Skin, abnormally dark or light

Considerations:
Normal skin contains cells called melanocytes that produce the brown skin-coloring pigment melanin . There are several conditions in which melanocytes are either abnormal or abnormally distributed. Most skin conditions that cause discoloration are harmless.

A pale area of the skin is the result of fewer or less active melanocytes than usual, whereas, a darker area (or area that tans more easily) indicates more numerous or more active melanocytes.

Sometimes mistaken for a suntan, bronzing of the skin often develops gradually starting at pressure points such as the elbows, knuckles, and knees and spreading from there. It is also seen in the creases of the soles of the feet and the palms of the hands. The bronze color can range from light to dark (in fair skinned people) with the intensity often a function of the underlying cause.

There are several types of benign hyperpigmentation that occur normally; however, any persistent hyperpigmentation that has not been medically explained ought to be seen by a dermatologist.

Common Causes:
  • exposure to the sun or sun lamp
  • inherited skin condition
  • phenothiazine drug use
  • chronic nutritional deficiency

Note: There may be other causes of hyperpigmentation and hypopigmentation . This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for hyperpigmentation and hypopigmentation, occurring alone or in combination with other problems.

Home Care:
Nonprescription depigmenting creams are available for lightening the skin. If used, 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.

For bronzing caused by malnutrition , a well-balanced diet is recommended.

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

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

Follow prescribed therapy to treat the underlying cause and for use of corrective cosmetics (over-the-counter bleaching creams are generally not effective).

Call Your Healthcare Provider If:

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



What to Expect:
The medical history will be obtained and a physical examination performed.

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

  • time pattern
    • When did the discoloration develop?
    • Did it develop suddenly?
    • Is it getting worse? How fast?

  • quality
    • Describe the change.
    • Is the skin turning darker or lighter?

  • location
    • Exactly where is the discoloration?
    • Has it spread to other parts of the body? In what pattern?

  • aggravating factors
    • 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?

  • other

The physical examination may include emphasis on evaluating the skin.

Diagnostic tests that may be performed include:

Some skin conditions can be treated. Vitiligo may be treated using ultraviolet lamp treatment combined with drug therapy, which is effective in about 50% of cases. 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).

After seeing your health care provider:
If a diagnosis was made by your health care provider related to abnormally dark or light skin, you may want to note that diagnosis in your personal medical record.


Diffuse melanoma can deposit large amounts of melanin in tissues, producing marked hyperpigmentation.



The white spots on this person's face have resulted from drug-induced vitiligo. Loss of melanin, the primary skin pigment, occasionally occurs as a result of medications, as is the case with this individual. The typical vitiligo lesion is flat (macular) and depigmented, but maintains the normal skin texture.



This is a picture of vitiligo on the face. Complete loss of melanin, the primary skin pigment, occurs for unknown reasons. The resulting lesions are white in comparison to the surrounding skin. Vitiligo may occur in the same areas on both sides of the face (symmetrically) or it may be patchy (asymmetrical). The typical vitiligo lesion is flat (macular) and depigmented, but maintains the normal skin texture. The dark areas around the eyes are this person's normal skin color.



Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.



Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.



Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.