Abnormal skin pigmentation
Birthmarks and other pigmentation disorders affect many people. Some of the most common problems are listed below. If you think you have one of these skin pigmentation abnormalities, make sure to visit a physician or dermatologist to receive an official diagnosis.
Birthmarks
As might be expected, this abnormal skin coloration will appear at birth or in just a few weeks following birth. While it’s important to know that most birthmarks are non-cancerous, certain birthmarks, described below, can pose health risks.
Pigmented birthmarks
The discoloration of the skin will appear smooth and flat. These spots are known by several names, including Nevus of Ota, characterized by bluish discoloration of the facial skin and sometimes the white part of the eye (sclera); Mongolian spots, which are bruised or bluish in color, typically appearing on buttocks; café-au-lait spots, which are light brown; and typical moles, which are also called nevi, which may be flesh-colored to light to dark brown. Moles should be monitored for bleeding, color, shape or size changes, or itching.
Macular stains
These appear anywhere on the body, appearing as mild red marks, but they are not elevated. Macular stains are the most common type of vascular (from blood vessels) birthmark. These marks can come in two forms: angel kisses, which may appear on the forehead and eyelids and typically disappear after age two; or stork bites, which will appear on the back of the neck and can last into adult years. Because these marks are often mild, there is no treatment necessary.
Hemangioma
Hemangiomas are growths composed of many tiny blood vessels bunched together and vary in severity. Typically, this birthmark is just a small mark on the skin of the face, trunk or extremities. However, in some children, hemangiomas can be large and grow rapidly through the first year of life. There are two types of hemangiomas: strawberry (or superficial) hemangiomas, which are slightly raised and can appear anywhere on the body; or cavernous (deep) hemangiomas, which are deeper birthmarks characterized by a bluish color. Fortunately, most hemangiomas will go away on their own: 50% resolve by age five, 70% by age seven and 90% by age nine. Reasons to treat hemangioma include problems with functions (such as sight, eating, hearing or defecation), ulceration, bleeding or pain. If medically indicated, hemangiomas can be treated in different ways, each of which carries its own risks. Corticosteroid medication can be injected or taken orally. Risks associated with corticosteroid medication include high blood pressure, high blood sugar, poor growth, or cataracts. Certain hemangiomas can also be treated with lasers to stop them from growing and facilitate resolution. Rare risks associated with that treatment include ulceration and scarring. In some cases, a hemangioma can also be removed with surgery.
Port wine stains
Port wine stains are caused by abnormal development of blood vessels (capillaries) and last a lifetime. The port wine stain (also known as nevus flammeus) appears as a flat, pink, red, or purple mark, and occurs on the face, trunk, arms, or legs. Port wine stains present on eyelids are thought to pose an increased risk of glaucoma. Physicians have tried many ways to treat port wine stains, including radiation, tattooing, freezing, dermabrasion, or sclerotherapy. Laser therapy is currently the treatment of choice, as it is the only method that destroys capillaries in the skin without causing damage to the rest of the skin. Port wine stains may be seen in certain medical disorders, including Sturge-Weber Syndrome, whose symptoms include port wine stains on the face, vision problems, convulsions, mental retardation, and perhaps even paralysis; and Klippel-Trenaunay Syndrome in which a limb has a trio of port wine stains, varicose veins, and/or too much bone and soft tissue growth. Each of these syndromes is very rare.
Skin pigmentation disorders
Albinism
Albinism, an inherited disorder, is caused by the absence of the pigment melanin and results in no pigmentation in skin, hair, or eyes. Albinos have an abnormal gene, which restricts melanin production. There is no cure for albinism, and individuals should use a sunscreen at all times because they are much more likely to get sun damage and skin cancer. This disorder can occur in any race, but is most common in Caucasians.
Melasma
Melasma (also known as chloasma) is characterized by tan or brown patches that may involve the forehead, cheeks, upper lip, nose, and chin. Although this condition is typically termed the "pregnancy mask," men can also develop it. It may also occur in women on birth control pills or postmenopausal estrogen. Melasma may go away after pregnancy, but persistent pigmentation can be treated with certain prescription creams and some over-the-counter skin care products. Remember to consult your dermatologist for a proper diagnosis of this condition before you choose to treat it yourself. If you have melasma, use a sunscreen at all times because sunlight will worsen your condition.
Pigmentation loss as a result of skin damage
If you’ve had a skin infection, blisters, burns or other trauma to your skin, you may have a loss of pigmentation in the affected area. The good news with this type of pigment loss is that it’s frequently not permanent, and cosmetics can be used to cover the area.
Vitiligo
Vitiligo is pigment loss due to the body’s immune system attacking pigment cells (melanocytes). Other associated immune system diseases include diabetes, pernicious anemia, thyroid disease, or Addison’s disease. Vitiligo causes smooth, white skin patches, usually around the mouth and eyes, or on the back of the hands. In some people, these patches can appear all over the body. There is no cure for vitiligo, but there are several treatments, including dyes or psoralens (light-sensitive drugs) used in combination with ultraviolet a light treatment, and more recently the excimer laser, which delivers UVB light.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/12/2007...#11014
