Hypopigmentation


Hypopigmentation is characterized specifically as an area of skin becoming lighter than the baseline skin color, but not completely devoid of pigment. This is not to be confused with depigmentation, which is characterized as the absence of all pigment. It is caused by melanocyte or melanin depletion, or a decrease in the amino acid tyrosine, which is used by melanocytes to make melanin. Some common genetic causes include mutations in the tyrosinase gene or OCA2 gene. As melanin pigments tend to be in the skin, eye, and hair, these are the commonly affected areas in those with hypopigmentation.
Hypopigmentation is common and approximately one in twenty have at least one hypopigmented macule. Hypopigmentation can be upsetting to some, especially those with darker skin whose hypopigmentation marks are seen more visibly. Most causes of hypopigmentation are not serious and can be easily treated.

Presentation

Associated conditions

It is seen in:
Areas of lighter pigmentation can be indications of hypopigmentation. Biopsies and genetic information are also used to diagnose.

Treatments

Often, hypopigmentation can be brought on by laser treatments; however, the hypopigmentation can be treated with other lasers or light sources.
Treatment for hypopigmentation depends on the initial cause of the discoloration.
Initial Cause of DiscolorationTreatment
Idiopathic guttate hypomelanosisNo treatment
Postinflammatory hypopigmentationTreat the underlying inflammatory disease to restore pigmentation
Pityriasis versicolorA topical ointment, such as Selenium sulfide 2.5% or Imidazoles.
Can also use oral medications, such as oral Imidazoles or Triazoles.
VitiligoTopical steroids, including Calcineurin inhibitors.
Patients can also have transplants if they're stable or a depigmentation with topical MBEH if the patient has widespread discoloration.
Chemical or drug induced leukodermaAvoidance of causative agent with subsequent treatment similar to vitiligo.
PiebaldismNone; occasionally transplants.