Skin color is determined by a pigment (melanin) made by specialized cells in the skin
(melanocytes). The amount and type of melanin determines a person's skin color.
Melanin's role is to protect DNA in body cells from sun damage. It gives color to
the skin, hair, and irises of the eyes. Sun exposure increases melanin production
to protect the skin against harmful UV (ultraviolet) rays. In addition, hormone changes
can affect melanin production.
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Pigment disorder
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Characteristics
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Treatment
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Albinism
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This is a rare, inherited disorder. It reduces the amount of melanin pigment in the
skin, hair, and eyes. People with albinism (albinos) have white hair, pale skin, and
pink or blue eyes. Their eyes may seem red in different lighting conditions. Many
also have vision problems.
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There is no cure for albinism. People with this condition should avoid sun damage
to the skin and eyes by wearing sunscreen, hats, and sunglasses.
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Melasma
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This causes dark brown to gray-brown, symmetric patches of pigment on the face. During
pregnancy, this is called the mask of pregnancy. Sun exposure, hormones, and birth
control pills are thought to cause melasma.
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Sunscreens and avoiding sun exposure can prevent melasma from getting worse. Other
treatment may include prescription creams containing hydroquinone and tretinoin to
lighten the patches.
Chemical peels and laser treatment can also be used.
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Pigment loss after skin damage
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Sometimes after an ulcer, blister, burn, or infection, the skin does not replace some
of the pigment in that area.
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No treatment is needed. Makeup can usually cover the blemish.
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Vitiligo
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This causes smooth, white patches on the skin. It is caused by the loss of pigment-producing
cells in the skin (melanocytes). It's thought to be an autoimmune disease. The white
patches are very sensitive to the sun.
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Treatment may include covering smaller patches with makeup or long-lasting dyes, light-sensitive
medicines, UV light therapy, corticosteroid creams, surgery, and removing the remaining
pigment from the skin (depigmentation) so that white areas are less obvious. A prescription
skin cream for vitiligo called ruxolitinib was FDA approved in July 2022.
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Solar lentigo
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Commonly known as age spots or liver spots, these areas vary from light to dark brown.
Age spots are caused by long-term sun exposure. They are found on areas of greatest
sun exposure, like the face, forearms, and backs of the hands.
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Treatment may include skin creams or procedures like chemical peels or laser therapy.
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