What are the differences between brown spots on the skin?
Brown spots differ from each other both visually and in terms of the triggering factors. There are only few people who do not have any corresponding discolorations on their skin and with age an increasing accumulation can be observed. To be distinguished are:
Moles or birthmarks
Moles and birthmarks are harmless and appear in some people a lot, in others a little. Behind this is a genetic disposition, i.e. the tendency can be inherited within a family. The size of moles or birthmarks is a few centimeters and the coloration is brownish. The reason lies in the cells that are clustered here and cause a brown coloration due to the melamine they contain. In many places there is also talk of melanocytes, i.e. colored cells.
Those who need a medical term for moles and liver spots speak of nevus. These should be checked at regular intervals by a dermatologist, because skin cancer can sometimes develop from them.
Age spots appear preferentially on the hands and face. People under the age of 40 are rarely affected, above that age the discolorations can appear. It is interesting to note that the appearance is influenced less by pure age than by sun exposure. For this reason, a visit to the dermatologist is also recommended to keep an eye on age spots. The coloration is a little different from moles and birthmarks, because the colorations in light and dark brown sometimes appear in areas.
Pregnancy mask or melasma and chloasma
Both the so-called pregnancy mask and melasma and chloasma refer to one and the same phenomenon. We are talking about hyperpigmentation on the face, which affects women in particular and appears in colors between yellowish and brown. The mouth area is affected, but also the cheeks, forehead and temples, with hormonal reasons being responsible. However, a pregnancy mask does not only appear during pregnancies, but also in the context of the use of hormonal preparations.
In unfavorable cases a mole or birthmark can develop into a melanoma. We are then talking about skin cancer and spots that are somewhat raised and the surface changes or grows. Melanomas are irregular and fringed at the edge and must be surgically removed and examined. The coloration can be similar to that of a mole or reddish or black and bluish. Sometimes a melanoma is colorless.To examine pigment spots for skin cancer, the so-called ABCDE rule (asymmetry, boundary, color or color, diameter, elevation) is recommended.
Freckles are possibly the most pleasant and sympathetic form of hyperpigmentation. In particular, fair skin types are prone to them, which is why the effect is mostly seen in northern regions. Freckles can be seen on the face as well as on the neck, shoulders and arms or hands, or in short, in the areas that receive direct sunlight. The tendency to freckles is genetic.
Milky coffee spots
Latte spots or café-au-lait spots are spots that are light brown in coloration and reminiscent of the coffee beverage. As a rule, the discolorations are not problematic, although it depends on the accumulation. Up to six latte stains are considered harmless, above that an examination is advised, because Recklinghausen’s disease or NF1 or neurofibromatosis can also be a trigger.
Discolorations after inflammations
After inflammation of the skin, postinflammatory hyperpigmentation appears here and there. This is referred to as healing discolorations, which occur in acne as well as in psoriasis or in the aftermath of a cosmetic treatment such as dermabrasion or laser treatment. These discolorations usually disappear on their own.
Erythrasma or bacterial infection of the skin
Erythrasma or dwarf lichen is an infection of the skin caused by corynebacteria. These bacteria are harmless and occur on the skin anyway, but they multiply uncontrollably when the skin is irritated. Especially under the arms but also in the groin area and under the breasts the skin reddening occurs and is promoted by sweat but also diabetes, overweight and a weakened immune system.
Brown spots as side effects of medication
After taking certain medications, brown spots can occur again and again. The reason is an increased sensitivity to UV rays. This can be seen with
- Medications that are applied locally (example: acne medications)
- malaria drugs such as chloroquine
- hormonal agents
- some drugs against rheumatism or cardiac arrhythmia
- St. John’s wort and various antibiotics
There are always notes on this in the package inserts and direct sunlight should be avoided if taken regularly.
Brown spots can also be a consequence of a phototoxic reaction. This is the case if there are intolerances to agents such as tea tree oil, bergamot oil or also plants such as composite plants, giant hogweed and lily plants as well as various metals and medications.
Weakness in veins
Weakness in the veins or venous insufficiency inevitably affects the skin. Due to the fact that the blood does not circulate properly in the legs, they become sensitive to pain and swell. The result is broom veins, varicose veins and brownish spots caused by decaying skin cells in the tissue. The trigger is the iron contained in the blood, which is why these are not melamine pigmentations, but rather reddish-brown or even bluish spots.
Under the name Purpura pigmentosa progressiva (PPP) is known a quite common disease in which the capillaries, i.e. the fine branches of the blood and lymph vessels are inflamed. Hemorrhages into the skin follow and spots often likened to peppercorns appear. Triggers are considered to be allergic reactions, both to food and to colors in textiles, etc.
Metabolic and systemic diseases
In the field of metabolic diseases, alkaptonuria (protein metabolism) as well as the liver disease hemochromatosis should be mentioned and also sarcoidosis as well as Peutz-Jeghers syndrome lead to brown spots on the skin.
When should a doctor be consulted about brown spots on the skin?
Most of the triggers for brown spots on the skin are harmless and often they are normal signs of aging that can be easily corrected cosmetically. Nevertheless, it is advisable to check regularly with a dermatologist and to follow the ABCDE rule when examining moles yourself. The letters stand for:
A = Asymmetry
A mole should be round or oval. Asymmetry is conspicuous.
B = Boundary
The edges or outline of a mole or birthmark should be sharp and not frayed or blurred.
C = Color or shade
If more than one color shade occurs, the mole should be observed or examined.
D = Diameter
More than five millimeters in diameter should be observed.
E = Elevation and development
If moles can also be palpated, this is as much a reason for closer examination as development and growth.