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What to do with pigment spots?

by Josephine Andrews
Published: Last Updated on 412 views

Pigment spots (medical: hyperpigmentation) are brown discolorations of the skin. The dark skin areas arise when special cells in the skin increasingly release the skin pigment melanin. Pigment spots are usually harmless. However, many people find them unsightly and cosmetically unappealing. Read how pigment spots develop and what you can do about them.

quick overview

  • What are pigment spots? Brownish, reddish or ocher marks on the skin that are not raised and therefore cannot be felt. They often form in areas exposed to light (such as the face). Most pigment spots are harmless; but they can also indicate skin cancer.
  • Causes: Excessive formation of the skin pigment melanin, for example as a result of exposure to the sun or predisposition. Female hormones (pregnancy, hormonal supplements), burns and various diseases and medications promote pigment disorders.
  • When to the doctor? generally every two years for a check-up with a dermatologist; A doctor’s visit is also advisable if the pigment spot is asymmetrical, has irregular borders, is not uniformly colored throughout and/or has a diameter of more than two millimeters.
  • Treatment: not absolutely necessary for harmless pigment spots; if necessary, removal by a dermatologist for aesthetic reasons, e.g. B. by peeling , laser, cold
  • Prevention: through sun protection, day cream with sun protection factor

Pigment spots: description

Human skin is rarely completely flawless. Especially in light-skinned people, the skin is prone to pigmentation disorders. Some forms such as freckles (ephelides) appear in children, age spots (lentigo solaris) develop over the course of life. The marks can be brownish, reddish or ocher and are usually not raised, i.e. not palpable. They mainly form on skin areas that are particularly exposed to light, for example on the face, décolleté or hands.

A special form of the pigment disorder is the nevus pigmentosus , which is also called café-au-lait spot because of its appearance . It is evenly colored from light to dark brown. The nevus spilus looks similar, which can be as big as the palm of a hand and has darker spots. Both forms of pigment disorders are present from birth , but can increase over the course of life.

Pigment spots: causes and diseases

Pigment spots are caused by certain skin cells, the melanocytes, which produce the skin pigment melanin. This ensures the tanning effect and protects the skin cells from UV radiation. If an excessive amount of melanin forms in some areas, spots appear. In addition to the sun exposure , the predisposition also plays a role.

The formation of pigment spots is promoted by female hormones . Women who use hormonal contraception (such as the pill ) have pigment spots more often than women without hormonal contraception.

Hormone-related pigment disorders can also occur during pregnancy . They manifest themselves as a large, darkly pigmented area on the face, known as the pregnancy mask or cholasma. These symptoms go away on their own after delivery.

Certain medicines increase the skin’s sensitivity to light and can also promote pigment disorders. These include some antibiotics, certain chemotherapy drugs, but also St. John’s wort preparations.

Pigment disorders can also be the result of burns or diseases . For example, the skin may be darker pigmented in places as a result of an insect bite, a skin condition (such as psoriasis, acne ), an infectious disease (such as shingles or syphilis ). Tumors, metabolic disorders, gluten intolerance and a folic acid or vitamin B12 deficiency can also result in pigment disorders.

risk of skin cancer

As harmless as pigment disorders are as a rule – sometimes a dangerous skin cancer hides behind the skin symptoms. Black skin cancer ( malignant melanoma ) is the most insidious. Black skin cancer originates from the pigment-forming cells of the skin, the melanocytes. You can move freely in your body.

This explains why black skin cancer spreads to other organs relatively early in comparison to other types of skin cancer and forms metastases there. Other, less aggressive forms of skin cancer are basal cell cancer and squamous cell cancer (collectively known as melanoma ).

Skin cancer is almost always curable in its early stages. Therefore, skin checks by the dermatologist, but also regular self-checks can be life-saving.

Pigment disorder: white spot disease (vitiligo)

Viticulture is actually the opposite of pigment spots. The skin of those affected does not produce too much melanin in certain areas, but too little. As a result, very light, pigment-poor or even pigment-free areas form on the skin. In principle, the pale, irregular patches can appear anywhere on the body, but initially they usually appear on the hands and face.

