Skin Spots and What to Do About Them

If you notice a spot on your skin, you should not panic, but you also should not ignore it.  In fact, all skin spots need to be assessed by a healthcare professional to rule out the worst case scenario of skin cancer.  Fortunately, the overwhelmingly vast majority of the spots on the skin are not cancerous or even pre-cancerous.

Assuming your particular spots are not the worrisome kind as assessed by your primary care doctor or a skin care doctor like myself, most people still do not like the appearance of their skin looking blotchy, discolored, or irregular.  Our natural tendency is to want the skin to look even in tone and color for our skin type.

Most of these skin discolorations are called hyperpigmentation, meaning excessive pigment deposited in the skin.  There are a number of reasons for developing hyperpigmentation, and they are important to know in order to ascertain the type of treatment to resolve it and ways to prevent further discoloration in the future.

Ultraviolet or sun-related damage to the skin is the most common cause of hyperpigmentation among both men and women.  UV rays, whether from the sun or a tanning bed, cause skin cells to produce excess melanin, which is the chemical that is deposited in the skin cells to become darker and tan.

When UV exposure ceases, the melanin is removed from the cells and the color fades.  When this process occurs repeatedly and cumulatively over the years, these cells become stained with melanin and the color never fades, resulting in an area of hyperpigmentation.  My best analogy is to describe the skin as developing rust.

Some common terms for these areas are age spots, sun spots, and liver spots.  The latter popular name is the most inaccurate and misleading, as these spots have absolutely nothing to do with the liver.  Therefore, the sun and aging process are the true causes of this problem.

In women, hormone changes can cause changes in melanin production within skin cells.  These spikes in melanin combined with UV exposure result in areas of diffused hyperpigmentation known as melasma.

Pregnancy is most commonly associated with this type of discoloration of the skin.  However, this can also happen with any other hormone changes, including changes in hormonal birth control and hormone replacement therapy associated with menopause.

Usually, the discoloration is lighter in color than purely sun- and age-related hyperpigmentation, but it can cover a wider area.  Limiting sun exposure around the time of hormone changes is the best prevention.  The treatment is the same as the sun-related hyperpigmentation.

Another kind of hyperpigmentation can occur with other traumatic injuries to the skin.  When the skin heals, many people who have high levels of melanin within their skin cells exhibit these injured areas as darker than the surrounding non-injured skin.

This reaction is technically known as post-inflammatory hyperpigmentation.  Although it can occur with any injury such as surgical scars, the most common manifestation occurs with acne.

The inflammation associated with the acne breakout itself can cause darkening.  If a pimple is popped or it breaks open, the resulting scar can also be darker in many instances.

Limiting acne breakouts and inflammation are the best ways to prevent longer-term darkened scarring.  This prevention can be accomplished by a regimen of good skin care to short circuit the cycle of acne related inflammation.

In UV related hyperpigmentation, a great defense can decrease the need for a great offense.  Sunscreen with an SPF (i.e. Sun Protection factor) of at least 30 is the best offense, and needs to be worn every day.

The face, back of hands, and the neck/upper chest are the most common areas that must be covered with sunscreen every day.  In the warmer months, more skin areas will be need a daily sunscreen treatment when they become more exposed.

While sunscreen is the best way to prevent sunspots from forming, what about when you already have sunspots and want them out of sight?  Fortunately, sunspots that already linger on the skin can be treated.

Treatments for sun damaged spots include facial peels, which will remove the top layer of pigmented cells, and topical retinols, which will cause a more rapid exfoliation of the pigmented cells.  Laser treatments remain the gold standard for the most thorough way to remove hyperpigmentation.

During a laser treatment, a focused beam of laser light of the proper wavelength can target cells with excess melanin.  Once targeted, the beam causes a wound healing response, which will lessen and eventually correct the pigmentation over time.

Sometimes, both topical products and antibiotics may be needed.  There are also specific laser interventions that can reduce oil production, shrink pores, and lower skin bacteria levels to also break that cycle.  In the end, the pigmentation related to acne and other scars can also be lightened with multiple therapies as noted above.

If you have any questions about abnormal pigmentation you may have and you want to have assessed, feel free to give us a call at (207) 873-2158 for a free consultation of your spots and an assessment of what would be involved in resolving them.  As you may know, our mission here at Maine Laser Skin Care is to beautify Maine one face (and body) at a time!

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