Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological SocietyDisclosure: Nothing to disclose. Melanin is produced by specialised cells called melanocytes present in the epidermis layer of the skin. 2015;42(2):21518. Genetic / rare conditions, Diagnosis based on predominant site 90% or more of body erythematous Any inflammatory condition in the skin (e.g., eczema, psoriasis), especially in dark-skinned patients, can lead to postinflammatory hyperpigmentation, a common late sequela characterized by patches of brown skin. [1] Loss of melanin in a particular area of your skin results in patches that are lighter or whiter than your basal skin tone. J Dermatol. Last reviewed: June 2017. 2013;26(6):796804. Activation of melanocytes in idiopathic guttate hypomelanosis after 5-fluorouracil infusion using a tattoo machine: Preliminary analysis of a randomized, split-body, single blinded, placebo controlled clinical trial. I hope this helps anyone who is seeking answers. Books about skin diseasesBooks about the skin Ortonne JP, Perrot H. Idiopathic guttate hypomelanosis. Cryotherapy and dermabrasion may have some benefit. [QxMD MEDLINE Link]. Pityriasis versicolor fluoresces blue-green on examination using a Wood lamp (long wavelength UVA1). Singh A, Choudhary R, Ganguly S, Singh V. Indian Dermatol Online J. Shin J, Kim M, Park SH, Oh SH. Your doctor may perform a Woods lamp examination to determine the specific type of hypopigmentation. are congenital (acquired by birth) therefore cannot be prevented. Melanoma-associated leukoderma. J Am Acad Dermatol. Now a leukoderma is simply a fancy term for a loss or lack of coloration in the You should complete the full antibiotic or antifungal course to avoid resistance to the medications. Ploysangam T, Dee-Ananlap S, Suvanprakorn P. Treatment of idiopathic guttate hypomelanosis with liquid nitrogen: light and electron microscopic studies. [QxMD MEDLINE Link]. Rerknimitr P, Chitvanich S, Pongprutthipan M, Panchaprateep R, Asawanonda P. Non-ablative fractional photothermolysis in treatment of idiopathic guttate hypomelanosis. [7]. Travel acquired / worldwide infections J Cutan Pathol. Indian Dermatol Online J. How Long Does Hypopigmentation Resulting As A Side Effect Of Treatment Last? Indian Dermatol Online J. and transmitted securely. 2022 Feb 3. learning points & advise them to attend too" GP WebIdiopathic guttate hypomelanosis is a common condition characterised by the presence of numerous, small, white macules found predominantly on the shins and forearms. Idiopathic guttate hypomelanosis (IGH) is an acquired, benign leukoderma of unknown etiology. Arrunategui A et al (2002) HLA-DQ3 is associated with idiopathic guttate hypomelanosis, whereas HLA-DR8 is not, in a group of renal transplant patients. Also known as diffused hypopigmentation, generalised hypopigmentation affects the entire body. Leukoderma Fungal skin infections Intertrigo (inflammation in body fold 17. Pagnoni A, Kligman AM, Sadiq I, Stoudemayer T. Hypopigmented macules of photodamaged skin and their treatment with topical tretinoin. Darker areas of skin sharing sensitive information, make sure youre on a federal https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA2ODQyMi1vdmVydmlldw==. 80 (2):141-4. Rose D. Top 12 natural remedies for eczema; 2019. 20021068422-overviewDiseases & Conditions, 20021068962-overviewDiseases & Conditions, encoded search term (Idiopathic Guttate Hypomelanosis) and Idiopathic Guttate Hypomelanosis, A 27-Year-Old Woman With White Spots on Her Face, White Lesions on the Hands and Lower Extremities, Guideline for the Diagnosis and Management of Vitiligo. Solve your problem quick & easy with online consultation. Sun damage can lead to age spots, or dark spots, on our skin, as well as white spots known as idiopathic guttate hypomelanosis (IGH). HHS Vulnerability Disclosure, Help Idiopathic guttate hypomelanosis (IGH) is an acquired leukoderma of unknown etiology. use, THE CUNLIFFE (TP) SKIN LESION DIAGNOSTIC TABLE, Trunk (chest, abdomen, back) / buttocks / axillae / groin, Leg & Other Chromium deficiency Chromium controls blood sugar, and also are low for people with vitiligo and idiopathic guttate hypomelanosis. De Schrijver S, Theate I, Vanhooteghem O. Halo nevi are not trivial: about 2 young patients of regressed primary melanoma that simulates halo nevi. "Extremely helpful to have memory stick with notes of talks 1. WebClinical and morphologic studies were made of 20 cases of guttate hypomelanosis. Before Decreased or absent pigment makes the skin appear lighter or white, known as hypomelanosis or hypopigmentation (Box 2). Photodermatol Photoimmunol Photomed. 