Causes of Skin Discoloration Around the Mouth

Skin discoloration around the mouth or corner of the lips may be due to :

• Medical conditions such as Addison’s disease, Cushing’s syndrome, digestive disorders ( biliary cirrhosis, porphyria) and iron-deficiency anemia.
• Injury or trauma to the area from fungal infections, chemical irritants, certain cosmetics, long term use of skin lightening creams and incorrectly performed skin procedures like dermabrasion.
• Excessive sun exposure that leads to sun burn can result in pigmentation around the mouth. This is more common in lighter skin complexions or those with sun sensitivity.
• Prolonged exposure to heat, common in beauty treatments with the use of procedures like long periods of facial steaming.
• Beauty treatments involving facial hair removal, such as waxing, threading or depilatory creams, can often leave the skin bruised and irritated, if performed incorrectly, done repeatedly in short periods or in more sensitive skin types. This can cause repeated trauma to the area resulting in the darkening of the skin.
• Hormonal changes such as menopause, puberty and pregnancy can contribute to dark skin discoloration around the mouth
• Melasma, which is a skin condition commonly occurring in females, results in the appearance of brown patches. This is occurs due to hormonal imbalances during pregnancy and menopause. Excessive sun exposure can aggravate melasma but does not usually cause the condition.
• Drug-induced pigmentation is hyperpigmentation that occurs as a side effect of certain drugs, like antimalaria drugs, antibiotics and certain oral contraceptives. However this is not a common side effect and occurs in only a small percentage of patients.
• Nutritional conditions such as carotenanemia (orange tinge of the skin due to over consumption of yellow food), malnutrition, malabsorption of food and pellagra may lead to hyperpigmentation of the skin.
• Hyperpigmentation can occur due to inflammatory conditions of eczema, systemic sclerosis, burns, healing of acne scars, blisters and photodermatosis.

Treatment and Management

• Avoid excessive sun exposure, especially if your skin is sensitive to the sun. Sun exposure aggravates most skin conditions, particularly when hyperpigmentation is a symptom of the specific condition. The use of a sunscreen  will assist with protection from the sun and it is advisable to use a protective cream with SPF 30 on a daily basis.
• Beauty procedures such as chemical peels, iontophoresis, intense pulse light therapy and laser surgery can help in the treatment of hyperpigmentation. However these procedures should be conducted by a reputable skin care professional as incorrectly performed procedures may aggravate the dark skin discoloration further.
• Topical cosmetic creams such as alpha hydroxy acid and hydroquinone are effective in treating hyperpigmentation but hydroquinone should be used cautiously as incorrect use can cause furthering darkening.
• Camouflage make up is often used in the concealment of pigmentation but this is not a solution to the problem.

Causes of Dark Circles Under the Eyes?

• Allergies such as hay fever can often result in dark under the eye circles as the allergens responsible for the hay fever results in inflammation of the eye lining, often experienced as itching, as well as inflammation of the skin around the eye. Nasal congestion that often occurs during the bout of an allergy and further contributes to the inflammation which leads to dark circle formation under the eye. This occurs due to the dilation of blood capillaries from the nose to the eyes.
• Hereditary. Fair skinned individuals with naturally deep seated eyes are often prone to developing dark circles under the eye as they get older. Dark eye circles can also develop due to genetic factors.
• Thinning of the skin around the eye occurs due to the loss of collagen and fat deposition  around the eye area as a result of ageing. Blood vessels become more distinct due to the decreased amounts of collagen and fat giving the appearance of dark eye circles. The development of puffy eyelids or hollows under the eyes occur due to the natural process of ageing
• Lack of sleep. Disturbances in the normal sleep cycle can result in the skin looking pale with development of circles under the eyes appearing darker in colour. A lack of sleep can also contribute to tired looking eyes that can often give the appearance of puffiness.
• Sun damage. The excessive amounts of sun exposure can cause the body to produce large amounts of melanin (pigment cells) to protect the skin against the harmful effects of the sun’s rays. This results in the weakening of skin tissue under the eyes contributing to dark eye circles.
• Lifestyle. The consumption of alcohol, caffeinated drinks and smoking results in the accumulation of toxins  in the body. This build up can often lead to the development of dark circles under the eye area.
• Dehydration. The decrease intake of water with the combination of alcohol and caffeinated beverages can lead to dehydration resulting in the appearance of dark circles under the eyes.
• Fluid retention in the body are commonly due to illness, excessive dieting, increased amounts of salt intake, smoking, medication, disorder’s of the heart, thyroid, kidney and liver. The above results in the dilation of the blood capillaries causing the eyes to appear engorged with dark circles under the eyes.

