What is Hypopigmentation and How is it Treated?

You’re probably familiar with hyperpigmentation. That’s the clinical term for too much pigment (color) in a specific area of the skin. But its counterpart, hypopigmentation, is relatively unknown.

Hypopigmentation is – you guessed it – the loss of skin color. In other words, a spot becomes lighter than the surrounding skin color. In can occur all over the body or just in a single area.

Melanocytes are cells that produce melanin, the protein that gives our skin, hair, and eyes their distinct color. When they don’t produce enough melanin, it results in hypopigmentation. That can happen as a result of a pimple, an injury, or following a rash. It can also be caused by a fungus called pityriasis versicolor, as well as a number of chronic conditions and medications.

How is it treated?

For all we know about hypopigmentation, there’s a lot that remains a mystery. For one, there’s no universally accepted way to restore pigment to the affected area. That said, there are a number of methods and ingredients that have proven to be effective.

Generally, the treatment is determined by the severity of the hypopigmentation. If it’s a mild case or a particularly small area that’s affected, topical corticosteroids and calcineurin inhibitors are usually enough. For more extensive scenarios, most dermatologists will turn to narrowband UVB phototherapy applied in combination with topical skincare.

“Multiple” pharmaceutical companies are reported to be developing drugs for restoring pigment. To date, no such drugs have received approval from the Food and Drug Administration. However, some of the ingredients that de-pigment the skin have been used in severe cases of hypopigmentation. Hydroquinone and monobenzone are two of the most common examples. Basically, they take the color out of the surrounding skin so that it matches the area (or areas) where hypopigmentation has occurred.

And if that doesn’t work?

Another alternative is increased exposure to the sun. It’s believed that UV light may increase the rate of repigmentation in the affected area.

This should be done with extreme care and only under the guidance of a board-certified dermatologist. You don’t want to increase your risk of skin cancer. (Should your doctor need to perform a biopsy in the area, the resulting scar could potentially become depigmented.) There’s also the possibility that the exposure will have the opposite intended effect, increasing the contrast between the hypopigmented and unaffected skin. 

Hypopigmentation that results from some sort of trauma, like a burn, can be a challenge to repigment. Though, as long all the melanocytes in the area weren’t destroyed by the incident, there is hope. By contrast, hypopigmentation caused by an underlying inflammatory condition, like eczema, is usually easier to treat and more likely to repigment with a topical corticosteroid.