Brief overview
- Treatment: Generally not necessary. Removal for aesthetic reasons by a dermatologist possible
- Causes: Excessive formation of the skin pigment melanin (e.g. due to sun exposure, predisposition). Female hormones, burns and various illnesses and medications promote pigmentation disorders.
- When to see a doctor? In the case of conspicuous pigment spots (irregularly bordered, not all the same color, etc.).
- Prevention: Sun protection, day cream with sun protection factor, preventive check-up with a dermatologist.
How can pigment spots be removed?
Harmless skin moles and age spots (lentigo solaris) do not necessarily require treatment. However, if they are disturbing for aesthetic reasons, the dermatologist will remove the pigment spots (hyperpigmentation). Various methods are available for this:
- Laser: An effective method is to laser pigment spots. The pigment accumulations are shattered by the light energy and then disposed of by the immune cells.
- Cold: In cold therapy (cryopeeling), the surface of the epidermis is frozen with liquid nitrogen so that it dies off.
- Abrasion: The pigment spots can be removed with a scalpel.
It is advisable to have all treatments carried out only by a dermatologist, as otherwise there is a risk of irregular pigmentation and scarring.
The skin is particularly sensitive for weeks after the marks have been removed. During this time, it tends to form new pigmentation spots and therefore needs even more protection from the sun than usual.
What can you do yourself?
There are various remedies and home remedies for pigment spots that are designed to help you remove them on your own. However, over-the-counter bleaching agents are less suitable for lightening or getting rid of pigment spots. Darker pigment spots in particular cannot be removed with their help. Instead, the tinctures and creams can cause considerable skin irritation.
Natural remedies are less harmful. However, their effect has not been scientifically proven or has only been tested on a small number of test subjects. Natural remedies that are said to help with pigment spots include, for example
- Lemon: The acid in lemon is said to have a lightening effect as it has an exfoliating effect. However, as it only penetrates the upper layers of the skin, the effect is likely to be minimal.
- Papaya: The fruit contains the active ingredient papain, which is said to help the body break down metabolic products more quickly. This should also gradually make skin spots disappear. However, papain may trigger allergies as it removes the skin’s barrier function.
- Vitamin A: This vitamin, also known as retinol, is said to slow down skin ageing and reduce the appearance of pigmentation spots.
If you would like to try one of these or another (home or natural) remedy for pigmentation spots, it is advisable to speak to your dermatologist first. He or she will advise you on the correct application and point out any side effects.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not improve or even get worse, you should always consult a doctor.
What causes pigment spots?
Certain skin cells, the melanocytes, are responsible for the formation of pigment spots. They produce the skin pigment melanin. This provides the tanning effect and protects the skin cells from UV radiation. If an excessive amount of melanin forms in certain areas, spots appear.
Female hormones also promote the formation of pigment spots. Women who use hormonal contraception (such as the pill) are more likely to have pigment spots than women without hormonal contraception.
Hormonal pigmentation disorders also sometimes occur during pregnancy. They manifest themselves as large, dark pigmented areas on the face, which are known as pregnancy moles or cholasma. The pigment spots appear on the forehead, temples and cheeks, among other areas. The symptoms disappear on their own after delivery.
Certain medications increase the skin’s sensitivity to light and also promote pigmentation disorders. These include some antibiotics, certain chemotherapeutic agents and St. John’s wort preparations.
Pigmentation disorders may be the result of burns or illnesses. For example, the skin may have darker pigmentation in places as a result of an insect bite, a skin disease (such as psoriasis or acne) or an infectious disease (such as shingles or syphilis). Tumors, metabolic disorders, gluten intolerance and a folic acid or vitamin B12 deficiency may also result in pigmentation disorders.
Are pigment spots dangerous?
This explains why, compared to other types of skin cancer, malignant melanoma spreads comparatively early to other organs and forms metastases there. Other, less aggressive forms of skin cancer are basal cell cancer and spiny cell cancer (collectively referred to as white skin cancer).
Skin cancer is almost always curable at an early stage. Therefore, skin checks by a dermatologist and regular self-checks may be life-saving.
White spot disease (vitiligo)
When white spots appear on the skin, known as white spot disease, this is actually the opposite of pigment spots. The skin of those affected does not produce too much melanin in certain areas, but too little. This results in very pale, pigment-poor or even pigmentless areas on the skin. In principle, the pale, irregular spots appear all over the body, but initially mostly appear on the hands and face.
What are pigment spots?
Human skin is rarely completely flawless. The skin of fair-skinned people in particular is prone to pigmentation disorders. Some pigment spots such as freckles (ephelides) already appear in children. Age spots, on the other hand, develop over the course of a lifetime.
Pigment spots are brown, red or ochre in color and usually not raised, i.e. not palpable. Such pigment spots (hyperpigmentation) mainly form on areas of the skin that are particularly frequently exposed to light, for example on the face, décolleté or hands. Depending on the type, pigment spots can also appear on the lips, in the eye (conjunctiva), on the neck, arms and legs.
Pigment spots also occur on other parts of the body such as the genital area (e.g. penis, glans) or on the back.
A special form of pigmentation disorder is the nevus pigmentosus, also known as a café-au-lait spot because of its appearance. It is uniformly light to dark brown in color. The nevus spilus has a similar appearance, which may be the size of the palm of the hand and has darker speckles. Both forms of pigment spots are present in children from birth and may increase in size in the course of life.
Pigment spots: When to see a doctor?
Keep an eye on your skin yourself between appointments. The ABCDE rule provides an initial assessment of moles and pigment spots. It stands for
- A = Asymmetry: In the early stages, melanomas often announce themselves with a non-symmetrical shape.
- B = Boundary: The pigment mark appears to run out at the edges, it is uneven, rough and jagged. Irregular edges and blurred borders indicate potential melanomas.
- C = Color: The mole is lighter or darker in some areas. Black, dark brown, bluish, red, gray to skin-colored areas on a mole indicate a melanoma.
- D = Diameter: Pigmented moles with a diameter of more than two millimetres should always be observed.
- E = Evolution: Changes in the pigmented mole; if they occur within three months, it is advisable to have this checked by a doctor.
Such features may indicate skin cancer. It is therefore advisable to have them examined by a dermatologist. This also applies if the marks bleed, itch or change in size and shape.
Pigment spots: examinations and diagnosis
Pigment spots: prevention
Better than trying to get rid of the spots is to prevent them from appearing in the first place. Consistent sun protection is the most important aspect if you want to prevent pigment spots and skin cancer. The UV light contained in sunlight favors both the one and the other.
Many people think about sun protection when they are at the beach or skiing, but neglect it in everyday life – in a convertible car, on a walk, in a café. With a day cream with a high sun protection factor, you are always well equipped. It is also a good idea to avoid the midday sun and apply sun cream generously to all uncovered areas of the body to prevent pigmentation spots and skin cancer.
