 What causes brown spots?
Small freckle-like spots (lentigines) often occur on sun-exposed areas of the skin during a persons thirties or forties. These are commonly referred to as age spots or liver spots. These spots are more common in fair-skinned individuals, but may occur in many skin types. The tendency to develop lentigines is inherited. Another type of brown spot is a seborrheic keratosis. These rough, raised spots often flake off only to reappear. Seborrheic keratoses are often mistaken for moles because they can be quite dark or irregular in shape, even though they are benign. They typically occur after age 30 as an inherited trait.
What causes brown patches on the face during pregnancy?
Many women develop brown patches on the face and other areas of the body during pregnancy or while taking oral contraceptives. This condition is called melasma, or chloasma. Estrogen stimulates the skin cells to produce excessive amounts of brown color. The patches are most commonly located on the cheeks, upper lip, and forehead, and are particularly prone to darkening in the sun.
How are brown spots or patches treated?
Lentigines may be treated by several different methods. Skin rejuvenation creams (Renova®, alpha-hydroxy acids) and bleaching creams can significantly fade these spots over the course of 3 to 6 months. These treatments will only be successful if strict sun avoidance and sun protection is practiced. Chemical peels and microdermabrasion are other effective treatments. If a limited number of lentigines are present, they may be frozen with liquid nitrogen or removed with a laser.
The most effective treatment for melasma is sun avoidance and sun protection, preferably with clothing, a hat, and a sunscreen that effectively screens both UVB and UVA light. Skin rejuvenation creams, bleaching creams, chemical peels, and microdermabrasion are also helpful. Melasma may fade after pregnancy or after stopping oral contraceptives, but many people find that it persists even after the hormonal influence is removed.
Seborrheic keratoses may be removed with liquid nitrogen or shaved off with a curette or scalpel. When seborrheic keratoses are numerous they are often treated with a lactic acid based cream such as LacHydrin® or AmLactin® (available over the counter).
How can I distinguish which type of brown spot I have?
Schedule an appointment with one of our doctors at Cary Dermatology for their expert assistance in diagnosing and treating your brown spots. Some brown spots are moles or even melanomas, so they should be carefully evaluated.
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