Causes of Pigmentary Disorders
Pigmentary disorders can result from a variety of factors, depending on the type of disorder. Sometimes, the exact causes are unknown. Among the known causes are:
- Autoimmune disorder in which the immune system mistakenly attacks healthy melanocytes
- Genetic defects that can be inherited (passed down) through families
- Increased estrogen and progesterone levels caused by pregnancy, birth control pills, or hormone replacement therapy (HRT) in menopause
- Inflammation of the skin due to acne, eczema, psoriasis, or other skin conditions
- Surgery or certain cosmetic or dermatological procedures, such as chemical peels or microdermabrasion
- An adverse reaction to a medication
Symptoms of Pigmentary Disorders
The main symptom of pigmentary disorders is abnormally white, light, or dark areas of skin, which may or may not have sharp borders or be symmetrical. Albinism includes other symptoms, such as white skin and hair, and pink or red eyes.
Diagnosis of Pigmentary Disorders
Our experienced dermatologists are skilled at evaluating symptoms to confirm a diagnosis. We begin with a thorough evaluation that includes a:
- Physical exam
- Review of personal and family medical history
- Discussion of symptoms
Often, we can confirm a diagnosis based on the appearance of the patient’s skin, hair, or eyes. We sometimes order further testing to confirm a diagnosis or guide treatment planning. Tests can include:
- Blood tests to check levels of hormones, glucose (sugar), and vitamin B12
- Eye exam to examine the retina for issues related to albinism
- Genetic testing to check for genetic defects that cause albinism
- Skin biopsy to remove of a small sample of affected skin and examine it under a microscope to rule out other causes of abnormal pigmentation
- Wood lamp examination uses a special ultraviolet lamp to evaluate skin color changes
- Dermoscopy uses a microscope-like handheld device to detect small structures on the skin
Treatment for Pigmentary Disorders
UT Southwestern dermatologists offer the latest treatments for pigmentary disorders to relieve symptoms and prevent complications. Some of the treatment options we commonly recommend include:
- Discontinuing of medications such as birth control pills or HRT can fade melasma patches.
- Topical (applied to skin) treatments, such as creams, lotions, gels, or liquids, can either lighten dark areas or restore skin color to light or white areas. Hydroquinone and tretinoin are some options for lightening. Immunosuppressants can help restore color, and corticosteroids are options for both lightening and re-coloring skin.
- Cosmetic procedures such as chemical peels, dermabrasion, and laser resurfacing
- Phototherapy can treat light-colored patches, such as vitiligo lesions
- Skin grafts transplant areas of normal-colored skin to light or white areas. UT Southwestern offers cellular suspension grafting, a groundbreaking procedure offered in only four centers in the U.S. It uses small pieces of donor skin that are processed into a cellular suspension and transplanted into much larger areas of vitiligo.
Our dermatologists typically also recommend minimizing sun exposure through lifestyle changes such as:
- Applying sunscreen with a sun protection factor (SPF) of 30 or higher
- Wearing sun-protective clothing
- Avoiding sun exposure between 10 a.m. and 4 p.m.
Clinical Trials
Our team is active in clinical research to improve treatments for patients with pigmentary disorders. We are currently involved in a multicenter study for patients with non-segmental vitiligo. Talk to one of our doctors to learn more.