Treatment of Dark Circles

• Increase the amount of water intake to help detox the body of the accumulated toxins. The daily recommended allowance of water intake is approximately 6 to8 glasses.
• Decrease or eliminate the consumption of alcoholic and caffeinated beverages to prevent dehydration.
• The use of a sunscreen would help prevent the weakening of the skin’s tissue around the eyes.
• Laser therapy and chemical peels can decrease the discoloration around the eye area.
• Hollows that develop under the eye due to aging can be corrected with collagen injections.
• Decrease smoking and salt intake, and increase sleep and vitamin intake which will help minimise the appearance of dark circles under the eye.

How are stretch marks formed?

Stretch marks, also known as striae, occur when the dermis (middle layer of skin) over stretches to accommodate excess fat or body enlargement (as in pregnancy( resulting in the break down of elastin fiber, which is responsible for the skin’s firmness. The stretching causes tissue inflammation and bleeding of the micro-vessels resulting in the formation of the typical stretch mark on the surface of the skin. These bright streaks are characterized by pink, red or purple raised scars. Over time these marks may fade into a silvery white to dark brown color, although it is usuall a few shades lighter than the skin’s natural tone because of the disruption in the collagen and melanin (pigment cells) production.

Causes of Stretch Marks

• Pregnancy. In the late stage of pregnancy, as the growth of the fetus accelerates, stretching of the skin occurs around the abdomen,although the hips, thighs and breasts may also be affected. Pregnant women with large or multiple babies (for example twins) are more susceptible to the increased development of stretch marks.

• Puberty. During this stage of life adolescents undergo a growth spurt. To accommodate the increase in height and body development the skin stretches resulting in stretch marks.

• Obesity is a common condition responsible for the formation of stretch marks due to the increase in fat deposition thereby stretching the skin.

• Zinc. A deficiency in zinc often contributes to the development of stretch marks

• Weight lifters develop stretch marks as the skin stretches to accommodate the increased amount of muscle bulk. Some body builders use steroids to develop muscle bulk quickly which affects the blood cortisone levels.

• Medication. The use of both oral and topical medication such as contraceptive pills, chronic use of steroid creams and medication contribute to the formation of stretch marks.M

• Medical disorders and conditions such as Cushing’s syndrome, other adrenal gland disorder and hereditary disorders play a role in the development of stretch marks.

Treatment of Stretch Marks

The treatments for stretch marks are partly effective as these marks cannot be completely removed.

• Topical applications of preparations such as tretinoin creams improves the appearance of newly formed stretch marks of less than 6 weeks old and are still pink in colour. Tretinoin rebuilds collagen and elastin fibres making stretch marks less visible but it is not effective on old stretch marks.

• Pulsed laser and excimer laser are the 2 types of effective laser therapies commonly used in the treatment of stretch marks. Pulsed laser therapy remodels the dermis (middle layer of skin) by stimulating the growth of elastin and collagen fibres. This type of therapy is effective on newly formed stretch marks. Excimer laser stimulates the production of melanin cells (pigment cells). This allows the hypopigmented stretch marks to blend into the surrounding skin marking it less visible. Excimer laser therapy is effective for both new and old stretch marks.

• Micro-dermabrasion resurfaces the skin by using minute sand-like crystals. These crystals erode the surface of the skin while a thin tube suctions the crystals and dead skin cells. Microdermabrasion is effective on old stretch marks as it removes the upper layer of skin (epidermis) resulting in the growth of new cells.

Picture of Severe Spider Veins & Varicose Veins

Telangiectasia is a condition commonly referred to as spider veins, where thin dilated blood vessels connected to larger blood vessels are visible at the skin’s surface. These veins appear in clusters of bluish-purple or red zones and are often shaped in a ’spider’s web’, hence the name spider veins. Although this condition can affect a small percentage of males it is mostly common in females. Unlike varicose veins, spider veins do not bulge or extend above the surface of the skin.

Causes of Spider Veins

The common causes responsible for the onset or aggravation of spider veins (telangiectasia) are :

• An insufficiency in the circulation of the venous system causes the vein valves to weaken resulting in pooling of blood (congestion). This eventually leads to the development of spider veins.
• Genetic factors play a role in the weak development of the vein wall resulting in the formation of spider veins. These veins can cause an increase the blood pressure of the surrounding superficial veins.
• Excessive exposure to the sun can trigger the development of spider veins especially in lighter skinned individuals.
• Hormonally induced conditions or medication that cause hormonal fluctuations such as pregnancy or menopause can cause the vein wall to ’soften’ increasing the incidence of spider veins. The blood volume also rises during pregnancy which increases the blood pressure in the venous system. This may result in the development of spider veins.
• Conditions such as obesity with an excessive amount of body fat and less connective tissue support around the veins may lead to spider veins.
• Individuals, in jobs that require extended periods of standing or sitting without regular intervals of leg movement, are more susceptible to spider veins
• Aggravating factors such as aggressive skin treatments or an increased intake of alcohol may be at risk of developing spider veins

