Medically reviewed by Minimalist Health Specialist -  Written by Viddhi Patel (Journalist) on 19th Nov 2020

Treatment for Hyperkeratosis-Hyperpigmentation 

Treatment for Hyperkeratosis

When your skin is thickened, it causes one skin condition, and when your skin is darkened, it causes another condition. There is a stark difference between hyperkeratosis and hyperpigmentation.

Although skin conditions, their occurrence relies on the production of two different compounds.

While hyperkeratosis is formed when your skin overproduces keratin, hyperpigmentation is when there is an overflow of melanin.

Although different, there is a disease that notes the occurrence of both of them, hyperkeratosis-hyperpigmentation syndrome. The very rare hyperpigmentation characterized by tiny dark spots occurs mainly on sun-exposed areas, together with mild punctate palmoplantar papular hyperkeratosis as a major feature. But the research on the same is limited.

Hyperkeratosis, a skin condition, occurs when a person's skin becomes thicker than usual in certain areas. On the other hand, hyperpigmentation or dark patches result from sun damage, acne scarring, and hormonal imbalances.

Read on to know all about them.  

What you need to know about Hyperkeratosis

The outer layer of your skin contains keratin, a tough, fibrous, protective protein. Inflammation or rubbing it onto something may cause the overproduction of keratin as a defensive response to pressure.

The outer layer of your skin thickens. Although it occurs mostly on the skin irritated less frequently, it may appear on skin that has not been irritated, resulting from heredity. Hyperkeratosis mainly occurs on large skin portions.

Keratin helps protect the body against filtration by water and other chemical and biological agents to which it is exposed and comes in contact every day. The skin thickening of this kind is often your body's natural response to pressure, rubbing, etc. However, there may be several other possible causes.

Mouths fitted with dentures are more likely to have hyperkeratosis problems in the mouth as ill-fitting dentures may rub against the skin in the mouth and cause the condition. 

Genetic hyperkeratosis

Unexposed or irritated to any infection may also lead to hyperkeratosis, and it may be a reason for an inherited condition. The signs of this kind of keratosis usually begin in infancy or childhood and affect large areas of one's body. Widespread, thick, scaly areas are a characteristic sign of this type of hyperkeratosis.

KRT1 or KRT10 gene mutation can cause epidermolytic hyperkeratosis. These are the genes involved in keratin 1 and 10 production, resulting in a blister and damage-prone skin, even to a mild injury. However, how these mutations lead to hyperkeratosis is still unknown.   

The different forms of hyperkeratosis and identifying them

All symptoms and forms involve an area of rough or patchy skin that is different from its surrounding.  

1. Corns and calluses   

Skin exposed to repeated friction or pressure develops corns or calluses. It is a response function of your skin: thick layers of dead skin cells pile up and harden.

Corns usually form on irritated toes, while calluses form on the hands' feet and palm soles. It may just be a cosmetic nuisance for some, while it may be painful and a troublesome medical condition.

Callus, an area of thickened skin, usually occurs on the feet but can also grow on fingers and are generally of even thickness.

Corns typically develop on toes or between them; it has a central lesion of very hard keratin with an outer ring of hard tissue that is comparatively softer.  

2. Warts  

Small bumps on your skin that are a result of human papillomavirus [HPV] infection are warts. Plantar warts are the ones that grow on the soles of the feet. The infection usually spreads by direct contact, typically when you touch or shake hands with somebody who has a wart or when you touch a contaminated surface, walking barefoot on a gym floor or a pool deck, or when you wear someone's shoes. 

3. Chronic eczema

Allergies often trigger the inflamed skin condition; irritating chemicals are also called dermatitis. Eczema causes itching, redness, and tiny blisters, but uncontrollable eczema may lead to:  

The lacy white on the inside of one's mouth or maybe an itchy, scaly patch elsewhere is lichen planus, and it may be related to the immune system's abnormal reaction. 

4. Actinic keratosis  

Flat, red, rough, sandpaper-like spots or patches of skin, as tiny as a few millimeters, are actinic keratosis. They are a result of excessive UV exposure and occur on sun-exposed areas of the skin. The condition may potentially lead to skin cancer.    

5. Seborrheic keratosis 

Small, noncancerous skin growth, maybe just a tan, brown, or black skin growth. They may appear on the face, trunk, arms, or legs. Seborrheic hyperkeratosis is very common, but what causes it is still a mystery.

Inherited conditions also cause hyperkeratosis and cause a widespread, thick, platelike scaling of the skin. It may show up shortly after birth or during early childhood.

What causes your skin to produce keratin absurdly?  

The various non-inflammatory skin diseases are characterized by the disturbance in the Novo obrazovaniya process, excessive development of stratum corneum, or normal exfoliation delays. Keratoses are very common, but the fuzzy classification is due to uncertainty in determining many of them' causes and pathogenesis.

  • Lack of regular skin treatments like peeling or cosmetic moisturizing is a potential cause of hyperkeratosis. Dry skin cells and dehydrated skin cells all work together to bundle and form a thick layer on your skin's surface.  
  • Adverse external factors like water, detergents, UF radiation, etc., are in contact with our delicate skin, causing an impairment in the lipid layer of the dermis.
  • Skin cells begin to die very quickly in connection with the violation of the skin's metabolic processes, causing the horny skin layer to become thicker.  
  • Hyperkeratosis often develops independently, with no apparent cause to define. Here genes and heredity come into play showing early signs after childhood and infancy. 
  • HPV contributes heartily to hyperkeratosis and may become another infection. Frambesia hyperkeratosis, for instance, is caused by a spirochete.  
  • Thickening and dryness of the skin can also be caused by vitamin A deficiency and is a potential reason for the appearance of hyperkeratosis.
  • Lack of estrogen in women during menopause contributes to hyperkeratosis appearance. 
  • Age-related skin changes are associated with hyperkeratosis.  

