Normal skin contains cells called melanocytes. These cells produce melanin, the substance that gives skin its color.
Skin with too much melanin is called hyperpigmented skin.
Skin with too little melanin is called hypopigmented skin.
Pale skin areas are due to too little melanin or underactive melanocytes. Darker areas of skin (or an area that tans more easily) occurs when you have more melanin or overactive melanocytes.
Bronzing of the skin may sometimes be mistaken for a suntan. This skin discoloration often develops slowly, starting at the elbows, knuckles, and knees and spreading from there. Bronzing may also be seen on the soles of the feet and the palms of the hands. The bronze color can range from light to dark (in fair-skinned people) with the degree of darkness due to the underlying cause.
Causes of hyperpigmentation include:
History of skin inflammation (post-inflammatory hyperpigmentation)
Over-the-counter creams are available for lightening the skin. If you use these creams, follow instructions carefully and don't use one for more than 3 weeks at a time. Darker skin requires greater care when using these preparations. Cosmetics may also help cover a discoloration.
Avoid too much sun exposure. Always use sunscreen.
Abnormally dark skin may continue even after treatment. Experts recommend emotional support or counseling.
Call your health care provider if
Call your doctor for an appointment if you have:
Skin discoloration that causes significant concern
Persistent, unexplained darkening or lightening of the skin
Any skin sore or lesion that changes shape, size, or color -- may be a sign of skin cancer
What to expect at your health care provider's office
Your doctor will perform a physical exam and ask questions about your symptoms, including:
When did the discoloration develop?
Did it develop suddenly?
Is it getting worse? How fast?
Has it spread to other parts of the body?
What medicines do you take?
Has anyone else in your family had a similar problem?
How often are you in the sun? Do you use a sun lamp or go to tanning salons?
What is your diet like?
What other symptoms do you have? For example, are there any rashes or skin lesions?
Some skin color changes may return to normal without treatment.
Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.