Spots & Discoloration

There are a host of reasons why your skin may develop new spots or discoloration. Although not all cases require a visit to a dermatologist, it is important to recognize when a dermatology visit is warranted. 

As you age, you may notice a new mole or a new pigmented brown spot on your face or body. While many skin changes are natural to the aging process, there are specific signs that a spot or discoloration needs to be evaluated by a dermatologist.

The ABCDE’s of Skin Cancer

Dr. Zenovia advises that you look for these key characteristics of a new spot. This can help you determine if the spot needs professional evaluation.

• Asymmetry: Benign moles or non-cancerous moles are symmetrical. This means you can draw a line down the middle of it and both halves would look the same. If your spot is asymmetrical, you should contact a board-certified dermatologist for a checkup.
• Borders: The edges of non-cancerous moles are usually smooth and even. If you’ve noticed that the borders of a lesion are notched or scalloped, it’s essential to get it checked.
• Color: Your lesions should be one homogenous color. If you notice a spot that is a variety of shades of a certain color such as brown, tan, and a little black, that’s not a good sign and may be indicative of skin cancer.
• Diameter: Non-cancerous lesions are usually small in size. If you have a larger one (larger than a pencil head eraser) it may be cancerous.
• Evolving: If your mole has changed in size or color, it could be skin cancer. If you notice a drastic change in the color, texture, size, or shape of your lesion make an appointment with a board-certified dermatologist.

*Any new, changing, or unusual mole on the skin should be examined by a board-certified dermatologist.

Key to the ABCDE’s of skin cancer is the combination of these characteristics. For example, an asymmetrical mole alone may not signify a problem, but if that same mole also exhibits border irregularity and color variation then indeed it is suspicious. 

Other Discoloration Skin Conditions

Melasma, solar lentigos, and birthmarks are typically not a medical concern; however, all skin discoloration should be monitored for change and growth.

Melasma

• Melasma is a benign skin disorder that can be identified by patches of darker skin on the face. It is a chronic condition caused by UV sunlight exposure and hormones. Melasma can be treated by a board-certified dermatologist with creams, chemical peels, or lasers.

Solar Lentigo

• Solar Lentigos are benign, flat brown sunspots (they look like large freckles). However, if the spots change in color or become flaky or scaly, they warrant an evaluation from a dermatologist.

Birthmarks

• Birthmarks can appear in multiple shades ranging from white, red, and blue, depending on the type. Birthmarks are caused by abnormal blood vessels or melanin production. Birthmarks do not need to be treated by a dermatologist unless the size and shape change- especially moles.

Treatment

While there are plenty of at-home treatment options for spots and discoloration, it is essential to be diagnosed by a board-certified dermatologist before proceeding with treatment for the most effective results. This is especially true if you have a brown spot that looks like a dark mole. Freckle appearing spots aren’t typically worrisome, but moles can lead to melanoma, a deadly skin cancer.

For the more benign conditions like melasma or solar lentigos, there are over-the-counter skin lighteners that can improve the appearance of dark spots.

A few safe ingredients for skin lightening include active Vitamin C, Retinol, Glycolic Acid, and 2% Hydroquinone. Products containing these ingredients alone may not have a high enough dose to treat the condition effectively. If symptoms persist, contact your board-certified dermatologist for stronger prescription creams or procedure options that will help.

Prevention

The best way to prevent dark spots and discoloration is with proper sun protection. I highly recommend wearing a daily physical sunscreen with SPF 30 or higher. Sunscreen not only prevents brown spots but it also protects you from early wrinkles, photo-aging, and non-melanoma skin cancers like squamous cell cancer and basal cell carcinoma. Ideally, the sun should be avoided as much as possible. Hats, protective clothing, and umbrellas are great to use when you’re at the pool, beach, hiking or doing any outdoor activity.

In addition to limiting sun exposure and wearing a daily SPF, incorporating antioxidants into your skin care regimen can further prevent dark spots. Antioxidants absorb the free radical damage that we get from UV light and other environmental factors. This damage triggers melanin production and causes brown pigment in our skin of various kinds.

Vitamin C, Vitamin E, Green Tea, and Coffeeberry are all powerful antioxidants that can help alleviate accumulated oxidative damage to the skin and ultimately prevent pigment/brown spots.

Further, for those that have documented skin cancer, it is helpful to incorporate DNA repair enzyme creams to help reverse cellular photodamage and prevent future complications.

When to Visit a Dermatologist

If spots, moles, or discolorations on your skin change in size, shape, or coloring you should contact your board-certified dermatologist. Often it is difficult to discern the difference between a sunspot or a cancerous spot which is why an annual dermatologist skin checkup is highly recommended.