations may appear in places which were previously affected by acne, some forms of skin rash (e.g. chickenpox), sunburns, allergies, injuries.
- Dermal – melanin located in perivascular macrophages in the papillary layer.
- Mixed – features of epidermal and dermal discolourations.
Most common locations of discolourations:
- Upper lip
The basis of the treatment of discolourations is efficient sun protection. It includes reduction of sunlight radiation exposure around noon, application of external UVB and UVA protection products, wearing clothes to cover the body.
Sun protection products ought to contain physical filters or a mixture of chemical and physical filters. Effective sun protection should be applied in our climate zone from April until the end of September. Persons working under fluorescent lighting should use sun filter creams throughout the year, irrespective of the season. Treatment of dermal lesions connected with discolourations is required during the process of effective removal.