The causes of these skin symptoms are not yet known. It is suspected that genetic factors play a role, but possibly also an autoimmune reaction. The white spot disease is harmless, but is often perceived by those affected as aesthetically disturbing, just like pigment spots. The disease cannot be cured. However, its progression can be mitigated by therapy with UV-B rays.

Pigment spots: when do you need to see a doctor?

For the layperson, pigment spots and other harmless birthmarks are not easy to distinguish from malignant changes in the skin. Therefore, have a skin check done by a dermatologist every two years.

But also keep an eye on your skin between appointments. The ABCDE rule enables an initial assessment of moles and pigment spots. she stands for

  • A = Asymmetry : In the early stages, melanomas are often announced by an asymmetrical shape.
  • B = Border : The pigmented mark seems to run out at the edges, it is uneven, rough and jagged. Irregular borders and blurred borders indicate potential melanoma.
  • C = Color : The mark is lighter or darker in some places. Black, dark brown, bluish, red, gray to skin-colored areas all at once indicate a melanoma.
  • D = Diameter : Moles larger than two millimeters in diameter should be observed in any case.
  • E = evolution: changes in the pigment mark; if they occur within three months, the mark should be checked by a doctor.

Such features can indicate skin cancer and should therefore be examined by a dermatologist. This also applies if the marks bleed or itch, or change in size and shape.

Pigment spots: That’s what the doctor does

Harmless skin marks and age spots do not need to be treated. However, if they bother you for aesthetic reasons, the dermatologist can remove the pigment spots:

  • Laser: An effective method is laser treatment. The pigment accumulations are shattered by the light energy and then disposed of by the immune cells.
  • Cold: During cold therapy (cryopeeling), the surface of the epidermis is frozen with liquid nitrogen so that it dies.
  • Sanding off: The pigment spots can also be sanded off with a scalpel.
  • Peeling: Pigment spots can also be removed by peeling with acids. But this is not a gentle method either. The acids used must penetrate relatively deep into the skin in order to be effective.

All treatments should only be carried out by an experienced dermatologist, otherwise there is a risk of irregular pigmentation and scarring.

After the marks have been removed, the skin remains particularly sensitive for weeks and tends to form new pigment spots. She therefore needs even more protection from the sun than usual.

Pigment spots: You can do this yourself

There are various (home) remedies that should help to remove pigment spots on your own. However, over-the-counter bleaches are less suitable for getting rid of pigment disorders. In particular, darker stains cannot be removed with their help. However, the tinctures and creams can cause significant skin irritation.

Natural remedies are less of a concern, although not entirely free of side effects. And: Their effect is usually not scientifically proven or only tested on a small number of test persons. Some of the natural remedies that are supposed to help with pigment spots include:

  • Lemon : Lemon ‘s acidity can have a brightening effect due to its exfoliating properties. However, because it only penetrates the upper layers of the skin, the effect will most likely be minimal.
  • Blood orange: According to a study by the University of Catania, blood orange extract is said to be able to reduce pigment disorders because it makes the skin more resistant to sun exposure.
  • Papaya: The fruit contains the active ingredient papain, which is said to help the body break down metabolic products more quickly. This should gradually make skin spots disappear. But papain can trigger allergies because it breaks down the skin’s barrier function.
  • Vitamin A : The vitamin, also known as retinol, is said to slow down skin aging and also influence the formation of pigment spots.

If you want to try any of these or any other (home or natural) remedies for pigment spots, you should speak to your dermatologist first. He can advise you on the correct application and point out any side effects.

Do away with prevention

Better than trying to get rid of the stains is not letting them develop in the first place. Consistent sun protection is the most important aspect if you want to prevent pigment spots, but also skin cancer. The UV light in solar radiation favors both the one and the other.

Many think of sun protection when they are at the beach or skiing, but neglect it in everyday life – in the convertible, when going for a walk, in the café. You are always prepared with a day cream with a high sun protection factor. Of course, you should avoid the midday sun and generously protect all uncovered parts of your body with sunscreen to prevent pigment spots and skin cancer.

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