Repeated sun exposure is the usual cause of dark spots on the skin, a
condition that commonly appears in middle age.
There are other factors that cause skin discoloration or hyper-pigmentation and one may need medical consultation to diagnose, treat them, and improve one’s appearance. You will need medical help to differentiate between harmless causes such as Seborrhoeic keratoses and moles (see below for pictures) and warning signs of future problems such as Solar keratoses. For harmless dark skin spots, we review several approaches improving the appearance of any hyperpigmentation below."
The most common cause of dark spots on skin is excessive sun exposure. Cumulative doses of ultraviolet radiation from the sun can result in skin damage and increased pigmentation.
Solar Keratoses (actinic keratoses)
Solar keratoses (actinic keratoses or sunspots) is a warning sign that you might be prone to a future case of skin cancer.
Source: American Academy of Dermatology
Symptoms include red, flat, scaling dry skin, stinging if the skin is scratched. Spots are greasy to the touch and do not go away. When they start to form they are small and then become raised with a stuck on appearance.
It appears on skin areas that are exposed to the sun such as the face and hands. It is usually seen on people over 40 years old.
Treatment of actinic keratosis includes removing the skin lesions using liquid nitrogen or photodymanic therapy. Topical immunotherapy and chemotherapy (5-flourouracil cream) can also be used.
Note that there is a very small risk of actinic keratosis becoming squamous cell carcinoma.
Post-inflammatory hyper-pigmentation is another common factor that produces dark spots on the skin, and this may be brought about by acne, wrong shaving techniques, allergic reaction, or other traumatic injury that causes inflammation and subsequent overproduction of melanin, the brown pigment produced in the skin.
Dark spots on the skin caused by sun exposure are called age spots, solar lentigo, lentigines or liver spots (not related to liver disease.) They can be seen in any area of the body that is not covered when outdoors are flat and are brown to tan in color.
Sunspots begin to appear after age 30 and are thought to be an inherited condition. It is not dangerous but should be checked if the spots become dark, change in appearance, or bleed as these could be signs of skin cancer. Treatment of these dark spots on skin is usually for cosmetic reasons. Sunscreens are thought to prevent the formation of additional skin spots.
Moles are harmless and range in size from 1mm to 10mm. These type of moles are uniform in shape and color. They may or may not be raised. Harmless moles can have uneven borders and be either black or brown.
Skin with multiple moles increases the risk of having skin cancer. Bring moles that change over time to the attention of a Doctor.
Seborrhoeic keratoses is a dark spot on skin with discrete edges. It appears as if it is sitting on top of the skin. The color ranges from black to orange. It can be 2 to several centimeters in size. Most spots appear after age 60.
Other conditions that may cause dark spots to appear on the skin include pregnancy, Addison’s disease, melasma, and intake of certain drugs like birth control pills, estrogen, certain antibiotics, phenytoin, and others. These conditions can lead to the development of dark spots or patches, which may or may not go away without treatment.
Source: Meisenheimer Clinic
A more serious condition that manifests as a dark spot on the skin is melanoma, a life threatening type of skin cancer.
The diagnosis of dark spots on skin usually depends on the medical history and physical findings upon consultation with a Doctor. Laboratory tests such as blood tests or skin biopsy may be done to rule out suspicious lesions like cancer.
Melanoma Skin Spots
See a Doctor if you see anything that has changed or that is unusual on the skin like the skin patches pictured below, which could indicate a case of melanoma.
Accompanying symptoms may vary depending on the cause of dark skin spots or patches. Dark spots that appear during middle age in exposed skin areas such as the face, hands, and arms are characteristic of age spots. These are more pronounced among fair-skinned individuals because of the contrast in color of the skin, but they also occur in dark-skinned people. No other symptoms are observed.
Post-inflammatory hyperpigmentation causes darks spots on skin to appear after a traumatic injury such as acne heals and leaves a dark color on the skin.
Dark patches that occur during pregnancy or are associated with hormonal changes or drug intake usually disappear after the birth of the baby or after discontinuation of the drugs. No other symptoms are observed.
If the dark spot is irregular in shape, size, and color, rapidly changing and accompanied by bleeding, skin cancer such as melanoma must be considered.
If black spots appear asymmetrical and rapidly change in size, shape, and color, they may be symptomatic of melanoma. These spots may bleed, and the borders may become irregular.
How To Get Rid Of Dark Spots on Skin
The goal of treatment in most cases is to improve appearance rather than cure an existing condition, except in cases of skin cancer, where the underlying disease must be treated.
Here are 4 approaches to getting rid of dark skin spots due to hyperpigmentation.
- Hydrocortisone Cream (1%)
Apply 1% hydrocortisone cream several times a day such as the cream offered by Aveeno.
- Use a Skin Cleansing Brush
A cleansing brush that is powered used every other day will clean the skin and remove any dead cells. This approach to exfoliation helps to improve the way any applied spot treatments work (see next suggestion)
- Treat the Dark Skin Spots
Use an over-the-counter cream or lotion such as Olay Regenerist Luminous Tone Perfecting Treatment.
- Use a Retinoid
Vitamin A lotions can accelerate the rate at which cells turn over. Dermatologists will prescribe retinoic acid or you can buy retinol online or in a pharmacy under the names Admire My Skin or Differin Gel. Products are used 1x a week or more (follow manufacturers instructions.) Some people start 1x a week to ensure that the skin reacts well to the product. Skin can be further lightened with a product like Olay Luminous Tone Perfecting Cream.
- Wear Sun Screen
Use a sunscreen that is SPR 30 or higher. This will protect the skin from the UV Rays that cause dark skin spots.
Other methods which can reduce dark spots and improve skin appearance include phototherapy, microdermabrasion, chemical peeling, and laser treatment.
A dark spot that is caused by skin cancer needs immediate treatment that may involve surgery, chemotherapy, radiotherapy, and immunotherapy, depending on the stage of the disease.
Natural Remedies Video
Video: Natural Remedies for Dark Age Spot Removal
FitLife TV segment on how to remove brown or dark age spots from the skin using home remedies.
by: Dr. Neil Alan Fenske
by: Dr. Lim Kar Seng