How to decipher them?  

Apart from corns, calluses, and eczema, there are other symptoms of the more common causes of hyperkeratosis:  

  • Epidermolysis hyperkeratosis: It causes extremely red skin and severe blistering of the skin at birth. With age, the baby develops thickened skin areas, particularly over the joints. 
  • Leukoplakia: Thick, white patches build up inside the mouth.
  • Plaque psoriasis: Excess skin buildup of skin cells that are mostly silvery and scaled.  

Treating hyperkeratosis  

Treatment depends on its cause, location, type, and severity of the condition.

Certain topical treatments are also used to moisturize, soften, and shed thick skin.  

  • Salicylic acid: to break keratin, causing thick skin to soften and shed. This consequently reduces the skin thickness. 
  • Urea-based agents: To increase the water content in the skin and soften the area. It helps break up keratin.
  • Alpha-hydroxy acid: For exfoliation and removal of hardened layers and unveil the softer layers underneath. They accept moisture easily.  

Word of caution 

You cannot control your genetics against this form of dermatitis, but you can prevent your skin from suffering by doing certain things:  

  • Using latex gloves, chemical exposure, and frequent hand wash can lead to hyperkeratosis, and hence, health care professionals, machinists, housekeepers, and beauticians are at a higher risk of developing symptoms.  
  • Hand dermatitis can be a result of a childhood history of eczema. 
  • Wear comfortable shoes. 
  • Don't go barefoot in gyms, locker rooms, or pool areas.  
  • Avoid extreme temperatures, dry air, harsh soaps, irritating chemicals to prevent triggers of chronic eczema.
  • Limit sun exposure, wear protective clothing, and apply sunscreen mandatorily of SPF 30 or above.

    If your hyperkeratosis causes pain or discomfort, see a doctor. 

What you need need to know about Hyperpigmentation

Patches of skin that are way darker than the rest are hyperpigmentation. They occur due to extra melanin deposit - color-producing pigment and appear on the face, neck, and around the mouth.

The damage of melanocytes leads to excessive melanin bundling. These clusters of melanin turn skin to dark patches or hyperpigmentation. It can occur to any skin type and age group; it is generally harmless.  

What kicks in the melanin production?  

  • Sun exposure 
  • Skin inflammation 
  • Melasma 
  • Age spots 
  • Certain drugs.   

The different forms of hyperpigmentation and deciphering them 

  • PIH [post-inflammatory hyperpigmentation]: occurs as a repercussion of a skin injury, acne, or injuries due to procedures like chemical peels, dermabrasion, and laser therapy. The patches are pink, red, brown, or black.  
  • Age spots [solar lentigines or liver spots]: manifest on sun-exposed parts of the skin. UVA and UVB trigger melanocytes to produce more melanin as a defense mechanism, causing discolored skin patches.  
  • Melasma: causes hormonal changes in pregnant women. 

Visit a dermatologist if you notice any change in skin, color, or size of the existing moles. 

Treating stubborn hyperpigmented patches 

Topical treatments 

The most common treatment option, but it requires a certain determination as results often show after weeks or months of religious use. 

Hydroquinone  

Skin lightening agent that reduces the amount of skin melanin 

Azelaic acid  

Acne leaves hyperpigmentation as it inflames. Azelaic acid, a leave-on gentle exfoliant, treats discoloration. It is among the safest and effective treatments for hyperpigmentation. 

Kojic acid  

Natural skin lightening agent derived from a fungus, kojic acid, inhibits tyrosine production- [an amino acid involved in melanin synthesis] Kojic acid2% combined with alpha arbutin 1% by beminimalist is anti-pigmentation and dramatically reduces dark spots, blemishes. It leaves your skin feeling brighter and even-looking.

Retinoids  

Vitamin A derivatives are miracle ingredients when it comes to anti-aging and skin-lightening.

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Vitamin C 

A powerful antioxidant that reduces hyperpigmentation caused by sun damage and inhibits tyrosinase activity. 

Vitamin C (Ethyl Ascorbic Acid) 10% + Acetyl Glucosamine 1%
Vitamin C (Ethyl Ascorbic Acid) 10% + Acetyl Glucosamine 1%

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Vitamin B3

Niacinamide or B3 helps in treating hyperpigmentation caused by sun damage and helps in collagen production

There are in-office treatments and chemical procedures you could opt for 

Chemical procedures that peel away or brush away the dark patches.

Chemical peeling  

Controlled chemical burning of the skin through chemicals like glycolic acid or lactic acid removes top skin layers peeling away dark patches, and allows the new skin cells to push up the surface. 

Laser therapy  

Laser resurfacing treatment beams light on targeted skin to remove epidermal layers of the skin.  

Microdermabrasion

A dermatologic treatment that uses an abrasive handheld machine could be useful. Rolling the device on the skin rids it of the top skin layer and associated pigmentation. 

Prevent the dark wave by: 

Wearing sunscreen and protective clothing.

Taking care of the skin with mild exfoliation, good moisturizer.  

Wrapping it all up

The two are skin conditions that are very far from each other. While one is skin darkening, the other is skin thickening. The two also follow very different treatment procedures. Hyperpigmentation is not painful, while hyperkeratosis of some kinds may appear as painful corns and calluses. There are a variety of medications and treatment options available for both of them. 

The last word 

Your skin requires you to keep both these skin conditions at bay, so you need to be a little vigilant. Hygiene, moisturization, and sun protection go a long way.  

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