2021 Feb 17;23(1-2):8-15. doi: 10.1080/14764172.2021.1957116. Chemical burn scar with leukoderma Dear, I'm 26 years old and have idiopathic guttate hypomelanosis. [Full Text]. eczema, Other guidelines - The British Back to Top Summary Buch J, Patil A, Kroumpouzos G, Kassir M, Galadari H, Gold MH, Goldman MP, Grabbe S, Goldust M. J Cosmet Laser Ther. C. You can mix powdered bakuchi seeds in coconut oil and apply on you hypopigmented patches to make them fade away over time. Int J Dermatol. Vitiligo affects approximately 1% of the population and both genders equally. It is not vitiligo. Actinic (solar) keratosis 3. Efficacy was assessed by improvement from baseline using the following scale: -1 = Worsening of IGH; 0 = No Improvement (IGH remained stable); 1 = Mild improvement of IGH (some re-pigmentation on <50% IGH); 2 = Moderate improvement (some re-pigmentation on >50% or full re-pigmentation on <75% IGH); 3 = Full re-pigmentation on >75% IGH. Available: om/articles/324228 70. FOIA Idiopathic guttate hypomelanosis is most common in countries with fair-skinned populations having a high degree of sun exposure. DermNet does not provide an online consultation service. Unwell with eg fever / malaise 2017 Apr. 2018 Dec;293(6):1469-1475. doi: 10.1007/s00438-018-1475-9. Int J Dermatol. [4]. Treatment is not necessary. The diagnosis is usually straightforward. Burns. This blog post is based on scientific evidence, written and fact checked by our doctors. An African-American patient with idiopathic guttate hypomelanosis on her leg. Skin lesion algorithm - common benign 4. Localised hypopigmentation: clarification of a diagnostic conundrum. Ask your doctor about using topical steroids. [QxMD MEDLINE Link]. Get 200 HealthCash. It is not a diagnosis in itself and has many causes. Idiopathic guttate hypomelanosis is a common acquired leukoderma characterized by multiple, discrete round or oval, porcelain-white macules on sun-exposed [QxMD MEDLINE Link]. 1987 Jan;16(1 Pt 1):35-44. doi: 10.1016/s0190-9622(87)70003-6. Other cutaneous signs of tuberous sclerosis include facial angiofibromas (adenoma sebaceum), fibrous plaques on the forehead, periungual fibromas (Koenens tumors), and connective tissue nevi (shagreen patches). MMP is a procedure done with tattoo devices using medication in place of ink. However, with increasing age and sun exposure, it is found almost equally in elderly men and women, It predominantly affects fair-skinned individuals, but it can be seen in older, darker-skinned individuals, Although most commonly found on the shins and extensor forearms, it can also affect other sun-exposed areas such as the face and neck, Lesions are usually smooth and have a well-defined edge. J Cosmet Laser Ther. Boils and folliculitis (including hid 8. Pigmentation tends to be persistent but can fade slowly after pregnancy or after discontinuing oral contraception. Leukoderma, Author: Vanessa Ngan, Staff Writer, 2003; Updated: Katrina Tan, Medical Student, Monash University, Melbourne, Australia; Dr Martin Keefe, Dermatologist, Christchurch, New Zealand. [QxMD MEDLINE Link]. I shall book again and already shared with colleagues Fair-skinned women develop this condition first; later, with increasing age and exposure to sun, both sexes seem to be equally affected. doi:10.1016/j.jdcr.2017.09.021. WebAyurveda treatment for idiopathic guttate hypomelanosis A 19-year-old male asked: Idiopathic guttate hypomelanosis occur at age of 20years? Controlled exposure to sunlight may help in production of melanin, which evens out the skin tone. Epub 2021 Jul 25. Please confirm that you would like to log out of Medscape. [QxMD MEDLINE Link]. DIFFERENTIAL DIAGNOSIS - Unlike IGM, Vitiligo tends to be periorificial and not confined to the lower legs. CLINICAL PERSPECTIVE: The discrete, hypopigmented macules range in size from 2-6 mm and possess an irregular border. Epub 2018 Jul 20. On the pathogenesis of idiopathic guttate hypomelanosis. JAAD Case Rep. 2018;4(3):2626. Do you have had any comments from people that something had helped by this condition? See the image below. REMEDIES Activated Spots On Legs. papers from reputed academic organizations. Idiopathic guttate hypomelanosis does not appear to be due to trauma or viral infection. The disorders can be genetic or acquired. 