Hypopigmentation and Depigmentation

Light or white skin patches are cosmetically bothersome especially in people with darker skin tones. The assessment of light/white patches is not simple and requires extensive history taking and full body examination with a Wood’s lamp (UV light). Partial or complete loss of skin/hair pigment can also happen secondary to inflammatory conditions such as eczema, infectious conditions (tinea versicolor), or autoimmune conditions (vitiligo), among others.

Vitiligo is a skin disorder where melanocytes (cells that bring the pigment to the skin) are attacked by the patient’s own immune system. Vitiligo can be segmental (unilateral), classic (bilateral, with predilection of sites of frequent trauma, genitals, and hands, around mouth and around the eyes) or generalized. Vitiligo tends to run in families and is occasionally associated with other autoimmune processes.

At Houston Dermatology and Plastic Surgery, we will provide you with a comprehensive and thorough skin examination and you will receive our expert’s opinion on the best approach for your condition. We have vast experience managing topical steroidal and non-steroidal immunomodulators, phototherapy (light treatment) and other cutting-edge approaches to control the disease.


Darkening of the skin (hyperpigmentation) is a common dermatologic condition found in patients with darker skin tones. Women and men of Asian, Hispanic and African decent are particularly vulnerable to suffer from hyperpigmentation after inflammatory processes (e.g. acne, eczema) cosmetic procedures, hormonal imbalances (melasma, acanthosis nigricans), use of certain medications or because of genetic conditions.

Melasma is a reticular (net-like) pattern of hyperpigmentation affecting the forehead, cheeks and chin, typically associated to the use of oral contraceptives and pregnancy but that can also occur without any evident trigger. At Houston Dermatology and Plastic Surgery, we will carefully assess the potential causes of melasma and will provide you with a series of recommendation to even out the tone of your skin. We have vast proficiency in the use of alpha-hydroxy acids, hydroquinone-based creams and a variety of chemical peels to tackle the brown pigment of the skin.

General recommendations to avoid/treat melasma:

  • Sun avoidance or daily sun protection with broad spectrum SPF 30+. For melasma, the use of physical barrier sunscreens (zinc oxide, titanium dioxide and iron oxide) provide additional protection compared to chemical-based sunscreens given its protection against UVA, UVB and natural light.
  • Re-apply sunscreen every 90 min, especially when swimming or performing sports.
  • Use of large brimmed hats is highly recommended.
  • Use of over-the-counter bleaching creams without professional supervision is not advised.

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