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HYPERPIGMENTATION
PATHOPHYSIOLOGY
Normal skin contains cells called melanocytes. These cells produce melanin, the substance that gives skin its color. Hyperpigmentation occurs when an excess of melanin is produced. As the body ages, melanocyte distribution becomes less diffuse and its regulation less controlled by the body. UV/UVB/UVA rays stimulate melanocyte activity, and where concentrations of the cells are denser than surrounding areas, hyperpigmentation is affected.

TYPES OF HYPERPIGMENTATION

Age spot
are due to an additional damage caused by sun exposure over time. They show as brown macular lesions, usually with a diameter of 1 cm, and are more common in men than in women. The areas most affected are typically those most vulnerable: the face and the back of the hand.

Sun spot
They occur mainly on the areas most exposed to solar radiation and are caused by excessive exposure to the sun without adequate protection, resulting in sunburn.

Post inflammatory
hyperpigmentation
These are dark and discolored spots that appear on the skin following acne that has healed. This occurs following skin injury from acne lesions, psoriasis, burns, friction and even certain professional skin care treatments. It begins to fade as the skin regenerates itself.

Lentigines
These are commonly known as liver spots or age spots. Although they do become more prevalent with age they are not directly caused by the aging process. Rather, lentigines are related to UV exposure.

Melasma
This is caused by hormonal fluctuations, common, for example, during pregnancy, with thyroid dysfunction, and through use of birth control pills and hormone replacement therapy. It is linked to an irregular and intense accumulation of melanin, is not accompanied by proliferation of melanocytes, but overproduction of the pigment itself. Mainly located on the central part of the face, but sometimes also on the neck, forearms and less exposed areas such as the chest.

CAUSE
The causes of hyperpigmentation include sun exposure, hemochromatosis (iron overload), certain medications, hormonal changes, or a congenital disorder of pigmentation.

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