19 Pigmentary changes of the ageing skin J. Ortonne Medicine The British journal of Patients with extensive or persistent pityriasis versicolor may be prescribed ketoconazole tablets or itraconazole capsules, 200mg daily for 7-10 days and prophylactically once each month. It is not a sign of an internal problem. Detailed Description: Split body design. This section provides a quick diagnostic and treatment guide in the Pink patches. A biopsy may be taken to determine an associated underlying skin condition. [QxMD MEDLINE Link]. Idiopathic guttate hypomelanosis is a very common condition to the point of being almost universal in elderly fair-skinned individuals. Leukoderma is more apparent in skin of colour than in ethnic white skin, but prevalence rates are difficult to determine. J Am Acad Dermatol. Our studies have shown that significantly fewer dopa-positive melanocytes are in the white macules of idiopathic guttate hypomelanosis than in normal skin. Post inflammatory hypopigmentation or scarring. The frequency of IGH increases with age. Pityriasis rosea 23. DermNet does not provide an online consultation service.If you have any concerns with your skin or its treatment, see a dermatologist for advice. Information provided by (Responsible Party): This pilot study included six patients with idiopathic guttate hypomelanosis on their lower extremities, which were recruited from an outpatient dermatology clinic. Melanocytes may be absent or present but unable to synthesise melanin or transfer it to the keratinocytes. Urticaria and angioedema 30. Scaly / rough / peeling email the declaration of consent form with the images to pcds@pcds.org.uk. Falabella R, Escobar C, Giraldo N, et al. Hands There are several over-the-counter or prescription options for the itchy, flaky skin, as well as the dryness and swelling. PO Box 789, Rickmansworth, WD3 0NU. No treatment is required and there is no definite treatment. Post inflammatory hypopigmentation, that is loss of coloration due to scarring usually goes away on its own. Women are more commonly affected. Published: April 2012 2015 May-Jun. Hypopigmentation is mostly harmless and most forms of skin discolorations go away by themselves over a certain period of time. Fordyce's granules), Adult Failla CM, Carbone ML, Fortes C, Pagnanelli G, D'Atri S. Melanoma and vitiligo: in good company. Mouth Normal skin color depends on melanin, hemoglobin (oxidized and reduced), and carotenoids. Dermatology. XTRAC excimer laser (wavelength of 308 nm) was performed using the standard vitiligo protocol of twice weekly treatments for twelve weeks. but there are natural remedies that can help. Web Design - Mode Ten Designs. Accessed 12 th February 2021. Idiopathic Guttate Hypomelanosis Rafael Falabella, M.D. Listing a study does not mean it has been evaluated by the U.S. Federal Government. It usually affects individuals aged over 40 years and the likelihood of acquiring it increases with age. Idiopathic guttate hypomelanosis progresses with increasing sun exposure and, to a lesser degree, with age. Ash leaf spots can resemble nevus depigmentosus, a single, stable, well-circumscribed hypomelanotic macule present at birth. C. You can try a hydroquinone containing gel for evening out skin discoloration. The white spots started on the outside of my ankles about 10 years ago and have since moved up to leg to the outside of my knees. Berry J. But, the uneven skin coloration may be a reason for psychological stress in some people, who therefore opt for different treatment strategies to get a more even complexion. Our primary objective is to educate GPs, nurses, other Idiopathic guttate hypomelanosis is a common acquired benign disorder characterized by small, well-defined, round white macules on the sun-exposed areas of the legs and forearms. 2017 May. