FACIAL BLACK PATCHES

 Dr. K S Prasanna, Dermatologist, Institute of Applied Dermatology, IAD, Kasaragod

Melanocytes are the cell in the skin that secretes melanin to give a colour. The colour of the skin depends upon the amount and distribution of melanin and hemoglobin. Hyperpigmentation usually results from an increase in melanin production and, or from an increase in the density of active melanocytes. Sometimes it is caused by the deposition of exogenous substances such as drugs(iron) or heavy metals.

Facial Pigmentation

The common facial pigmentation is Melasma. It is characterized by black patches with an irregular outline, most commonly seen on the face. Some of the patients are worried about it, thinking that it is a sign of evil. The reasons for this pigmentation could be due to excessive exposure to sunlight, pregnancy, the oral contraceptive pill, or during menopause. The main ways of treatment are the proper application of sunscreens during day time and depigmenting agents at night. Melasma, being a challenging disease to treat and get a complete cure, both patients and doctors are worried about this condition.

The next common condition is dark circles around the eye. The skin around the eyes, appear brown to black depending upon the skin type. It could be hereditary, stress-induced (physical and mental), lack of sleep, or too much reading. Freckle, Lentigens, Post-inflammatory hyperpigmentation (PIH) and reactions to systemic drugs are the other causes of hyperpigmentation.

Another condition where we can see black raised dots on the face is a condition called seborrheic keratoses. These lesions can be removed either by chemical or electrocautery.

Treatment for Pigmentation

Treatment of facial hyperpigmentation includes proper application of sunscreens, avoid direct exposure to sunlight, and also the application of depigmenting agents at night. If the one is on birth control pills or any hormonal pill, then it should be stopped. The duration of the treatment is long, ranging from six months to one year. If the patient doesn`t respond, the next option is to do chemical peeling and laser. Epidermal pigmentation responds to chemical peeling and topical agents, whereas dermal pigmentation is difficult to treat.  Cosmetic camouflage is helpful for patients with recalcitrant melasma.

Besides avoidance of any kind of stress, either physical or mental, is very important in the reduction of hyperpigmentation. A healthy balanced diet also plays a role to give a glow to our face. A healthy mind is a healthy body. Our face depicts our minds. The face is the index of the mind.