what are skin blemishes?
Skin discoloration or spots indicate a limited or diffuse change in normal skin color. The color of the skin depends above all on a pigment called melanin, which is responsible for the five basic colors of the skin and hair: black, brown, red, yellow, white (absence of melanin). SKIN SPOTS are Two other substances that contribute to skin color are hemoglobin and carotenoids, yellow pigments produced by plants that accumulate in the epidermis and subcutaneous tissue. In most cases, however, the changes in skin color are linked to an altered distribution of melanic pigmentation and can thus be academically divided into two large groups:

  • hypermelanosis or hyperchromias characterized by an increase in skin melanin;
  • hypomelanosis with reduction or absence of pigment from the skin that appears lighter than normal skin.

Hypermelanosis, the most common, are usually localized in specific areas or diffuse and may be due to both an increase in the number of melanocytes (cells that produce melanin) and an increase in the melanin produced (dark pigment produced by melanocytes) with normal number of melanocytes.

What are the triggers?
The causes of hypermelanosis can be both genetic and environmental. The most frequent triggers are exposure to ultraviolet rays (both solar and artificial sources); taking photosensitizing or phototoxic drugs; the application of cosmetics, perfumes or waxes that generate post-inflammatory
hyperpigmentation in predisposed subjects; hormonal factors, in particular estrogen hormones and especially progesterone or metabolic dysfunctions.

Can hypermelanosis also appear on the face?

Absolutely yes. SKIN SPOTS The most common hypermelanosis that can appear on the face are senile lentigos, that is, brown spots, often round in shape, which appear after the age of 40 linked to chronic photoexposure; freckles, small yellowish or blackish brown macules (darker than ephelids) not induced by UV radiation (unlike ephelids) or melasma, which presents with brown spots that are not perfectly symmetrical that usually affect the central facial region mainly the upper lip, cheekbones and forehead, sometimes nose and chin, very often associated with pregnancy.

Who is most frequently affected by hypermelanosis?
Hypermelanosis affects women of childbearing age more frequently, as the hormones estrogen andprogesterone play an important role in this pathology. It is therefore no coincidence that most of the diagnoses of hypermelanosis occur in women undergoing hormone therapy for therapeutic or contraceptive purposes or in pregnant women for whom, in this case, we speak of Melasma gravidarum or Chloasma.

What is the first thing to do?
The complexity of the causes of skin implies the need to perform a correct diagnosis as only by determining the specific cause, the most appropriate and effective treatment can be undertaken. The dermatological examination is fundamental: the specialist, after a careful clinical examination of the lesions, will have to identify the depth of the pigment arrangement, as this constitutes the basis for setting the most suitable therapy for its eventual removal. Discriminating is the use of a Woods; (long ultraviolet wave source) which makes it possible to assess the localization of the accumulation of pigment. Generally, the brown or black spots; have this accumulation more superficially, that is at the
level of the epidermis, while the bluish gray spots are due to a deeper arrangement of the pigment at the level of the dermis. The deeper the pigment, the more difficult it will be to remove the stain.

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