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. If your white patches are a result of bacterial or fungal infection, they will not disappear till you have the infection. American Association for Physician Leadership, American Society for Dermatologic Surgery, International Society for Dermatologic Surgery. This condition is the same for vitiligo and idiopathic guttate hypomelanosis in treatment because both are fungus. Some of these microbiologist knew about this (and dandruff) since the beginning of the last century (early 1900) f, but the information is lost (it is nowhere to be found today) they are also fungus too, but they are different species. Treatment is usually not required as the marks are completely harmless. It is not a sign of a cancer or any contagious skin problem. Itch [QxMD MEDLINE Link]. If you would like to donate, please use this Biopsy shows increased pigment in the epidermis and dermis. conditions. Child abuse / domestic violence Arbache S, Michalany NS, de Almeida HL Jr, Hirata SH. Webproducing cells of the skin (melanocytes). Why Should I Register and Submit Results? Acquired Speckled Acrofacial Hypomelanosis: A Novel Presentation of an Existing Dermatosis. Peripheral lesion findings include amoeboid, featherlike, and petaloid patterns described in lesions of idiopathic guttate hypomelanosis. Approximately 30% to 40% patients have a family history of vitiligo, and disease has occurred in monozygotic twins. 2010 Mar. Most patients are reassured of the benign nature of the condition and no treatment is recommended. Hypopigmentation marks are particularly prominent among people who have darker skin, however, it affects fair skinned people as well. 2022 Sep 5;13(5):657-659. doi: 10.4103/idoj.idoj_633_21. Frequency Threshold for Reporting Other Adverse Events, University of Texas at Austin Medical School and Seton Family of Hospitals. [QxMD MEDLINE Link]. [2, 3] In 1967, Hamada and Saito found a 50% reduction in melanocytes. Charity No. Low Platelets. Vitiligo often follows trauma, with disease common on extensor sites, such as the hands, elbows, and knees. Treatment of choice for limited disease is mid- to high-potency topical corticosteroids, although topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, can also be very beneficial. View this study on Beta.ClinicalTrials.gov, U.S. Department of Health and Human Services, The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. 1967 Dec. 96 (6):673-6. 43 (4):553-557. Copy edited by Gus Mitchell. J Drugs Dermatol. Grate some ginger or its roots and rub it on your scars with hypopigmentation. "Hypomelanosis" more specifically refers to a reduction of epidermal melanin. Melanin is the major color determinant and is responsible for variations in skin color. They include: Find out which species of Malassezia is most likely to be responsible for pityriasis versicolor. Idiopathic guttate hypomelanosis dermoscopy, Chemical leukoderma including occupational and, Treatment of an associated or underlying cause. Melasma is an acquired hypermelanosis, seen predominantly on sun-exposed areas in women. Eczema - atopic (including facial ecz 12. 1990 Oct. 23(4 Pt 1):681-4. 2021 Jan-Mar. JAAD Int. 28 (3):271-275. Do you have patches on your skin that are a tone lighter than your normal skin tone? Dermatology Made Easybook. Harris JE. Medscape Drugs & Diseases wishes to recognize Stephen W White, MD for his original contributions to this article. 2015 Jul 27. Kreeshan FC, Madan V. Idiopathic Guttate Hypomelanosis Treated with 308-nm Excimer Light and Topical Bimatoprost. The site is secure. Nails Genetics Home Reference; Oculocutaneous Albinism; Accessed 5 th June 2020. 6. These spots are small, but they can appear unsightly and unattractive. My Mom also had the same white spots. Typical histologic findings are epidermal atrophy of the actinic type, a patchy decrease or absence of melanocytes and melanin, flat rete ridges, and basket weave hyperkeratosis. Lets take a closer look at what causes hypopigmentation, how is this condition diagnosed, and what are the different treatment options available. Pigment Cell Melanoma Res. 2013 May 8. Kubba A, Batrani M, Taneja A, Jain V. Tumor of follicular infundibulum: an unsuspected cause of macular hypopigmentation. Idiopathic guttate hypomelanosis is most commonly a complaint of middle-aged, light-skinned women, but it is increasingly seen in both sexes and older dark-skinned people with a history of long-term sun exposure. Statement Policy, Data WebIdiopathic guttate hypomelanosis (affects shins and forearms, due to photoageing) Pityriasis alba (large patches on face and upper arms) Pityriasis rosea (short history and rapid onset) Postinflammatory hypo- or hyper- pigmentation (irregular distribution, prior inflammatory episode) Seborrhoeic dermatitis (distribution includes scalp and face) The doctor may further ask you to go for a skin biopsy if