A Clinician’s Needs to Know: Understanding Abnormal Skin Pigmentation

All clinicians should have a solid understanding of skin pigmentation, including abnormal skin pigmentation. With that in mind what is abnormal skin pigmentation? It can be birthmarks and other pigmentation disorders, causing abnormalities in the tint of the skin. And if a client suspects they may have a skin pigmentation disorder they should see a dermatologist or their family doctor to receive a diagnosis.

Fortunately, most abnormal skin pigmentations are not harmful, but it is still always best to check and make sure. Better safe than sorry. Birthmarks as you might expect are smooth, flat discolorations that appear at birth. Some are characterized by a bluish discoloration of the skin on the face, or the white part of the eye. Mongolian spots, bruised or blue in color generally appear on the buttocks. Light brown or café au lay spots and moles may also appear. They can range from flesh color to light or dark brown. Moles should be monitored for bleeding, itching, shape or size changes and color.

Macular stains appear almost anywhere on the body and are mild red marks, but not elevated. Macular stains are a common type of vascular birthmark and come in two forms: angel kisses which can paper n the forehead and the eyelids and usually disappear after age two; and stork bites which appear on the back of the neck and can last until adult years. These marks are usually mild and no treatment is necessary.

Another type of birthmark are hemangiomas, or growths composed of many many small blood vessels all bunched up together. They can vary in severity but usually are just small marks on the facial skin, the trunk or the extremities. However in some children they can grow to be quite large through the first year of life.

Another common disorder is albinism, which is inherited and is caused by an absence of the pigment known as melanin. Albinos generally have no pigmentation in their skin, eyes or hair. Albinos have an abnormal gene which restricts the reduction of melanin. It most often occurs in Caucasians but can be found in any race or ethnic group.

Melasma is another disorder characterized by brown or tan patches on the forehead, upper lip, nose, chin or cheeks. It is sometimes called the pregnancy masks but men can develop it also. It may go away after pregnancy. Remember to consult with a dermatologist or refer her client to a dermatologist if you suspect a skin pigmentation disorder.