Skin color variations
Skin color is determined by cells called melanocytes. All races have the same number of these cells. Melanosomes are structures in melanocytes that produce the pigment melanin. The melanocytes in dark skin are more chalk-nosed and their size is also larger than in light skin. Although people with skin of color are better protected against skin cancer and premature wrinkles due to sun exposure, regular use of a good, broad-spectrum UVA/UVB sunscreen with SPF15 is essential to protect all people with skin of color.
Post-inflammatory hyperpigmentation
Post-inflammatory hyperpigmentation (darkening of the skin) can occur after an injury such as a cut, scrape or burn, or after certain types of disorders such as acne or eczema. It occurs on all skin types, but occurs more frequently and is more noticeable on dark skin. Prompt treatment of the underlying condition can help prevent the development of dark spots.
The darkened areas of the skin may take many months or years to resolve, although medications may help. Chemical peels, microdermabrasion and bleaching medications prescribed by a dermatologist can fade pigment faster. Avoid abrasive, aggressive scrubbing, or plucking treatments unless prescribed by a dermatologist.
Daily use of sunscreen is very important to prevent darkening of post-inflammatory hyperpigmentation.
Vitiligo
Vitiligo is a disease in which pigment cells are destroyed, resulting in white patches. The exact cause is unknown, but it is thought to be an autoimmune disorder (the body produces antibodies of its own pigment).
The degree to which the skin loses color varies from person to person. It is impossible to predict how much pigment will be lost. Although rare, people can lose skin pigment all over their body. In most patients, skin color does not recover after treatment.
Several methods, including cortisone or other creams, light, laser, pulsed intense light (PIL) treatments, or skin grafts, can be used to treat vitiligo, but there is no perfect treatment. The most common method is PUVA therapy, which combines taking the drug prosalen and treatment with UVA light. In cases where vitiligo affects a large part of the body, destroying the remaining normal pigment sometimes helps. A dermatologist can determine which treatment is best based on the extent of the disease.
Darkening of the skin of the lower extremities
Darkening of the skin of the legs refers to structural changes in the epidermis. It may indicate serious illnesses that can lead to serious harm to health (including loss of a limb). However, timely consultation with a doctor can prevent adverse consequences.
Diseases in which the epidermis darkens
Darkening of the skin of the lower extremities appears for the following reasons:
- vascular pathologies;
- diabetes;
- gangrene.
Discoloration of the upper layers of the epidermis can be caused by vascular diseases, including thrombosis and venous insufficiency. It is caused by insufficient blood flow in the area of the feet and legs, and a lack of oxygen in the tissues of the legs. In this case, it is impossible to get rid of darkening with the help of cosmetics - they require more serious treatment. Neglecting a visit to the doctor can lead to serious consequences such as necrosis.
The skin may darken due to varicose veins. With the disease, vascular tone significantly deteriorates. Because of this, they cannot raise the blood upward. Stagnation occurs, as a result of which the veins expand even more. Swelling occurs, making everyday activities difficult and causing discomfort.
Diabetes also seriously impairs blood flow, including in the lower extremities. Lack of oxygen and nutrients in the tissues of the legs leads to darkening of the epidermis. The formation of small ulcers is possible, which, due to the nature of diabetes mellitus, do not heal on their own. Pathogenic microorganisms that can cause inflammation easily penetrate into such damage.
Darkening of the skin may be a sign of gangrene. When tissues die, they change their structure. This also applies to the epidermis. Gangrene can be caused by vascular diseases, diabetes, and infection.
Causes of pathologies
Diseases that can cause discoloration of the skin of the lower extremities may appear for the following reasons:
- increased load on the legs;
- genetic predisposition;
- injuries;
- surgical operations;
- hormonal changes in the body.
If a person’s work involves constant standing or carrying heavy objects, he may develop vascular pathologies in the legs. This also applies to weightlifters who lift heavy weights. Often varicose veins appear in women after pregnancy, as during pregnancy there is increased stress on the legs.
There may be a genetic predisposition to pathologies of the vessels of the lower extremities and diabetes mellitus. People whose relatives suffer from venous insufficiency, varicose veins, and other diseases are at risk.
Injuries and surgical interventions lead to the launch of regenerative processes, which can result in the appearance of blood clots and growths of connective tissue on the inner walls of blood vessels. This is often the cause of various vascular pathologies.
