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Skin pigmentation is caused by excessive secretion of melanin particles by melanocytes or uneven distribution of melanin particles in the skin, resulting in spots and plaques with darker color than normal skin.

Classification of color spots

1. qualitative spots: qualitative spots are stable in nature and will not be changed by external factors. Once removed, the original part will no longer appear. Common qualitative spots are pigmented nevus, senile plaques and birthmarks.

2. Active spots: Active spots are spots caused by tyrosinase activity. Its nature is unstable, and its color depth changes due to external sunlight and endocrine factors. Common active spots are chloasma, freckles and secondary pigmentation spots.

Causes of pigmentation

There are many reasons for the formation of color spots, and the types are more complicated. But our most common spots are freckles and chloasma. How are they formed? To sum up, there are four reasons:

(1) Genetic reasons. Autosomal inheritance is the main cause of freckles. Most of them start from children around the age of 5, mostly women, emphasizing spring and summer over autumn and winter. Light brown to yellowish brown spots from the tip of a needle to the size of a grain of rice are symmetrically distributed on the face (especially the nose).

(2) ultraviolet irradiation. Ultraviolet rays in the sun are an important reason for the formation of spots, which is also the reason why sun protection is needed in summer. When the skin receives too much sunlight, the epidermis will produce more melanin particles, which can absorb ultraviolet rays and protect the human body from harm. This is why the skin will turn black after sunbathing. Moreover, ultraviolet radiation will cause chloasma and deepen the color of ordinary freckles.

(3) Endocrine causes. Endocrine disorder is also an important cause of female pigmentation. Changes in sex hormone levels during menstruation and pregnancy will affect the production of melanin. In addition, endocrine instability usually leads to emotional instability and indirectly leads to the formation of pigmentation (Chinese medicine believes that the formation of chloasma is mainly due to liver depression, which is more complicated).

(4) Living habits. Bad living habits such as stress, partial eclipse and lack of sleep will also increase melanin. Therefore, the skin metabolic rate of people with unstable sleep time is poor, which will affect the production of melanin particles.

(1) chloasma

Chloasma usually occurs on forehead, eyebrows, bridge of nose, cheeks and upper lip. It looks like a butterfly, so it is also called butterfly spot. In patients with advanced hepatitis, liver cancer, liver cirrhosis and poor liver function, the skin turns black and yellow, accompanied by chloasma, usually called liver spot; When a woman is pregnant, chloasma, also known as pregnancy spot, often occurs due to great changes in body endocrine, which is a common pigmentation disease. Chloasma is mostly related to endocrine, especially sex hormone imbalance, which is most common in women during reproductive activities.

The etiology of chloasma is complex, and the definition of chloasma is not uniform at present. Butterfly spots can occur in both men and women, mainly because of sex hormones in the body. After pregnancy, hormones in women change, and progesterone and estrogen are secreted vigorously, causing facial skin pigmentation; Melanin secreted by pituitary gland can also lead to local skin color deepening. The dysfunction of pituitary, uterus, ovary and other secretory organs of adolescent girls will also produce more melanin, which will be deposited in the skin, so there will be butterfly-shaped gray spots in adolescent girls. In addition, working in the field for a long time, too much sunlight; Long-term use of certain drugs such as hibernating spirit and phenytoin sodium; Improper use of cosmetics can also produce butterfly spots.

There are two causes of western medicine:

1, internal cause

Endocrine dysfunction: the secretion of male and female hormones in the body is unbalanced. Estrogen can promote the increase of melanocyte activity and melanin secretion, thus leading to diseases (chloasma).

A. Pregnancy: that is, due to the need of gestating the fetus, the imbalance between androgen and androgen during pregnancy is generally not enough to cause chloasma, but if it exceeds this range, the activity of melanocytes will increase, and melanin will be deposited in sensitive parts of the skin, resulting in chloasma. About 70% of postpartum patients can heal themselves if they are well nursed, happy and have enough rest, but 30% of them can't heal themselves and still need medication. The spots produced during pregnancy are also called pregnancy spots or pregnancy spots.

B, irregular menstruation: endocrine dysfunction itself will cause irregular menstruation and chloasma; Other diseases can also cause irregular menstruation, such as tumors, hematological diseases and gynecological diseases. Irregular menstruation can also directly cause chloasma, which becomes a causal relationship in the pathogenesis. In the process of onset, chloasma and irregular menstruation can also be parallel.

② A manifestation of diseases in the face and skin.

First, caused by reproductive organ diseases. Reproductive organ diseases such as menstrual disorder, dysmenorrhea, chronic diseases of uterine appendages and ovarian cysts may be accompanied by facial chloasma.

B, endocrine gland lesions, hypothyroidism, adrenal cortex dysfunction can produce chloasma.

C, chronic diseases, such as hepatitis B, tuberculosis, tumors and other diseases, may increase the activity of melanocytes in the body, and cause the disease (chloasma).

(2) Freckles

It is a kind of punctate brown spot that is easy to occur on the face. It begins to develop as early as childhood, and the average person mainly grows slowly in adulthood. Usually there are more women, and this spot also affects the appearance.

