As we age, we seem to develop brown spots on our face. Do you wonder what these brown spots are, how they can be treated, and which ones you need to be concerned about? Here’s a list of common pigment disorders to help answer those questions.


These brown spots seem to develop on the face in isolated areas, most often on the cheek areas. They are also called age spots and sometimes liver spots. These brown spots are harmless patches of darkened skin resulting from exposure to UV radiation. They often also occur on the hands. These spots are more common in fair-skinned individuals. Your physician can treat solar lentigo with cryotherapy, but treatment may leave a white mark. This is preferable to the brown spot for many people as it is easier to camouflage with makeup. Prevention includes minimizing sun exposure and using mineral sunscreens. This prevention needs to start early in life.


These are harmless warty spots, usually of a brown or dark color. Often there is a genetic predisposition to these spots. They can occur on the face, neck, and torso. Your physician can also treat these with cryotherapy if they are cosmetically undesirable.


These spots are the ones to be careful not to miss. They can appear as a darker patch on the skin or arise from within a mole or freckle. Melanomas can occur anywhere on the body, not only in areas that get a lot of sun. The first sign of melanoma is usually an unusual-looking freckle or mole. Physicians often use the ‘Ugly Duckling’ sign when checking moles on your body. They check for moles that stand out and look different. If you are unsure about a change in a mole or the appearance of a new lesion that ‘looks different’, please schedule an in-person appointment with your family physician.


Melasma is a common skin disorder that presents as a bilateral blotchy brownish facial pigmentation. Melasma is more common in women and is most common in people who tan easily or have naturally brown skin (Fitzpatrick skin prototypes 11, 1V). Factors involved in the development of melasma include family history, sun exposure, and hormones (including the use of oral contraceptive pills and IUDs). Some cosmetics may also trigger this condition. It is ESSENTIAL to diagnose melasma accurately as the treatment for other pigment disorders may make melasma worse. Because melasma can be triggered by light, it is IMPORTANT not to have brown spots treated with a light-based device (IPL or intense pulsed light) as this will worsen your brown spots. To reduce brown spots caused by melasma, the year-round use of mineral-based sun protection (zinc, titanium dioxide, or ferric oxide) is essential. Discontinuing hormonal contraception is helpful if possible. Many topical products can be used, including hydroquinone, retin, kojic acid, tranexamic acid, and other plant-based products. Your physician should supervise the use of these products. Hydroquinone and retin can, for example, cause skin irritation and need to be added to your skincare regime slowly and carefully. There are few laser treatments that are truly effective. Microneedling may be helpful when combined with effective topical products. Q switched lasers may have some benefits also. The good news is that treatments can be very effective, but the condition is permanent and needs to be managed. The use of daily mineral sunscreen is imperative.


Not all pigment disorders are the same, and diagnosis by your physician is essential before embarking on a treatment regime.

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Posted in: General, Skin Conditions

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