Hormonal changes most often occur during adolescence, in women after pregnancy or as a result of the use of contraceptive drugs. They can also cause vascular diseases (varicose veins, thrombosis, venous insufficiency, spider veins).
Seborrheic eczema
Seborrheic eczema is a condition that causes round, light-colored patches on the skin covered with small scales. It mainly occurs in children, in whom the spots can appear on any part of the body, but are most noticeable on the face and upper arms. White patches are the result of mild eczema, and the loss of color is temporary. This disease can be treated locally.
When does darkening of the skin indicate illness?
Sometimes darkened areas of the epidermis indicate the development of a skin disease. In this case, we are mainly talking about various fungal infections. For example, spots in the groin can be caused by epidermophytosis or erythrasma, on the legs and arms - depriving Zhiber. They differ significantly from uneven skin pigmentation, including symptoms such as:
- have a rough, flaky surface;
- most often accompanied by itching;
- small areas of damage quickly increase their area and can merge into a single focus;
- are located mainly in skin folds.
The standard clinical picture of such diseases is flaky, itchy, dark spots on the skin under the arms, in the groin, under the breasts. They occur when the skin is damaged by pathogenic fungi of various types. Such formations will not go away on their own; moreover, they will spread, affecting the healthy surface of the body, if they are not treated in time. A rash appears in the groin and spreads to the genitals. Treatment consists of using topical antifungal agents.
In addition to fungal, dark spots can also be bacterial in nature. An example of such a disease is erythrasma. In this case, the darkening is brown or brown in color, there is no pain, itching or burning. For the development of bacterial activity, certain conditions are necessary, for example, damage to the skin, a violation of its acid-base balance, excessive sweating, lack or, conversely, excess hygiene of the intimate area.
Given that such conditions are most common in large skin folds, erythrasma develops primarily in the same areas as fungal infections. Moreover, it occurs more often in men than in women only due to the difference in the anatomical structure. It should be noted that it is possible to return the causative bacterium within the physiological norm only by exposing the lesion to special preparations. Such dark spots on the skin between the legs or in the armpits will not go away on their own either.
To prevent these reactions, it is recommended to properly care for the skin and perform hygiene procedures regularly, but without excessive zeal, since their excess can disrupt its normal condition, including the acid-base balance. When staying in the sun, you should use protective equipment suitable for the given climatic conditions. If there is a predisposition to hyperpigmentation, it is better to avoid direct sunlight altogether.
Dry or ashy skin
Dry skin is a problem for people of all skin colors, but is especially problematic for people with dark skin tones. Dry skin is easily noticed in people with dark skin, as the color becomes greyish, “ashy”. Regular use of moisturizer can help, although some moisturizers can worsen conditions such as acne (pimples). If acne occurs or worsens, you should stop using the moisturizer and visit a dermatologist.
Ashiness can also affect the scalp. Pomades or hair oils that make hair more manageable may reduce scalp dryness, but may worsen seborrhea, an inflammatory, scaly, itchy skin condition. If pomade or hair oil is applied to the forehead, it can clog the pores, leading to pimples or “pomade acne.” If this happens, stop using the product or apply the pomade an inch away from your hairline.
Lipsticks can also contribute to a bacterial scalp infection called folliculitis, which causes pus, bumps, and redness to form around the hair. It can also lead to hair loss. If this happens, stop using the lipstick and visit a dermatologist.
Causes
Some causes of dark spots are due to internal conditions or external influences. Others are associated with diseases.
Hyperpigmentation
In simple words, it is the appearance of dark spots or areas that can cover a small area of the skin or spread over the entire body. Dark spots appear due to increased melanin production caused by the activity of pigment cells known as melanocytes located in the epidermis.
Here are the three main causes of hyperpigmentation, although there are many more.
Lentigines or lentigines
Lentigines often resemble freckles, but have clearer edges and do not darken in the sun.
The first cause of hyperpigmentation is lentigines. These are dark spots caused by exposure to the sun's UV rays and are usually scattered randomly throughout the body. They can affect the entire surface of the body or only part of it. Lentigines are similar to freckles, but they are different formations. Unlike freckles, they do not change their light after exposure to the sun and have clearer contours, although often they can only be distinguished by a specialist after examining the tissue.
