Hyperpigmentation of the skin and mucous membranes is the main dermatologic finding in Addison's disease, occurring in >90% of patients. It occurs secondary to cortisol deficiency leading to increased ACTH and melanocyte-stimulating hormone which increases melanin synthesis [62].
Hyperpigmentation is always accompanied by a number of endocrine diseases, such as Addison's disease and hemochromatosis. However, the occurrence of hyperpigmentation in thyroid dysfunctions is rarely reported in the literature.
Presentation of chronic Addison disease
Hyperpigmentation of the skin and mucous membranes often precedes all other symptoms by months to years. It is caused by the stimulant effect of excess adrenocorticotrophic hormone (ACTH) on the melanocytes to produce melanin.
Skin problems
Changes in hormones, including estrogen and progesterone, can also cause hyperpigmentation — dark patches on the skin. It's most likely to occur on the neck, groin and under the breasts.
Some causes of hyperpigmentation include pregnancy-related birthmarks, age spots, acne scars, and a number of drugs, including antibiotics, birth control pills, antimalarials, and tricyclic antidepressants. A rare condition called Addison's disease results in black skin patches and decreased adrenal gland activity.
While autoimmune adrenal insufficiency (Addison's disease) remains the commonest cause of hyperpigmentation due to systemic disease, there are sparse reports in the literature of hyperpigmentation associated with hyperthyroidism.
Symptoms of Addison's disease include: Steadily worsening fatigue (most common symptom). Patches of dark skin (hyperpigmentation), especially around scars and skin creases and on your gums.
Melanocyte-stimulating hormone describes a group of hormones produced by the pituitary gland, hypothalamus and skin cells. It is important for protecting the skin from UV rays, development of pigmentation and control of appetite.
A number of factors can trigger an increase in melanin production, but the main ones are sun exposure, hormonal influences, age and skin injuries or inflammation. Sun exposure is the number one cause of hyperpigmentation as it's sunlight that triggers the production of melanin in the first place.
Hyperpigmentation in Cushing disease
Some patients with pituitary Cushing disease or ectopic adrenocorticotropic hormone (ACTH) syndrome may have generalized hyperpigmentation of the skin and oral mucosa, caused by increased ACTH that acts through binding to melanocyte-stimulating hormone receptors.
Addison disease can occur at any age but most often presents during the second or third decades of life. The initial presenting features include fatigue, generalized weakness, weight loss, nausea, vomiting, abdominal pain, dizziness, tachycardia, and hypotension.
Standard high-dose ACTH stimulation test — A standard high-dose (250 mcg) corticotropin (ACTH) stimulation test should be performed to establish the diagnosis of adrenal insufficiency in patients with indeterminate serum cortisol values in whom hypoadrenalism is suspected.
Although subclinical hypothyroidism is commonly asymptomatic, it may be unexpectedly linked to certain dermatologic findings, such as hyperpigmentation. As seen in this case, such patients may be successfully treated for their underlying thyroid condition in order to treat the secondary skin conditions.
It occurs when the skin produces excess melanin, the pigment that gives skin its color. Hyperpigmentation is very common on skin of color, as darker skin tones already have a higher melanin content. Burns, bruises, acne, rashes, or other trauma to the skin can cause it to produce more melanin and lead to dark spots.
Primary adrenal insufficiency caused by Addison's disease may present with skin hyperpigmentation. Hyperpigmentation in patients with darker skin tones may be missed. Adequate replacement of glucocorticoid in Addison's disease improves hyperpigmentation.
Ongoing Fatigue
Fatigue is one of the most common symptoms of a hormone imbalance. Excess progesterone can make you sleepy. And if your thyroid -- the butterfly-shaped gland in your neck -- makes too little thyroid hormone, it can sap your energy.
Mean E2 and progesterone serum concentrations were higher in PCOS women supplemented with CoQ10 in comparison with no-treatment (168.9 ± 75 vs. 138.3 ± 70.2 pg/ml, p < 0.05 and 10.2 ± 1.03 vs. 8.9 ± 0.9 pg/ml, p < 0.001, respectively) [16].
Does Progesterone cause belly fat? Although progesterone doesn't cause belly fat, one of the side effects of progesterone can be weight gain. As we age, hormonal disruptions like progesterone levels dropping faster than estrogen levels can impact belly fat too.
Hyperpigmentation of the skin and mucous membranes is the main dermatologic finding in Addison's disease, occurring in >90% of patients. It occurs secondary to cortisol deficiency leading to increased ACTH and melanocyte-stimulating hormone which increases melanin synthesis [62].
Hormonal imbalances are the primary reason for the condition called melasma. Certain treatments to rectify hormonal imbalances could lead to hyperpigmentation. Hormonal imbalances are often treated along with medication such as hydroquinone and retinoid for managing pigmentation.
If you've been wondering, "Why is my skin becoming darker?" without obvious sun exposure, it's essential to understand that several factors could be at play. Your skin can react to many triggers, both internal and external. These include hormonal changes, medications, ageing, and stress.
(KUSH-ing dih-ZEEZ) A condition in which there is too much cortisol (a hormone made by the outer layer of the adrenal gland) in the body. In Cushing disease, this happens when an adenoma (benign tumor) in the pituitary gland makes too much adrenocorticotropic hormone (ACTH).
Infections: Chronic infections, such as HIV/AIDS and tuberculosis, and COVID-19 can lead to symptoms similar to those of adrenal insufficiency. Depression and Anxiety: These mental health conditions can cause fatigue, appetite changes, and weight changes, similar to adrenal insufficiency.