Skin color, patchy

Alternative names:

hypomelanosis; hypopigmentation; loss of skin color in places; mottled skin; patchy loss of skin color

Home care:

Spontaneous return of normal skin color may occur in some cases. Patience is the most effective measure for loss of skin color.

Exposure to sun or ultraviolet (UV) light, especially after sensitization with an oral medication (psoralens), may increase pigmentation. This is effective for about 60% of hypopigmentation lesions if done 2 to 3 times a week for 2 or 3 years, but it may have side effects and may increase the risk for skin cancer.

Lotions that bleach or lighten the skin, such as benoquine or hydroquinone lotions, may be used to reduce hyperpigmented skin or to even the skin tone where hypopigmented areas are large or conspicuous.

Selsun blue or Tolnaftate (Tinactin) lotion can help in treating tinea versicolor. Apply as directed to the affected area daily until the lesions disappear. Unfortunately, tinea versicolor often returns no matter what type of treatment is used.

Cosmetics or skin dyes may be used to disguise pigmentary changes. Make-up can help hide mottled skin but will not cure the underlying problem.

Avoid excessive sun exposure and use sun block because hypopigmented skin sunburns easily.

Call your health care provider if:

• the skin is mottled at the elbows and knees, or all over, and is pale, cool, and clammy. This may indicate hypovolemic shock, which requires immediate medical attention.
• there is any change in skin pigmentation that occurs without an obvious cause and is persistent.
• you notice a new mole or other growth, or an existing one has changed color, size, or appearance.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting patchy skin color in detail may include:

• time pattern
  • When did it develop?
  • Did it develop slowly or suddenly?
  • Is it getting worse? How fast?

• quality
  • Is it a loss of pigment?
  • Is it a problem with the blood vessels?
  • What color is the affected area?
  • What is the normal skin color?

• location
  • Exactly where is the skin color changed?
  • Is it in more than one location?

• aggravating factors
  • Have you had any trauma to the skin (including sunburn or frequent sun tans)?
  • Are you pregnant?
  • What medications do you take?
  • What medical treatments have you had?

• other
  • What other symptoms are also present?

A detailed examination of the skin will be performed.

Diagnostic tests that may be performed include:

• scrapings of skin lesions
• Wood's lamp (ultraviolet light) examination of the skin

Patients may be encouraged to have regular examinations and to avoid tight clothing and overexposure to cold or heating devices, such as hot water bottles and heating pads.

After seeing your health care provider:
You may want to add a diagnosis related to patchy skin color to your personal medical record.