Melasma. Melasma (also known as chloasma) is marked by tan or brown patches that may appear on the forehead, cheeks, upper lip, nose, and chin. Although this condition is often called the “pregnancy mask,” men can also develop it. It may also occur in women who are taking birth control pills or postmenopausal estrogen. Melasma may go away after pregnancy, but if it remains, it can be treated with certain prescription creams and some over-the-counter skin care products. In addition, lasers that target pigment can be helpful. Remember to consult your dermatologist for a proper diagnosis of this condition before you choose to treat it yourself. If you have melasma, use a sunscreen at all times because sunlight will make the condition worse.

Vitiligo. Vitiligo is a condition where the body’s immune system attacks pigment cells (melanocytes), causing pigment loss. Other immune system conditions associated with vitiligo include diabetes, pernicious anemia, thyroid disease, and Addison’s disease. Vitiligo causes smooth, white skin patches, usually around the mouth and eyes, or on the back of the hands. In some people, these patches can appear all over the body. There is no cure for vitiligo, but there are several treatments, including: topical steroid preparations; topical immunomodulators; topical vitamin D analogs; dyes or psoralens (light-sensitive drugs) used in combination with ultraviolet A (UVA) light treatment; and, the Excimer laser, which delivers targeted ultraviolet B (UVB) light. All treatments may take 6 or more months to be effective.

Pigmentation alteration (change) as a result of skin damage (post-inflammatory hyper- or hyperpigmentation). If you have had a skin infection, blisters, burns, or other trauma to your skin, you may have a decrease or increase of pigmentation in the affected area. This type of alteration is usually not permanent, but may take up to several months to fade or get better. Cosmetics can be used to cover the area. In the case of hyperpigmentation (dark spots), prescription or over-the-counter lightening creams may help decrease the amount of time for the areas to fade. You should also wear sunscreen, as sunlight can prolong the darkness of the areas.

Albinism. Albinism, an inherited disorder, is caused by the absence of the pigment melanin, and results in no pigmentation in the skin, hair, or eyes. Albinos have an abnormal gene that restricts the production of melanin. There is no cure for albinism. People who have this disorder should use a sunscreen at all times because they are much more likely to get sun damage and skin cancer. Albinism can occur in any race, but is most common in Caucasians. In addition, almost all patients with albinism have problems with their eyes, such as decreased vision or abnormal eye movement, and should be seen by an ophthalmologist.