Individual Differences in Normal Pigmentation


Normal Pigmentation Varies Widely from Person to Person

Physiologic pigmentation refers to normal pigmentation that varies widely from person to person. Normal encompasses a wide spectrum because it varies from person to person and refers to the range of normal pigmentation in the population, which does not mean everyone has the same amount of melanin; rather that the level of melanin in each individual is within the range of normal physiologic variation, as determined by rigorous scientific methods such as biometric analysis and ethnic specific standards..

What does it mean?

Simply said, physiologic pigmentation refers to normal pigmentation. Illness, drugs, or exposure to metals are not the cause. It means that a person’s level of pigmentation is within a normal range. Normal encompasses a wide spectrum because it varies from person to person. Physiologic pigmentation can be classified into several types: post-inflammatory hyperpigmentation (PIH), drug-induced hyperpigmentation (DHI), and dental amalgam tattoos (DAT). These types of pigmentary disorders have different etiologies and presentation, but they all affect skin coloration in some way.

How do you know if you have normal physiologic pigmentation?

It can be difficult for people to determine if they have normal physiologic pigmentation or some other condition causing hyperpigmentation. Conditions, such as post-inflammatory hyperpigmentation, hypopigmented macules and scars, drug-induced hyperpigmentation, dental amalgam tattoos and poikiloderma of Civatte are often confused with physiologic pigmentation. To differentiate between physiologic pigmentation and those secondary conditions, your doctor will perform a skin biopsy on an area of concern, which may reveal an increase in melanin production that is not associated with any particular pathologic process. In rare cases when disease processes are suspected despite negative biopsies, a skin biopsy may still be performed but within its limitations should not be considered diagnostic.

What causes low physiologic pigmentations?

Post-inflammatory hyperpigmentation is common and occurs in a variety of diseases, including acne, psoriasis and lichen planus. It often appears in certain ethnic groups, including African Americans and those with a genetic sensitivity to tetracycline (commonly used as an antibiotic). Exposure to nicotine also can contribute post-inflammatory hyperpigmentation because it stimulates melanocyte production. People with dark complexions are more susceptible. Treatment depends on what’s causing it: For instance, topical hydroquinone is used for pigment related to photodamage; azelaic acid helps resolve pigmented lesions due to inflammatory skin conditions such as rosacea or perioral dermatitis.

What causes high physiologic pigmentations?

There are many reasons for a person’s skin color to be darker than others. Medical conditions such as Addison’s disease, hormone disorders, and certain types of cancers can cause high physiologic pigmentation in patients. However, lifestyle choices such as smoking and sun exposure can also contribute significantly to hyperpigmentation. For example, in cases of chronic sun exposure, photodamage occurs first followed by inflammation caused by UV-induced immune reactions and finally by postinflammatory hyperpigmentation [5].

Physiologically, how do people with different skin tones live in climates differently?

People with fair skin tones, who are at higher risk of developing melanoma, can wear sunscreen with a high SPF to protect themselves. People with dark skin tones don’t need as much protection because their pigmentation acts as natural sunscreen. Still, they should use sunscreen and avoid prolonged sun exposure just in case. People of all skin tones should also wear protective clothing and stay out of direct sunlight when they can. Most importantly, do not burn!

What is physiologic pigmentation?

While most of us have heard of post-inflammatory hyperpigmentation, some people who have other dermatologic diseases experience what’s referred to as physiologic pigmentation. This is normal pigmentation. It means that you’re more likely than other people to develop post-inflammatory hyperpigmentation on your skin because your skin has a higher density of melanocytes—the cells that produce pigment—in it. For example, if you have darker skin, you may be less likely to see these effects. But for people with lighter skin, those with physiologic pigmentation are more likely than others to develop these marks after repeated injury or inflammation in their skin occurs.

What is physiologic melanin pigmentation?

Physiologic melanin pigmentation refers to normal levels of pigmentation. You are born with your level of physiologic melanin pigmentation. It is not influenced by exposure to sun, chemicals, or drugs. Other factors may influence your visible pigmentation such as inflammation or injury related to a disease process. For example: post-inflammatory hyperpigmentation (PIH) is an acquired increase in skin color that occurs after a dermatitis episode. PIH often appears as patchy discoloration and/or dark spots on areas of skin where there was inflammation and injury. This includes smoking-induced stigmata.

What are three physiological factors that affect skin color?

Skin pigmentation has many causes, including aging, exposure to UV light and genetics. But it also depends on more than one factor. Most people are aware of factors like tanning or being exposed to UV light in getting a tan. Sunburns can result in mild to severe hyperpigmentation. In addition, smoking and alcohol consumption is also associated with discoloration that may be mistaken for acne or other dermatologic conditions . These discolorations can be post-inflammatory hyperpigmentations caused by other dermatologic diseases, these include smoking. Severe cases of discoloration may be referred as vitiligo (loss of pigment) but are sometimes difficult to tell apart from melasma or post inflammatory hyperpigmentations without a skin biopsy.