Pigmentation disorders

Melasma, also called a pregnancy mask, looks like dark symmetrical spots on the face.

In summer, the spots become darker, while in winter they are distinctly paler. The sun plays an important role here.

Melasma is most commonly observed in women. As far as female hormones are concerned, this is usually seen in pregnant women or women taking oral contraception (the pill). We also know that perfumes and perfumed creams promote the appearance of spots.

Treatment:

• During the summer, it is important to provide good sun protection.
• During the winter, it is possible to work with bleaching creams.
• Sometimes, medication is also started.

After skin inflammation, discolouration may occur. This discolouration can be either darker or paler. We see that a long-standing eczema can temporarily leave a brown colour. You should always avoid the sun after treatment with cryotherapy, an operation, a laser treatment or a peeling in order to avoid post-inflammatory hyper-/hypopigmentation.

Your dermatologist can provide you with further advice on this.

Vitiligo is a benign skin disorder that causes milky white spots on the skin and sometimes also in the hair. This is more evident during summertime, with quick sunburns. In winter, the condition is less noticeable as there is less contrast with the 'normal' skin. The condition is quite common, approximately 1% of the population has it. Although it is most common around the age of 20-30 years, it can develop at any age. You are never born with vitiligo. White spots at birth may have a different cause, discuss this with your dermatologist.

It is an autoimmune disorder. This means that a person's own immune system attacks his or her pigment cells. There are no more pigment cells in the vitiligo spots (i.e. depigmentation).

This condition often occurs in families with vitiligo or other autoimmune disorders (e.g. thyroid diseases, rheumatic conditions, intestinal diseases).

There are several cream treatments available. These should prevent the further spread of white spots (i.e. stabilisation). These include creams containing cortisone and also immunomodulators (e.g. pimecrolimus and tacrolimus). The stains can be repigmented (i.e. contain pigment again) but this requires a stabilisation of the condition (by the creams) and then ultraviolet light. Ultraviolet light is obtained from sunlight, but can also be provided through light therapy. It is important to know that these white spots get burnt very quickly. Excessive sun exposure is not recommended. Applying sunscreen is definitely necessary.