Melanin is responsible for imparting color to the skin, hair and iris of the eyes. Levels of melanin depend on race and amount of sunlight exposure. Melanin production increases with exposure to the skin so as to protect the skin against harmful ultraviolet rays. Skin pigmentation disorders occur as a result of the body producing either too much or too little melanin. Skin pigmentation creates a darker or lighter skin tone that may be blotchy and uneven. Sun damage is probably the leading cause of skin pigmentation problems. Other factors include drug reactions, hormonal changes, genetic factors and medications.
Hormonal therapy, childbirth or birth control pills can cause skin pigmentation changes. Many people suffer from skin pigmentation problems as a result of locally increased skin pigment production. They appear as age spots, moles, liver spots or hyper pigmentation after local skin damage. Freckles are another variation in pigmentation of the skin. They are caused but by uneven release of the pigment.
Hypopigmentation or loss of skin pigmentation is a condition where the body does not produce sufficient melanin. Sometimes after an ulcer, blister, burn, or infection heals, the skin loses some of its pigment in that area. Albino is one who suffers total hypopigmentation at birth.
Vitiligo: Vitiligo is another form of hypo pigmentation caused by the loss of pigment-producing cells in the skin (melanocytes). These white patches are very sensitive to the sun. This skin pigmentation disorder affects nearly 2% of the population and is more evident in those with darker skin. Some scientists believe vitiligo may be caused by an autoimmune disorder. It is also linked to hyperthyroidism and Addison's Disease that affects the adrenal glands.
Hyper Pigmentation is a condition where the body produces too much melanin thereby causing it to become darker than usual. Hyper pigmentation can occur due to excessive sun bathing or drug reactions. Many a time wounds and scars leave a darker patch of skin. Birthmarks, moles, and aging spots are also indications of hyper pigmentation. It is important to keep on the alert for any change in size, color or texture for indications of skin cancer.
Lichen Simplex Chronicus: This skin pigmentation disorder is characterized by dark patches of skin accompanied with severe itching. This can lead to permanent scarring and infection if untreated.
Melasma: This hyper pigmentation condition is a fallout of pregnancy hormones. A dark mask appears over the cheeks, bridge of the nose and the neck. This skin pigmentation condition is also known as chloasma and can be treated with prescription creams and over-the-counter products.
Birthmarks: This type of skin pigmentation appears at birth or in the few weeks following birth. These birthmarks do not generally pose any health risks.
Port-wine Stains: These skin pigmentation spots are caused by abnormal development of capillaries and appear as a red or purple mark on the body.
Hyperpigmentation is a condition where parts of the skin turn darker in color than surrounding areas. These dark patches are generally seen on the face, hands, shoulders, or the neck area of an individual. These spots are usually referred to as liver spots, solar lentigines, pregnancy mask or freckles. Some kinds of hyperpigmentation spots could turn cancerous if not treated appropriately. A dermatologist could help distinguish hyper pigmentation from regular tanning or sunburn and provide effective treatment.
Hyper pigmentation causes
Melanocytes present in the skin's epidermis produce melanin which is the pigment responsible for the color of skin, eye and hair of an individual. Hormonal, physical changes or environmental factors trigger melanocytes to produce excessive melanin. This imbalance in production also affects the melanocyte's ability to distribute melanin evenly across the skin's epidermis. Therefore the excess melanin usually forms clusters and the skin tends to appear darker in the melanin concentrated areas, leading to uneven skin tone and darker areas.
Hormonal changes occurring during pregnancy and menopause can trigger excess melanin production. Diseases like hypothyroidism and Addison's disease can set off melanocyte stimulating hormones. Excessive sun exposure can play havoc on melanin production. Some medications such as those for insomnia, infertility, hypertension and oral contraceptives can cause hyperpigmentation.
Creams containing Hydroquinone, alpha Hydroxyl acid, licorice, green tea extracts or Retinol are prescribed for topical application. Chemical peels and skin dermabrasion are done to improve the skin tone. Laser procedures can work on melanin pigments.
Cryosurgery is increasingly becoming popular especially in the removal of tumors. Cryosurgery involves the administration of liquid nitrogen at very low temperature to remove tumors and cancerous tissues by cell death. This method is also called as cryogenic cell death. Cryosurgery is also used in the treatment of precancerous tumors in cervical cancer.
Cryosurgery is usually performed when the patient is in a conscious state. Different types of cryoprobes are used to treat cancers or tumors associated with specific regions in the body. Once the cry probe is introduced in the body, the compressed liquid nitrogen with a temperature ranging from -20°C to -50°C is passed into it to freeze and destroy the unwanted tissue through contact. The cells are subject to osmotic pressure changes because of the increased fluid content caused by the cry probe. Cryosurgery is done at regular intervals to promote thawing of the tissue and subsequently freezing it to destroy the layer of cells that are not required.
Precautions and side effects of Cryosurgery
In most cases, an interval of three minutes is given throughout the procedure. The probe inactivates the nerve endings touching the adjacent cells to inhibit the sensation of pain caused by the abnormal tissue. Vascular changes also occur during the procedure such as initial numbness and flushing sensation during the thawing process. Cryosurgery is most suggestive in case of precancerous stages as it enables treatment of the cancerous tissue effectively. It is predominantly used in the treatment of Neuroma, prostate cancer, cervical cancer and skin cancer. Patients generally complain cramping sensation during the procedure which usually subsides on its own.
Other complications include infection and swelling. Since cryosurgery does not require major invasion, the side effects are minimal. Cryosurgery can be done both as external and internal procedure. The healing patterns after the procedure vary from one area of the body to another. In case of skin cancers or melanomas, the deterioration of the unwanted warts and subsequent tissue rejuvenation may take up to six weeks. Malignant melanomas are not treated by using cryosurgery.
Cryosurgery cannot be performed for all types of cancers and on all organs, because of the probability of normal tissue damage and formation of unwanted scarred tissues. Careful analysis is done by the physician to identify the form of tumor and the type of cells associated. Biopsy is performed to detect any form of malignancy or metastases of the respective cancer. Salicylic acid is applied on the warts prior to cryosurgery to reduce the size. In some cases cryospray is used directly on an external growth for a period of 20 to 30 seconds.
Although cryosurgery is one of the most preferred techniques, elderly persons are not suitable for this procedure. Most patients undergoing cryotherapy experience blisters, itching and oozing for a short period of time. Precautions are taken to avoid any form of secondary infection. Cryosurgery associated with skin cancers such as basal cell carcinoma, have side effects such as hypo pigmentation and hyper pigmentation. In some rare cases nerve damages have been reported. Studies indicate that patients who have a history of human papilloma virus infection also prefer cryosurgery for the removal of genital warts.
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Bibliography / Reference
Collection of Pages - Last revised Date: December 10, 2019