From the Guidelines
Poor liver function can cause hyperpigmentation in African Americans, as liver dysfunction can lead to increased levels of circulating hormones and metabolites that stimulate melanin production. This occurs because the liver plays a crucial role in metabolizing hormones, including estrogen, which can trigger melanocyte activity and lead to hyperpigmentation 1. When the liver isn't functioning properly, it may fail to metabolize estrogen adequately, leading to elevated estrogen levels. Additionally, liver disease can cause jaundice, which may appear as yellowish discoloration of the skin, and in some cases of advanced liver disease, hemochromatosis (iron overload) can cause a bronze or grayish discoloration.
Some key points to consider in the context of liver disease and hyperpigmentation in African Americans include:
- African American patients with liver disease tend to have more advanced stages of hepatic fibrosis at presentation, are younger at presentation, and have higher frequencies of liver failure and mortality 1
- The clinical phenotype, treatment response, and outcome can vary in different ethnic groups within the same geographical region, highlighting the importance of considering individual factors in diagnosis and treatment 1
- Hyperpigmentation has many potential causes beyond liver dysfunction, including medications, hormonal changes, inflammatory conditions, and genetic factors, making it essential to consult a healthcare provider for proper evaluation and diagnosis.
In African Americans, these pigmentation changes may be more noticeable or present differently due to the naturally higher melanin content in the skin. If you notice unusual skin darkening, especially when accompanied by other symptoms like fatigue, abdominal pain, or yellowing of the eyes, you should consult a healthcare provider for proper evaluation and diagnosis.
From the Research
Hyperpigmentation and Liver Function
- Hyperpigmentation can be a manifestation of liver disorders, both acute and chronic, as seen in a study published in 2022 2.
- The exact pathophysiology of cutaneous hyperpigmentation in liver diseases is unknown, but it may be related to the degradation of melanin or the release of fibroblast growth factors 2.
- Hyperpigmentation can result from various factors, including excess melanin, cutaneous iron deposits, cutaneous carotene deposits, or cutaneous deposits of a substance not normally found in the skin 3.
Liver Disease and Hyperpigmentation in African-Americans
- There is limited research specifically focusing on the relationship between liver function and hyperpigmentation in African-Americans.
- However, a review of disorders of hyperpigmentation published in 2023 discusses the various causes of hyperpigmentation, including systemic diseases, but does not specifically address the relationship between liver function and hyperpigmentation in African-Americans 4.
Treatment and Management
- Ursodeoxycholic acid has been used to treat biliary tract diseases and may have an effect on polycystic liver disease, but its impact on hyperpigmentation is unclear 5.
- Hydroquinone is a commonly used treatment for disorders of pigmentation, and its use has been supported by strong evidence, particularly when used in combination with retinoid and corticosteroid 6.