Can ability or medical conditions cause changes in skin color?

From the Guidelines

Yes, medical conditions can cause changes in skin color, with vitiligo being a notable example where white patches occur due to melanocyte destruction. As discussed in the guideline for the diagnosis and management of vitiligo 1, vitiligo is characterized by the destruction of melanocytes, leading to white patches on the skin. These patches can be symmetrical and often increase in size over time. The condition can also affect mucosal areas and hair roots, resulting in white hair and eyelashes.

Some key points to consider about vitiligo and skin color changes include:

• The condition can be associated with autoimmune diseases, such as thyroid disease, and a family history of autoimmune conditions is common in patients with vitiligo 1.
• Treatment options for vitiligo include topical steroids, pimecrolimus, and depigmentation with monobenzyl ether of hydroquinone, although the choice of treatment depends on the extent and location of the depigmentation 1.
• Other medical conditions that can cause changes in skin color include jaundice, cyanosis, erythema, and hyperpigmentation disorders like melasma.
• Certain medications, such as antibiotics, antimalarials, chemotherapy drugs, and amiodarone, can also trigger skin color changes, which typically resolve after discontinuing the drug 1.

In terms of treatment efficacy, a study on narrowband ultraviolet B phototherapy found that it can be effective for treating vitiligo, with some patients achieving over 75% repigmentation 1. However, the response to treatment can vary depending on the location and extent of the vitiligo, as well as the individual's skin type.

Overall, the management of skin color changes due to medical conditions like vitiligo requires a comprehensive approach that takes into account the underlying cause, extent of depigmentation, and individual patient factors. As noted in the guideline for the diagnosis and management of vitiligo 1, the goal of treatment is to restore skin color and improve quality of life, while minimizing potential side effects and complications.

From the FDA Drug Label

Topical application of hydroquinone produces a reversible depigmentation of the skin by inhibition of the enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylalanine (dopa)

• Changes in skin color can be caused by certain medical treatments, such as the use of hydroquinone, which can produce a reversible depigmentation of the skin 2.
• This effect is due to the inhibition of melanocyte metabolic processes, resulting in a decrease in skin pigmentation.
• However, exposure to sunlight or ultraviolet light can cause repigmentation of bleached areas.

From the Research

Ability or Medical Conditions Causing Changes in Skin Color

There are various medical conditions and abilities that can cause changes in skin color. Some of these conditions include:

• Hyperpigmentations, which clinically manifest by darkening of the skin color 3
• Leukodermia, which is characterized by lightening of the skin 3
• Hypermelanosis, which corresponds to an overload of melanin or an abnormal distribution of melanin in the skin 3
• Melanodermia (brown/black) and ceruloderma (blue/grey), which are distinguished depending on the color 3
• Dyschromia, which can be related to the abnormal presence in the skin of a pigment of exogenous or endogenous origin 3

Treatment of Skin Color Changes

Some treatments for skin color changes include:

• Topical corticosteroids, which can produce a mild depigmenting effect 4
• Triple combination cream (hydroquinone, tretinoin, and corticosteroid), which remains the most effective treatment for melasma 5
• Hydroquinone alone, which is also an effective treatment for melasma 5
• Chemical peels and laser- and light-based devices, which have mixed results 5
• Oral tranexamic acid, which is a promising new treatment for moderate and severe recurrent melasma 5

Factors Influencing Skin Color

Several factors influence skin color, including:

• Melanin pigment, which is considered the most important factor because its type and quantity can determine variations in pigmentation shades 6
• Ultraviolet radiation (UVR), which can lead to changes in skin pigmentation over time 6
• Genetic adaptation to new environmental conditions, which can gradually lead to changes in skin pigmentation 6