Graphic analysis of the relationship between skin colour change and variations in the amounts of melanin and haemoglobin

Background/aims The L*a*b* coordinate is the most commonly used colour system to measure skin colour in dermatology and cosmetology. In this system, a* and L* are often used for quantification of the degrees of erythema and pigmentation. The aim of this study was to examine whether a* and L* can be used as specific scales to indicate the amount of haemoglobin and melanin, respectively, in the skin. Methods The a* and L* values were examined with a reflectance spectrometer in various skin conditions or lesions caused by a change in the amount of either melanin or haemoglobin, i.e. vitiligo, ultraviolet‐induced pigmentation (PG), erythema resulting from slapping (ER), corticosteroid‐induced blanching, erythema due to stasis by arm lowering, and a combination of PG and ER. The differences in values between the test sites and the adjacent normal skin, Δa* and ΔL*, were plotted on the Δa*–ΔL* plane and analysed statistically and geometrically. Results L* depended substantially not only on melanin but also on haemoglobin, especially if the oxygen saturation level was expected to be low. a* was also influenced by melanin. The results of graphic analysis indicated that a linear transformation of (Δa*, ΔL*) into (ΔHb = 1.68 Δa* + 0.60 ΔL*, ΔMel =−1.06 Δa*–1.44 ΔL*) was suitable for separately estimating the change in the amount of haemoglobin (ΔHb) and in that of melanin (ΔMel). Conclusion The results of this study may be of value for understanding the relationship between colour coordinates of the skin and the quantities of haemoglobin and melanin, and may be of use when pigmented lesions of the face are monitored by tristimulus colourimetry, as facial skin colour is affected considerably by the rich and easily variable cutaneous blood flow.