Formation of freckles:

Genetic factors: but not necessarily inherited from parents. It may be inherited every few generations. Generally speaking, freckles appear on the face with whiter skin.

Exposure: on the one hand, ultraviolet rays in the sun stimulate the frequent activities of pigment cells under the skin, producing a lot of melanin; On the other hand, it damages the normal metabolic function of skin cells, so that melanin can not be discharged smoothly and remains on the skin, even deposited in the dermis. Therefore, excessive sun exposure will aggravate and deepen freckles, but freckles will gradually fade in winter.

Characteristics of freckles:

1. Small brown spots from the tip of a needle to a grain of rice, named for their shape and color like bird eggs.

2. Freckles are common in sunburned parts such as face, neck and arms, and the face is mostly scattered on cheeks and bridge of the nose.

3. The number of freckles is uncertain, and they don't blend with each other.

4. Generally, there are more women than men in childhood, often accompanied by family history and no other symptoms.

The incidence of freckles is about 18.7%, and most of them are women. Skin lesions usually occur around the age of 5, and often worsen before and after puberty. Skin lesions often occur in exposed parts, especially the face, especially the nose and cheeks. Severe cases may involve the back of the hand, neck, shoulders, upper back and other parts. It is characterized by light brown or dark brown punctate pigmentation spots, which are round, oval or irregular, with clear boundaries, a diameter of about 2mm, a smooth surface, isolation but not fusion, and different densities. Without any conscious symptoms. This disease is an autosomal dominant hereditary disease, which is obviously related to sun exposure. The number, size and color of its pigment spots depend on the amount of sunlight absorbed and the individual's tolerance to sunlight. Freckles are abundant in summer and dark brown in shape, and decrease in winter.

(3) Sunspots

This is a common manifestation of photoaging. Although this pigment spot looks like freckles, it is different from freckles. Sunspot's face looks more like a "dirty" face, and the skin may be accompanied by other problems, such as loose and dry skin.

Photoaging refers to the premature aging of skin caused by light. Photoaging can appear before the age of 30 at the earliest, and may first be manifested as abnormal and disordered pigments, such as some punctate or irregular brown pigment spots on the face, similar to freckles, also known as sunspots. Some people's pigment spots will merge into larger brown spots. There are also changes in senile plaques and hypopigmentation plaques. In the future, the skin will gradually relax and wrinkle, and some people will have tiny telangiectasia (red blood on their faces), and some people will have rough skin, large pores and even an orange peel-like appearance. The comprehensive result is that the skin will gradually age and lose its former beauty. After people are over 30 years old, more problems begin to appear on their faces, such as abnormal pigment (age spots, sun spots and so on). ), loose skin, fine lines, red blood on the face, large pores and dull complexion. The comprehensive result is that the skin begins to age.

(4) Freckle nevus

It is a brown mottled lesion very similar to freckles, but its distribution is very different from freckles, and most of them are localized patches.

Sunspots are also called freckles, but they are two different pigmented skin diseases.

It can be distributed in any part of the skin, at the junction of skin and mucosa or at the conjunctiva of eyes, with brown or dark brown spots, some slightly raised and round, generally about the size of a needle tip to sesame seeds. There may be slight desquamation on the surface of spots, but the delicate skin has not changed. Pigmentation is uniform and uniform, and the edge gradually fades close to normal skin color.

Sunspots mostly occur in childhood, but they can gradually increase until adulthood, and some suddenly appear in large numbers, and some disappear after years of gradual reduction. There are also generalized sunspots and median sunspots, which belong to special types of sunspots.

The difference between sunspots and freckles is that sunspots are darker than freckles and are sparsely distributed. After sun exposure, the color does not deepen and the quantity does not increase. Freckles are closely related to sun exposure, and their distribution is limited to sun exposure. In summer, due to sun exposure, the number of freckles increases, the color deepens, and the damage becomes greater, while in winter, the number decreases, the color fades, and the damage shrinks.

Sunspot is a common pigmented disease, and sometimes it is one of the clinical manifestations of some hereditary syndromes. There is no particularly effective treatment. If the patient needs treatment, it can be removed by surgery. Although freckles are related to heredity, they are closely related to sun exposure. Reducing sun exposure and using sunscreen will reduce the occurrence of freckles.

There are also such things as:

Coffee spots are brown flaky pigment lesions, mostly oval, but also irregular. The nevus of OTA presents as bluish-gray patches on the face.

Brown-blue spots on zygomatic region are a kind of punctate pigment spots, which often occur in bilateral zygomatic regions of middle-aged women. In fact, it may be a special type of nevus of OTA, so some people call it acquired nevus of OTA.

Some verruca plana, porokeratosis and so on. It will also show freckles.

In addition, various inflammatory skin diseases (such as acne, etc. ) will leave different degrees of pigmented lesions (post-inflammatory pigmentation) on the face. Trauma or any skin inflammation can lead to skin pigmentation. Some congenital skin diseases will also show various manifestations of pigment spots.

Excerpted from Encyclopedia of Dynamic Housing