Skin - abnormally dark or light

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Hyperpigmentation 2	Hyperpigmentation w/malignancy	Incontinentia pigmenti on the leg	Incontinentia pigmenti on the leg
Post-inflammatory hyperpigmentation 2	Post-inflammatory hyperpigmentation - calf	Vitiligo, drug induced	Vitiligo on the face

Hyperpigmentation; Hypopigmentation

Nonprescription depigmenting creams are available for lightening the skin. If you use these creams, follow instructions carefully and don't use one for more than 3 weeks at a time. Darker skin requires greater care when using these preparations. Cosmetics may also help in covering a discoloration.

Avoid too much sun exposure (use sunscreens or blockers).

Hyperpigmentation may persist even after treatment, so emotional support is recommended.

• A skin discoloration causes significant concern or lifestyle impairment.
• There is persistent, unexplained darkening or lightening of the skin.
• Any hyperpigmented area (like a mole) changes shape, size, or color (this may be a sign of malignancy).

The medical history will be obtained and a physical examination performed.

Medical history questions documenting abnormally dark or light skin in detail may include:

• When did the discoloration develop?
• Did it develop suddenly?
• Is it getting worse? How fast?
• Describe the change.
• Is the skin turning darker or lighter?
• Exactly where is the discoloration?
• Has it spread to other parts of the body? In what pattern?
• What medications are used?
• Is there anyone else in your family that has had a similar problem?
• Are you often in the sun or exposed to a sun lamp?
• What is your diet like?
• What other symptoms are also present?
• Are there any rashes or skin lesions?

The physical examination may include emphasis on evaluating the skin.

Diagnostic tests that may be performed include:

• Adrenocorticotropin hormone stimulation test
• Skin biopsy
• Thyroid function studies
• Examination of the area under a Wood's lamp

Some skin conditions can be treated. Vitiligo may be treated using ultraviolet lamp treatment combined with drug therapy. Pityriasis versicolor is usually treated using anti-fungal ointment. Moles that have changed color are usually surgically removed and a biopsy is taken.

Some pigment changes spontaneously return to normal skin color, unless there is scarring of the skin.

Review Date: 07/22/2005
Reviewed By: Jonathan Kantor, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.