People over 60 years of age are more prone to lentigines.
Post-inflammatory hyperpigmentation (PIH)
PIH is a temporary pigmentation that follows trauma (eg, thermal burn) or inflammatory skin disorder (eg, dermatitis, infection).
PIH, or post-inflammatory hyperpigmentation, can be caused by a number of conditions, injury, or the use of harsh skin care products. For example, with burns, acne or psoriasis, such dark spots are likely to appear.
Chloasma (melasma)
Another relatively common cause of hyperpigmentation is chloasma, which occurs due to hormonal imbalance. Women may notice the appearance of dark spots during periods of hormonal surge, such as pregnancy or menopause. It also occurs as a side effect of taking birth control pills and hormone therapy. Chloasma can also occur as a result of dysfunction of the thyroid gland, pituitary gland, liver, diseases of the reproductive organs in women, malaria, tuberculosis, syphilis, pellagra.
These spots have different shapes and sizes, irregular shapes, smooth surfaces and clear boundaries. Their color is light yellow to gray-brown and dark brown. They do not always go away on their own, as they are often chronic.
Liver dysfunction
Dark pigmentation is one of the signs of liver damage, along with other common symptoms (eczema, hives, rash, white coating on the tongue, dark urine, and others). The liver cannot filter out all the fats, drugs and other substances that enter the body. This means that some of the toxins that are responsible for skin discoloration remain in the body. Fatty liver disease, or non-alcoholic fatty liver disease (NAFLD), can cause liver damage from eating too much fat.
Acne scars
Acne can affect any part of the body - face, neck, back, chest and others. Common symptoms of this condition include pimple formation and blackheads or whiteheads. Once healed, they usually fade into dark scars that together form spots. However, some scars turn white and can cover the entire body.
To reduce pigmentation, use topical creams and gel solutions containing benzoyl peroxide. You can also try sulfur lotions, cleansers and masks, or try salicylic acid. Antibiotics successfully fight bacteria that cause acne.
Rough scrubs and friction
Whenever you wear tight clothing or use harsh scrubs, the skin becomes inflamed and melanin is released. And the longer the contact with hard materials and substances, the more dark spots appear.
Sun exposure
Prolonged exposure to the sun causes dark spots to appear. The UV rays emanating from the sun are harmful to the skin as they cause burns, which in turn lead to dark spots on the skin. There are different types of dark spots from sun exposure. Let's take a look at some of them.
Age spots
Age spots do not necessarily appear in old age, although more often at a more mature age.
In fact, this is lentigo (lentigines) mentioned at the beginning of the article. These “flat lesions typically have separated borders, are dark in color, and have an irregular shape.” [Www.aocd.org].
Exposure to UV rays causes spots on areas exposed to the sun, namely the face and hands. They vary in size at different ages. Learn more about age spots and their removal.
Chloasma (melasma)
These are dark spots that sometimes appear during pregnancy, or are caused by other hormonal changes or medical conditions, and usually go away on their own. They were described above in the section on hyperpigmentation, and there is a photo there.
Ephelides (freckles)
They may appear if you spend a lot of time in the sun.
"Light Bulbs"
These are spots on dark skin caused by rays from artificial lighting. According to David Banik (a professor at Columbia), “Visible light causes pigment formation in the same way that UV radiation does.” [www.allure.com]
Since melanin determines our skin color, you can prevent blemishes by using mineral sunscreens containing zinc oxide or titanium dioxide.
Bra
According to Jeanine Downey, MD (a dermatology expert in New Jersey), a bra that is too tight can cause red, black, or dark spots. There is constant friction between the bra and the breasts, which causes irritation of the skin around the chest, shoulders or back. They look like burn marks.
Laptops (spots on thighs)
Prolonged heat exposure from a laptop sometimes causes spots on the thighs
Research has shown that exposure to radiant heat from a laptop on the thighs while using it can lead to hyperpigmentation. Also known as erythema reticularis or toasted skin syndrome, these are “patches of discolored skin on the legs,” [dailymakeover.com] that appear after prolonged laptop use on the thighs.
The best way to avoid this is to use cooling pads or trays.
