Skin disorders presenting with abnormal pigmentation are usually difficult to manage due to their uncertain etiology or pathogenesis. The pathomechanisms may differ in individual patients even in the same disease. Therefore, it is critical to determine the cause of the management of abnormal skin pigmentation.

Abnormal pigmentation is an acquainted symptom of aging skin. This association between skin aging and skin pigmentation abnormalities may be due to certain inherited disorders described by premature aging and abnormal pigmentation in the skin and some therapeutic modalities effective for both. 

Some causative mechanisms, like DNA damage and telomere shortening, are involved in hereditary disorders that exhibit accelerated aging and skin hyperpigmentation or hypopigmentation, furnishing reliable evidence for the association between skin aging and pigmentation abnormalities. However, oxidative stress, hormonal changes, and autophagy impairment may not adequately support the relationship between skin aging and pigmentation abnormalities.

Epigenetic changes, especially DNA methylation and microRNAs, are also suggested to be involved in skin aging without an identified role in skin pigmentation. More studies are required to establish the role of skin aging in various conditions showing abnormal skin pigmentation.

Source- Lee AY. Skin Pigmentation Abnormalities and Their Possible Relationship with Skin Aging. Int J Mol Sci. 2021;22(7):3727. Published 2021 Apr 2. doi:10.3390/ijms22073727