leprosy, sarcoidosis or other malignancies are suspected. The exact pathogenesis remains controversial. The natural coloration of your skin is due to the presence of the pigment known as melanin. Copyright 2000-2023 The Cleveland Clinic Foundation. For fungal or bacterial infections, appropriate antifungal or antibiotic medications will be prescribed by your doctor. It is pink or coppery in pale subjects, but on tanned skin the patches are pale brown, since tanning does not occur in the affected areas. We do however hope that visitors to this site can contact us regarding comments that are considered misleading or incorrect so that we can continue to improve the site. One report describes successful treatment with pimecrolimus 1% [ 12] ; however, caution is warranted because the author has anecdotal experience possibly Would you like email updates of new search results? Our team of dermatologists and formulators strive to be objective, unbiased and honest. Melasma is an acquired hypermelanosis seen predominantly on sun-exposed areas in women. [see Dermoscopy of vitiligo, Idiopathic guttate hypomelanosis dermoscopy]. Note that this may not provide an exact translation in all languages, Home Pityriasis versicolor Malfunctioning of the pituitary gland may lead to the reduction in the melanocyte stimulating hormone (MSH) which results in a rare form of acquired generalised hypopigmentation. In atypical cases of idiopathic guttate hypomelanosis, a biopsy may be indicated. Idiopathic guttate hypomelanosis is a common benign acquired disorder characterized by small, well-defined, round white macules on the sun-exposed areas of the legs and forearms. Protection Policy, The Leading Dermatological Society for GPs, It is thought to be an inevitable part of ageing, with a gradual reduction in melanocytes, Inherited factors may be relevant as lesions appear to be more common in family members, Idiopathic guttate hypomelanosis is seen far more frequently in women of a younger age than in men. government site. Eczema - atopic (including facial ecz 16. Statement Policy WebDEFINITION - Idiopathic Guttate Hypomelanosis, or Disseminate Lenticular Leucoderma, comprises small, white irregularly shaped macules occurring mostly on the anterior lower legs. Hair Naveh HP, Rao UN, Butterfield LH. version, Concise guidelines for common skin Photosensitive rashes (rashes made wo 31. You have reached the maximum number of saved studies (100). American Society of Dermatologic Surgeons. - how to use, THE CUNLIFFE (TP) GENERAL DERMATOLOGY A Wood light examination could be helpful in revealing unsuspected involvement. Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Association for Physician Leadership, American Society for Dermatologic Surgery, American Society for MOHS Surgery, International Society for Dermatologic SurgeryDisclosure: Nothing to disclose. Skip areas of retained melanin can help histologically differentiate this condition from other disorders of pigmentation. Thus, the face, neck, hands and arms are most often affected. The white patch itself is asymptomatic but there may be clinical features of the underlying condition. IGH is more common in people with light skin and may appear in women at younger ages than it does in men. 2018 Sep;68(674):444-445. doi: 10.3399/bjgp18X698825. Download, The Certain forms of hypopigmentation can indicate the presence of a systemic disorder. Environmental factors such as sunlight, other stresses to the skin. However, with increasing age and sun exposure, it is found almost equally in elderly men and women. arrow-right-small-blue Usage of cosmetic products containing lead or bleaching agents. They are IGH which tends to be just confined to the lower legs. [8, 9], Several light and electron microscopic studies have revealed a characteristic pathologic picture for idiopathic guttate hypomelanosis. readers, especially in skin of colour: Copyright 1994 - 2021 The Primary Care Dermatology Society. Thank you. Careers. 6 (3):164-7. 