Facial hair removal
Some women who have excess chin hair remove it using chemical creams, tweezers, or manually plucking it out. After exposure to products with aggressive components, such as chemicals or creams, the skin will become inflamed, causing post-inflammatory hyperpigmentation to develop.
Use a gentle cleanser to get rid of post-inflammatory hyperpigmentation dark spots. Hydrocortisone cream will help relieve pain, but use it for no more than 4-7 days. Avoid using toner and scrub to prevent further damage to your skin.
Pigmented nevi (birthmarks, moles)
These are naturally occurring black or brownish raised growths on the skin that are found either individually or in groups on the body. The main cause of nevi is the clustering of melanocyte cells in one place, instead of being evenly distributed during cell division and growth. Mostly darken after exposure to sunlight.
There are two common types of moles: congenital and dysplastic. Less common are destructive melanocytic nevi and complex melanocytic nevi.
Pimples
During puberty, many young people develop acne as part of the teenage stage. After acne marks have healed, they darken due to the production of melanin.
As a precaution, you can try using Hydrocortisone 1% to reduce inflammation and lighten dark spots.
Keloids
When a scar from a cut or wound enlarges and spreads beyond the original wound, the phenomenon is called a keloid. Keloids can come in different sizes, shapes, and locations, and most often occur in people with skin of color.
Most often occurring on the earlobes, chest, back or arms, keloids usually occur after injury or infection. In some cases they arise spontaneously, especially in the middle of a pile of cells. Keloids often occur after surgery or ear piercings.
Depending on the location, treatment may include cortisone injections, pressure bandages, silicone gels, surgery, laser treatment, cryosurgery, liquid nitrogen, radiation therapy, or combination therapy. Unfortunately, keloids are difficult to treat and will recur, sometimes larger than before. New treatment regimens are being developed.
Types and localization
The main types of stains are distinguished.
Lentigo. These are dark brown spots on the skin. Usually slightly elevated above her level. They have an oval, round shape. The size of manifestations can increase to a small coin.
Lentigo is divided into solar and age-related. Solar sunburn occurs after prolonged exposure to ultraviolet radiation on the skin. Young people are at risk. Such spots can occur after frequent visits to the solarium.
Localized on the neck, shoulders, chest, hands. Age spots are associated with hormonal imbalance. Affects the skin of the face, décolleté, and neck.
Freckles. They tend to spread throughout the body. Spots with clear boundaries, light brown in color. It mainly affects people with fair skin.
Pathology has a genetic predisposition. Spots on the back and other areas appear depending on the time of year. In spring and summer their color is brighter than in autumn and winter.
Chloasams. Large spots affect large areas of the skin. They are often associated with hormonal imbalances. Usually occur in females.
The elements have irregular features and tend to merge into large spots. Spread to the area of the face, ears, neck. Prolonged exposure to sunlight aggravates this problem.
Nevi. Moles, light brown spots, are one of the common types of pigmentation. They can be smooth, convex, with a clear outline.
Appear due to improper distribution of melanin. They affect the epidermis throughout the body.
Post-acne. Spots appear on the site of former acne. They are pink in color.
Hypopigmentation. Accompanied by vitiligo and albinism. The skin of such people completely or partially lacks melantocytes.
These are rare pathological conditions of the skin. Manifestations can affect large areas.
Any spots on the skin require diagnosis. This will help to effectively and safely identify the cause and carry out appropriate therapy.
The material was prepared specifically for the website mazikrem.ru, edited by clinical pharmacologist Nedelko K.V.
Keloid acne of the neck or keloid folliculitis
Some men, especially those who use a razor blade to remove hair from the back of the head and neck, develop bumps and keloid-type scars. The area may be itchy and sometimes become infected. Treatment includes oral antibiotics, topical acne products, and topical or injected cortisone. If the damage is severe, surgical removal or the use of a laser may be necessary. Timely treatment by a dermatologist is essential to achieve better treatment results.
Melanoma
Melanoma can occur on the palms, soles, fingers and toes (and between them), nails, and mucous membranes (mouth or nose) of people with skin of color. A new dark mark or a mark that changes in size, shape or color in these areas should be seen by a dermatologist immediately. Skin, hair, and nail conditions that are common among people of color are usually not serious, but can be a nuisance. These diseases can be easily recognized and successfully treated by visiting a dermatologist.
