Pigmentation

Is your scar darker or lighter than the surrounding skin? Then you’re dealing with pigmentation disorders caused by scar formation.

About Pigmentation Disorders

The color of your skin is mainly determined by melanin, a substance made by special cells in your skin. These cells help protect your skin from sunlight.
Scars can look different in color due to problems during the healing process. This is called a pigmentation disorder.
Some scars become darker (hyperpigmentation) because of a strong inflammatory reaction, while others become lighter (hypopigmentation) due to long-lasting inflammation that stops pigment cells from producing color.
Whether a scar regains its pigment also depends on whether there are hair follicles present in the skin.

How do you treat pigmentation disorders?

Lasers like Q-switched lasers and picosecond lasers, along with microneedling, work well for scars that are too dark (hyperpigmentation).
Creams containing ingredients like hydroquinone and azelaic acid are also often used.
For lighter scars (hypopigmentation), treatments like micro-transplantation and microneedling, combined with applying a suspension of your own skin cells, can help.
These skin cells are not grown in a laboratory.

Frequently asked questions

Why are my scars turning brown?

Scars can turn brown because of post-inflammatory hyperpigmentation.
Simply put, this means your skin produces extra pigment (melanin) as a reaction to damage, like from a wound or surgery. This happens more often in people with medium to darker skin tones but can actually happen to anyone. Sun exposure often makes scars darker because the new skin cells are more sensitive. If a scar is touched or irritated often (for example by clothing), it can also darken. If the wound healed with a lot of inflammation (such as from an infection), the risk of brown discoloration is even higher.

Why does pigment disappear after scar formation?

Pigment can disappear after scar formation because of damage to melanocytes — these are the cells that normally produce pigment (melanin) in your skin. If you have a deep wound (like from a burn, cut, or acne scars), the healing process can damage or destroy these pigment-producing cells. As a result, less pigment is produced in that area, which is why scars can sometimes appear lighter (depigmentation) than the surrounding skin.

Possible treatments for pigmentation

Q-switched lasers, picosecond lasers and microneedling have been effective in the treatment of hyperpigmented scars. Topical creams like hydroquinone and azelaic acid are also often prescribed. Treatment option for hypopigmented scars include micro-grafting and microneedling combined with a non-cultured autologous epidermal skin cell suspension.

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