50(7):798-805. Bleaching agents with hydroquinone (a hydroxyphenolic compound that inhibits the conversion of dopa to melanin), in concentrations of 2% to 4%, can help to minimize (lighten) the pigmentation. Natural Remedies For Idiopathic Guttate Hypomelanosis Natural Remedies BLOG The Truth About Gelatin HABITAT What Do Robins Eat? Arch Dermatol. IGH does not require treatment; however, patients may seek out a dermatologist for aesthetic reasons. Do you think this will work? I'm happy to hear that it has a name and that it won't spread to my face. Falabella R, Escobar C, Giraldo N, Rovetto P, Gil J, Barona MI, Acosta F, Alzate A. J Am Acad Dermatol. J Am Acad Dermatol. The patches are usually asymptomatic and can resemble vitiligo. Natural Remedies REMEDIES Activated Charcoal Activated Charcoal for BO Acupressure ACV and Baking Soda ACV for Weight Loss ACV Side Effects ACV: Where to Idiopathic guttate hypomelanosis is a common acquired skin condition characterized by multiple discrete, round, porcelain-white macules on the extensor aspects of the extremities in the elderly population. Idiopathic guttate hypomelanosis Over-the-counter treatments (for pati Peeling skin Idiopathic guttate hypomelanosis affects fair-skinned people at a younger age. WebIdiopathic guttate hypomelanosis (IGH) manifests as small white spots on skin that receives high amounts of sun exposure. Idiopathic guttate hypomelanosis (IGH) is another hypomelanosis disorder characterized by white macules [7]. Leukoderma is a clinical diagnosis confirmed on Wood lamp examination.. Dermoscopy can be helpful in the diagnosis of some forms of leukoderma. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Limitations included a small sample size with minimal variation in Fitzpatrick skin type, an all-female pool, and lack of extended follow-up. Itch (pruritus) 18. Acta Derm Venereol. Pigmentation follows the pattern of the initial disease, making the diagnosis straightforward in most patients. Numbers and differentiation status of melanocytes in idiopathic guttate hypomelanosis. Feet A few common causes of hypopigmentation include: This form of hypopigmentation is followed by a previous skin problem, such as the following: (i) Inflammatory skin diseases like atopic dermatitis, lichen striatus, etc. Nodules (larger palpable lesions) Aggravated by cold or heat The yeast produces azelaic acid, which diffuses down and impairs the function of the melanocytes. DIAGNOSTIC TABLE, Rash arises periodically lasting days-weeks, Macules (small flat lesions) / papules (small raised lesions), Patches / plaques (larger flat or flat-topped lesions), Pustules (small pus-filled lesions) / boils, Bullae (blisters) / vesicles (tiny blisters), Ulceration / necrosis (black non-viable skin), Skin Lesion Diagnostic Tool - how to Certain cosmetic treatments such as laser therapy may result in hypopigmentation patches especially in people with darker skin tones. Genetics play an important role in conditions such as vitiligo, which sometimes run in families. The exact cause of idiopathic guttate hypomelanosis is not agreed upon; however, it is hypothesized that ultraviolet light plays an important role. [QxMD MEDLINE Link]. you can keep this webpage open when working for ease of access. Chemical-induced vitiligo. These spots are small, but they can appear unsightly and unattractive. Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA Leukoderma is more obvious in racially pigmented or tanned skin compared to ethnic white skin. Ears Dopa Dopa staining can be useful because dopa-positive melanocytes are decreased. Share cases and questions with Physicians on Medscape consult. Psychological Would recommend it to other GPs." Eyelids Introduction. WebA: Your condition has a long name with lots of syllables: idiopathic guttate hypomelanosis. Please remove one or more studies before adding more. Perioral dermatitis 21. Please refer to notes on image rights at bottom of the page with regards to individual image Information for patients, carers, Intertrigo (inflammation in body fold 21. Subject reported level of re-pigmentation for treated lesions was asse Subject reported level of re-pigmentation for treated lesions was assessed by improvement from baseline using a scale from 1 - 4 with 1 being the least amount of re-pigmentation and 4 being the most re-pigmentation: 1 = Worsening of the light spots that were treated (the light spots seem to have gotten lighter or I have more light spots in the areas that were treated); 2 = No Improvement of the light spots (light spots have not changed since starting this study); 3 = Mild improvement of the light spots (there is some darkening of the light spots, but not in more than half of them); 4 = Moderate improvement (there is some darkening of the light spots in more than half of the light spots, but not more than 75% of them).