Girl with freckles

What Causes Hyperpigmentation?

Dark areas on the skin are technically called hyperpigmentation. If you want to try and lighten these spots, turmeric compounds could be a safe, gentle, and effective option. Often the hydrogenated form of curcumin (called tetrahydrocurcumin) is used because it is off-white rather than yellow in color. Tetrahydrocurcumin is also a powerful natural antioxidant compound. (xi.2)

What Causes Hyperpigmentation?

There are different types of hyperpigmentation, but generally speaking the spots are related to excess melanin pigments at the epidermal skin surface. Melanin is produced by melanocyte skin cells. The pigment is packaged inside of tiny spheres bound by membrane. These organelles are called melanosomes, and they are transported by fingerlike extensions on melanocytes into nearby keratinocyte cells. (xi.59)

Figure XI.6: Melanin-Producing Skin Cells

Figure XI.6: Melanin-Producing Skin Cells (xi.26-2759)

DID YOU KNOW?

One of the reasons keratinocyte skin cells take in melanin is to help shield their cellular DNA from the sun's UV radiation. (xi.60)

Melanin production and a person's skin color are mainly regulated by the MC1R gene. However, this gene doesn't just determine the color of the skin you are born with. MC1R is responsible for expressing a receptor protein on the surface of the cells that produce melanin. Stimulating the gene to express the MC1R protein throws the switch on for melanocytes to manufacture melanin. (xi.60)

One good example of how this works is when you get a tan, a form of hyperpigmentation: (xi.60)

Figure XI.5: How Does Skin Tan?

Figure XI.5: How Does Skin Tan?

Other enzymes and proteins play important roles in how the melanin is transported and taken in by skin cells. Their actions help influence the regulation of melanin production and the appearance of color pigments in the outer layer of skin. Some hormones, such as α-MSH, promote tyrosinase's melanin-producing activity by binding to and blocking tyrosinase inhibitors. (xi.60)

Medical Conditions Can Cause Hyperpigmentation

Figure XI.7: The Connection between Stress and Hyperpigmentation

Figure XI.7: The Connection between Stress and Hyperpigmentation

Some diseases can also cause hyperpigmentation, especially those related to endocrine disorders and hormone imbalances (such as Cushing syndrome and pituitary tumors). For example, excess adrenocorticotropic hormone (ACTH) is caused by pituitary tumors and Cushing syndrome. ACTH is secreted by the pituitary gland, and is a precursor of alpha melanocyte-stimulating hormone (α-MSH). It also promotes MC1R, one of the primary proteins that stimulate melanin production. (xi.5961-62)

Stress is a mood disorder that can also cause hyperpigmentation. ACTH may help explain the connection between stress and skin discoloration. In fact, chronic stress triggers the hypothalamus to secrete CRH, the hormone that stimulates ACTH. Chronic stress also promotes unregulated hormone levels: (xi.5962-63)

Food Poisoning, UV Radiation, and Toxins Can Trigger Hyperpigmentation

Exposure to UV radiation and toxins that damage skin cell DNA can also cause hyperpigmentation. For example, two incidents of mass food poisoning from toxins in rice oil occurred in the 1970s in Taiwan and Japan. Dermatological symptoms included acne and dark pigmentation of the skin, gums, and nails. Babies born to women exposed to PCBs during pregnancy also had areas of their skin marked by dark brown pigmentation. (xi.64-65)

Figure XI.8: Toxic Inducers of Hyperpigmentation

Figure XI.8: Toxic Inducers of Hyperpigmentation

How can toxins cause hyperpigmentation? Researchers determined that the toxins trigger the AHR transcription factor in skin cells, which stimulates melanin as a protective reaction: (xi.64)

Toxins that can induce hyperpigmentation include:

Table XI.4: Food and Environmental Toxins That Cause Hyperpigmentation
TOXIN POSSIBLE SOURCE OF EXPOSURE

CHLORINATED DIBENZOFURANS (CDFS) (xi.64)

  • Burning paints or other solvents. (xi.66)
  • Insecticides can form CDFs when burned. (xi.66)
  • Plastics can form CDFs when burned. (xi.66)
  • Food poisoning. (xi.64)

DIOXINS (xi.64)

  • Burning household garbage. (xi.66)
  • Food poisoning. (xi.64)
  • Hospitals and municipalities that burn sewage. (xi.67)
  • Wood, coal, and petroleum gas burning. (xi.67)

POLYCHLORINATED BIPHENYLS (PCBS) (xi.64)

  • Cooking oil contaminant. (xi.64)
  • Paper manufacturing. (xi.67)
  • Bleached paper products. (xi.67)

TOBACCO (xi.64)

Kinds of Hyperpigmentation

While lots of people choose to get a suntan, there are other types of hyperpigmentation that are far less desirable cosmetically. Unfortunately, excess UV radiation can contribute to these skin discolorations, as well as accelerate skin aging.

Table XI.5: Hyperpigmentation Skin Conditions
CONDITION SYMPTOMS RISK FACTORS

MELASMA

  • Chronic condition. (xi.68)
  • Irregular brown, tan, or grey/brown patches of skin. (xi.68)
  • Mostly occurs on the forehead and around the mouth. (xi.68)
  • Often worsens in summer months. (xi.68)
  • Characterized by increased activity of the enzyme tyrosinase, which is involved in producing the melanin pigment. (xi.68)
  • Most often occurs in women. (xi.68)
  • More common in those with darker skin types. (xi.68)
  • Exposure to high levels of ultraviolet radiation from sunlight. (xi.68)
  • Oral contraceptives. (xi.68)

POST-INFLAMMATORY

  • Hyperpigmentation due to increased production of melanin triggered by a lesion or injury to the skin. (xi.59)
  • Irregular-shaped dark spots. (xi.59)
  • Recurs in susceptible people. (xi.59)
  • Difficult to treat (since treatment can make it worse). (xi.59)
  • Spots tend to improve over time. (xi.59)
  • Darker skin color. (xi.59)
  • Asian ethnicity. (xi.59)
  • History of post-inflammatory hyperpigmentation. (xi.59)
  • Acne. (xi.59)
  • Allergic skin rash. (xi.59)
  • Eczema. (xi.59)
  • Trauma. (xi.59)
  • Cosmetic medical treatments. (xi.59)

SOLAR LENTIGOS

(also known as liver spots, age spots, and Lentigo senilis) (xi.69)

  • Unlike freckles, these brown lesions contain a higher number of melanocytes (the cells that make melanin) than normal. (xi.59)
  • Typically ½ inch in diameter. (xi.59)
  • Significant risk factor for skin cancers, including melanoma. (xi.59)
  • Age (the vast majority of people have at least one by the time they're elderly). (xi.59)
  • Male gender (females typically are more likely to have freckles). (xi.59)
  • Acute and/or chronic sun exposure. (xi.59)
Into the keratinocyte skin cells. (xi.59)
Also known as pregnancy mask and chloasma(xi.68)
Ephelides is the medical technical term for freckles. (xi.59)

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