Pigment spots are among the pigmentation disorders of the skin. Doctors use this term to summarize all types of changes in the coloration (pigmentation) of the skin and mucous membranes. It is normal for Central Europeans to have pigment spots or to develop them in the course of their lives. From a medical point of view, the color changes are usually absolutely harmless.
However, many people find them unsightly and
cosmetically annoying, especially if the pigmentation disorders occur on the
cheeks, forehead, upper lip, hands, arms, legs or on the décolleté. With
sun and age spots in particular, there are various options for removing or at
least reducing the brownish discoloration of the skin.
Pigment spots: causes and forms
The so-called melanocytes are responsible for pigment
spots. These cells in the top layer of the skin make melanin. The dye
occurs in humans in a brown-blackish and a lighter yellowish-reddish variant
and protects the skin from UV radiation. Depending on the appearance and
causes, doctors distinguish several types of pigment spots. This includes:
White spot disease (Vitiligo)
Strictly speaking, white spot disease is the
opposite of pigment spots. Instead of producing too much, the melanocytes
here produce too little melanin - why is still largely unclear today. As a
result, area with little or no pigment appear on the skin, which accordingly
appear very light.
Most of the time, the irregularly shaped white
patches of skin appear on the face, hands and feet. In principle, however,
they can arise anywhere on the surface of the skin and also on the mucous
membranes. The white spot disease cannot be cured. Apart from an
increased risk of sunburn on the affected skin areas, Vitiligo is
harmless. But there are ways to reduce the white spots, for example with
UV therapy at the dermatologist.
Moles and birthmarks
Moles are caused by an accumulation of
melanin-producing cells in the skin. They show up light to dark brown,
sometimes even almost black, and sharply delimited. Doctors speak of
pigment nevi, colloquially they are often referred to as birthmarks. This
is not entirely corrects, however, as the term birthmark also includes other
benign changes in the skin or mucous membranes.
In this part of the world, practically everyone
already has moles as a child, and they often become more in the course of
life. They are often found on parts of the body that are exposed to high
levels of sunlight. In addition to the face, neck and hands, this also
includes upper arms, shoulders and the cleavage.
Although the majority of liver spots are completely
harmless, they can develop into skin cancer . If
moles enlarge, lighten, darken, itch, bleed, ooze, or otherwise change, a
dermatologist should be consulted. It is generally advise to take
advantage of the preventive examinations for skin cancer paid for by health
insurers.
Freckles (ephelids)
Freckles occur mainly in people with fair skin
types, and this usually already in childhood or early adolescence. The
small reddish-brown pigment spots are preferred where the sunlight falls
unhindered on the skin, i.e. on the face, on forearms and hands as well as on
the cleavage.
The reason for the freckles is that the melanocytes
in appropriately predisposed people produce more pigment under the influence of
UV radiation. The dye accumulates in the deepest layer of the epidermis
and thus ensures the harmless spots that become pale in autumn and winter when
the sun is less.
Age spots and sunspots
Whether back of the hand, forearms, face or
décolleté: Age spots (Lentigo senilis) or sunspots (Lentigo solaris) form in
skin regions that have been exposed to the sun for many years. This means
that they accumulate from the 40th birthday and are already the norm for people
over 60. But younger people can also get these yellowish-brown to dark
brown pigment spots.
Age spots occur because more melanin accumulates in
the affected areas in the epidermis. They can be tiny, but also several
inches tall. Their shape also varies from round to oval to irregularly
delimited spots. Unlike freckles, they hardly fade when the UV exposure
drops in autumn and winter.
Age spots are usually harmless. Since certain
types of skin cancer can look similar, these pigment spots should be examined
by a dermatologist every two years as part of skin cancer screening. Some
people find the brown spots to be an optical flaw and therefore want to get rid
of them. There are several methods to remove age spots; Lasers are
considered to be the most effective.
Chloasma / Melasma
This type of pigmentation is caused by hormonal
changes: usually due to pregnancy, the use of birth control pills or hormone replacement therapy during
menopause. That is why the ocher to light brown flat discoloration occurs
almost exclusively in women. They are noticeable in the area of the
upper lip, forehead, temples and cheeks.
After childbirth or after stopping the pill or
hormone replacement, the darker pigmented areas on the face usually disappear
on their own.
Remove pigment spots
Pigment spots in pregnancy subside when the
hormonal balance returns to normal after the birth. Other forms of pigment
spots are more stubborn, but usually just as harmless. From a medical
point of view, therefore, they do not have to be treated.
Above all, the age spots that increase with the
number of years of life perceive those affected to be so cosmetically annoying
- especially if they appear on the face - that they would like to get rid of
them. There are the following more or less promising methods to remove the
skin marks:
Laser pigment spots
Whether on the face, neck or cleavage - the most
effective method to remove pigment spots is laser therapy from a dermatologist
who specializes in this treatment. Here the pigment accumulations are
shattered by the high-energy laser light and then disposed of by the cells of
the body's own defenses.
Since this leads to an intentional inflammation,
the lasered skin can swell, redden and burn like a sunburn in the first few
days. After two weeks, the treated areas have largely healed, but remain
particularly sensitive for a while. For this reason, patients should not
go into the blazing sun without appropriate protection in the first eight weeks
after laser treatment.
Depending on the sizes and severity of the
hyperpigmentation, one to two therapy sessions are required to completely
remove age spots. Since the reasons are purely aesthetic in nature, those
affected usually have to pay for the laser treatment themselves. The cost
per session depends on the size of the area of skin to be treated.
Peels
Another way to treat pigment spots is with
peelings. They contain chemical substances such as fruit acid or
trichloroacetic acid. Applied to the affected areas, they loosen the top
layers of skin with the pigment accumulations. New, lighter skin then
grows back there.
However, the treatment is very irritating to the
skin, carries the risk of infections at first and can lead to the formation of
scars. That is why such a chemical peel should only be carried out by
experienced dermatologists. Depending on the extent of the age spots,
several therapy sessions may be necessary. Here, too, the costs are
usually not covered by health insurance companies.