Argyria

What is Argyria?

Argyria is a condition that occurs due to exposure or consumption of silver. It causes a slow change in the color of the skin or mucous membranes to blue or gray. The word ‘argyria’ originates from the Greek word for silver, ‘argyros’. This condition can lead to color changes that are localized or spread out, depending on how the person was exposed to silver. Silver is a valuable, white transitional metal that has a variety of uses due to its high electrical and thermal conductivity, as well as reflectivity.

Silver is widely used in many areas of life, from jewelry to water filters. It’s also used as currency in the form of silver coins in some economies. Historically, silver has been associated with health benefits which is why phrases like ‘born with a silver spoon in his mouth’ refer to good health instead of wealth. The idea was that silver spoons and pacifiers could protect children from getting sick. Even in modern times, silver is known for its health benefits, especially its antimicrobial properties. When silver ions are released, they can interact with and damage bacterial cells, thus preventing their growth.

What Causes Argyria?

Argyria, a condition that causes the skin to turn blue or gray, often results from exposure to silver, usually in the workplace or through medicinal use. Jobs that regularly handle silver, such as jewelers, silver miners, silversmiths, and photo developers, are most at risk. This type of argyria usually affects specific body parts, like a jeweler’s fingers, depending on where the silver exposure occurs. Silver can even accumulate in the eyes of silversmiths, causing a condition called ocular argyrosis.

Medicinal use of silver has become less common today due to the effectiveness of modern antibiotics. As a result, there are only a few FDA-approved medical uses for silver in the U.S. These include its use in certain forms, such as silver sulfadiazine and silver nitrate, for conditions including eye infections in new-borns, wound healing after severe burns, mucosal cautery, and as a deterrent for smoking due to its unpleasant taste when combined with smoke. It is also used in catheters and tubes as an additional way to combat infection.

Even with the decline in medicinal use, silver, particularly in a form called colloidal silver, is still marketed as a universal remedy in alternative and homeopathic medicine. It’s sold as a way to boost the immune system and can be bought online, or in pharmacies and supermarkets. The ability of silver to kill bacteria has also led to its use in products like toothpaste, contact lenses, bandages, hair dye, and parts of breast pumps.

Risk Factors and Frequency for Argyria

Argyria, a condition caused by prolonged exposure to silver, is not as common today as it was in the past due to reduced exposure and its diminished use in medicine. Yet, it still manifests in some people, especially amongst those who use colloidal silver as a type of alternative medicine. Argyria can affect anyone, regardless of their race, gender, or age.

Signs and Symptoms of Argyria

When examining a patient for silver exposure, doctors usually looks for a few telltale signs. The patient’s skin might show a blue or gray color, which can be all over the body or only in specific areas. The white part of the eye, the mouth’s lining, and the nails can also show changes. Areas of the skin exposed to the sun often appear darker. This is because sunlight can act like a trigger, turning elemental silver in the body into a darker color.

Testing for Argyria

Argyria is usually diagnosed after a detailed patient medical history review and physical examination, and it’s often confirmed only after ruling out other potential conditions. The best way to definitively diagnose Argyria is by taking a small skin sample, known as a biopsy, from the affected area. Under examination, this skin sample will often reveal brown or black tiny particles gathered along the skin’s lower surface and around sweat glands and hair roots.

There is also a non-invasive technique, known as Energy-Dispersive X-ray Spectroscopy (EDXS), which is considered the top-level method for Argyria diagnosis. Other methods that doctors may use to diagnose Argyria include dermatoscopy, which is a skin examination tool for localized argyria, and a slit-lamp biomicroscopy technique, useful in diagnosing Argyria.

Treatment Options for Argyria

Argyria is a permanent skin condition that doesn’t have a known cure. Various treatments have been tried, such as chelation, dermabrasion, and hydroquinone, but none of them have shown any significant results.

In recent years, some studies have reported temporary improvements in the skin’s appearance after laser treatments. One such study investigated the use of a specific type of laser, known as a Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser which is commonly used for removing dark tattoos. Researchers hoped that this laser might reduce the gray and blue pigmentation seen in people with argyria. However, they found that the intensity of this particular laser was too high for treating argyria, causing pinpoint bleeding and significant pain.

Yet, when a less intense, low-fluence 1064-nm Q-switched Nd:YAG laser was used, it successfully removed the discoloration after seven treatments. This promising result, however, might only be temporary. Some documented instances show the return of argyria about a year after the Q-switched Nd:YAG laser therapy was performed.

What else can Argyria be?

There are several conditions that can cause certain symptoms similar to one another. Here’s a quick list of these conditions:

• Cyanosis (a condition where the skin appears bluish due to poor blood circulation or low oxygen levels)
• Hemochromatosis (a disorder that causes the body to absorb too much iron from the diet)
• Methemoglobinemia (a blood disorder where too much methemoglobin- a form of hemoglobin- is produced)
• Methylene blue poisoning (from overexposure to the chemical methylene blue)
• Melanoma (a type of skin cancer)
• Ochronosis (a metabolic disorder resulting in darkened skin and connective tissue)
• Chrysiasis (a medical condition caused by long-term use of gold salts, typically resulting in blue-gray discoloration of the skin)
• Usage of certain drugs such as Amiodarone, Minocycline, or Phenothiazines can also lead to similar symptoms.

It is key that the physician takes into account these possibilities and performs necessary tests to identify the correct condition.

What to expect with Argyria

Argyria is a condition that worsens if you keep ingesting or coming into contact with silver. This is because the silver builds up in your body. Even if you stop the exposure, the condition doesn’t get better. Argyria ends up causing your skin to change color permanently in the areas it affects.

While this condition isn’t dangerous to your life, it does adversely affect your appearance, leading to changes in the way you look, which many people find unfavorable.

Possible Complications When Diagnosed with Argyria

Argyria is a skin condition that occurs when a person is exposed to silver for a long time. If a person suddenly consumes a large amount of compounds that contain silver, they can become very sick from silver poisoning. In fact, it can even be fatal. The fatal dosage is 50 milligrams or more of a silver substance called colloidal silver. If this amount is injected into the bloodstream, it could cause fluid accumulation in the lungs, bleeding, and death of tissue in the bone marrow, liver, and kidneys.

Preventing Argyria

Argyria is not life-threatening, but its effects on a person’s appearance can cause emotional distress. Offering psychological support, educating patients about treatment options, and discouraging them from self-treating with colloidal silver found online can help. Despite it not being serious, Argyria can greatly impact a person’s mental wellbeing.