Management of Spider Veins

• Certain cosmetics, like foundation, can be used to camouflage the appearance of spider veins
• Regular physical activity aids, in cases of hypertension (high blood pressure), obesity and poor circulation, may assist with reducing the extent of spider vein proliferation.
• The use of flat shoes and support hose can reduce or decrease the occurrence of spider veins in person’s with venous insufficiency of the leg or varicose veins.
• Avoid excessive consumption of alcohol
• In occupations that require extended periods of sitting or standing, it is advisable to exercise the legs with short episodes of walking.
• Decreased sun exposure, especially in persons with sun sensitivity of skin, and the use of sunscreens help in the management of spider veins.

Treatment of Spider Veins

There are two types of treatments that are commonly used in treating spider veins. These treatments include the invasive yet effective sclerotherapy, and non-invasive laser treatment.

Sclerotherapy

Sclerotherapy is a highly effective invasive treatment requiring several sessions. An irritant solution such as concentrated saline or a specialized detergent solution is injected directly into the spider veins causing pain that last for a few minutes. The solution damages the wall of the vein resulting in swelling and constriction of the blood supply. The spider vein becomes a scar tissue and disappears over a period of days to weeks. The side effects of sclerotherapy include skin sores, bruising and discoloration around the treated skin.

Laser treatment

Laser treatment is a non-invasive procedure that uses an intense pulsed light to heat the surface of the skin. The laser is focused on individual vessels causing the wall of the spider veins to ’seal’ (cauterization) minimizing the damage to the surrounding tissue. Since the veins appear red, pink and sometimes bluish-purple they tend to absorb more of the laser than the surrounding normal skin. When the light of the laser is absorbed the spider veins shrink without damaging the normal skin. The side effects of laser treatment includes redness, swelling, and discoloration of the skin. These effects usually subside after a few weeks.

Dermabrasion is an effective procedure done under local anaesthetic for the treatment of skin imperfections. A high speed brush with a spinning disc is used to remove the outer surface layer of skin (epidermis) to allow for regrowth of new skin tissue. The uneven, old scar tissue is replaced to alter the contour of the scar. The deep exfoliating effects of dermabrasion treatments can often remove deep wrinkles around the chin and mouth area, some scars and surface pigmentation.

How are acne marks and other scars formed?

Acne scars occur as a result of the body’s inflammatory response to the skin oils (sebum), bacteria and dead skin cells which form blockages in the pores of the skin. These blockages result in a plug like formation and begin to develop in the follicle of the skins pore. This causes local inflammation and the body releases white blood cells to fight of infections and repair damaged skin tissue. Fibrous scar tissue, eroded skin tissue or an increased amount of skin tissue may result (keloid scar).

The extent of scarring differs between each individual as it is dependent on the different skin types (oily or dry) and the condition (chicken pox, acne) resulting in the formation of the scars. There are two types of scar formation :

Depressed scars such as ‘ice pick scarring’ usually occurs due to a lack of skin tissue formation. The scars are usually firm and appear with irregular edges. A depressed scar can improve when the skin is stretched such as periods of growth spurts or weight gain. Depressed scars are also known as ‘crater scars’ or ‘pock marks’.

Raised scars which are also known as keloid or hypertrophic scars occur with an increase in tissue formation. An excessive build-up of cell substance called collagen forms a raised scar. The scar appears smooth with an irregular shaped border resulting in the abnormal growth of scar tissue.

What are the benefits of dermabrasion treatments?

Dermabrasion is often use in the treatment of acne scaring, removal of tattoos, pigmentation, birth marks, liver spots, keloid and chicken pox scaring, freckles and sun damaged skin. The appearance of the skin is improved with long lasting effects of the treatment. Dermabrasion resurfaces the skin and removes severe imperfections. The principle behind dermabrasion involves causing inflammation to the skin and allowing it to heal, hopefully removing pre-existing imperfections. Medicated creams or vitamin-rich ointments, usually high in vitamin A, may be applied to allow the skin to heal more effectively.

What are the side effects of dermabrasion?

Dermabrasion is not suitable for all types of scars, like ice pick scars, as the scar can become more noticeable if it appears wider after treatment. The abrasive technique of dermabrasion may aggravate pigmentation or melasma. After the treatment of dermabrasion the skin usually appears raw and irritated which leaves the area treated more susceptible to pressure and light or sun sensitivity. Infections can occur after the dermabrasion treatment which can result in further scarring and leave the skin looking worse that it initially appeared. Individuals that suffer with conditions such as rashes due to allergic reactions may have adverse effects to the dermabrasion treatments.