Having good skin is more than making a person look attractive and young. Having healthy skin is more than just for a good look. There are many skin functions such as protection against possible infection and injury such as from physical or hazardous substances. There are many things that can make the skin unable to perform its function optimally. In this DoctorOnCall’s article, we will be learning about a skin disorder known as argyria that makes a person’s skin look different than many normal people do.
Argyria is a skin condition characterised by the bluish-grey to slate-grey staining of the skin caused by deposition of silver particles in the skin. Silver is not truly a bad substance and it is used in medical treatment such as in bandages and eye drops. However, argyria is a condition that occurs after a large-dose exposure or prolonged exposure to small amounts of silver. Argyria is a rare condition.
There are several sources that can cause a person to be exposed to silver. The most common one is through occupational exposure such as those working in silver mining, silverware, metal alloy and metallic films on glass. Medications with silver salts of the irrigation of the nose or urethra, in eye drops and wound dressing can be the source for exposure to silver. Silver sutures in surgical and dental procedures with dental fillings (amalgam tattoo) is another source for silver exposure.
There are 2 kinds or forms of argyria that can be seen. The first one is known as generalised argyria. In this form, it often leads to a grey/blue saltish or metallic skin colour that is more obvious under the sun. Patients are commonly seen with the darker skin colour to the face, neck, arms and hands. In some cases, the entire skin can be seen as slate blue-grey colour. The second form is known as localised argyria. It can occur in the eye as result from using eye drops containing silver, in the mouth due to amalgam tattoo and to the silver earring sites or acupuncture needles. Thus, the differences between the general and localised argyria is the site that is affected and the extent of the damaged skin.
Due to the fact that argyria is a rare condition and because it is quite unfamiliar to be seen in daily clinics, it can be difficult to be diagnosed at first or even mistakenly diagnosed as another condition. The best way to diagnose this skin condition is to perform a skin biopsy. However, doctors usually will do other tests first such as tracing the amount of silver through blood and urine tests.
The biggest question to patients with such conditions is if there is a cure for argyria. Unfortunately, there is no cure. The pigmentation is considered permanent and is almost untreatable. The condition would not be improved even after discontinuing the silver exposure. Even so, it seems like there is hope for patients as recent trials and studies have shown promising treatment to help with skin discolouration. There are the use of laser treatment such as 1064 nm QS Nd: YAG laser for argyria but it is still considered limited as there is more research needed to determine the effectiveness of this method. Some reports have suggested using hydroquinones to reduce the number of silver in the upper part of the skin (upper dermis) and around the sweat glands. De-pigmentary agents and chelation are considered unsuccessful and impractical. In localised argyria, patients may be offered with surgery to remove the lesion and to replace the lesion with transplantation.
The best way to prevent further exposure is to tackle the possible sources of the silver. This includes to stop ingestion of silver and application of all silver containing remedies. Those working with silver should always wear protective wear. Cosmetic should be examined for the presence of silver before using it. Using sunscreen can help avoid further darkening skin pigmentation. In certain cases, patients might want to use cosmetic camouflage to improve their appearance.
In essence, argyria is a skin condition resulting from prolonged exposure with small amounts or a condition that occurs after exposure to a big amount of silver. Presentation of the skin condition depends on the way a person is exposed to the silver. Although argyria itself is not a life-threatening condition, it often results in an unfavourable appearance. It is worth noting that silver can be dangerous if a person ingested a large quantity of silver-containing compounds and this is known as silver toxicity. Silver toxicity can be lethal as it can lead to organ damages. Even though there is no cure for argyria, there are possible remedies that are still under research and seem to promise good results. Until then, patients are advised to take preventative steps to prevent further exposure to silver and may consider cosmetics camouflage as it is easily available or practical.