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Pigment spots are the umbrella term for a wide variety of skin discolorations, such as freckles, age spots and much more. Pigment spots are not always harmless. Especially if such discolourations suddenly appear and then change, a dermatologist should be consulted.
The so-called melanocytes are the skin cells that produce the dye melanin. This fabric ensures that we get brown when exposed to the sun and thus protects our skin. Mostly pigment spots appear when too much of the dye accumulates in different places. Other reasons are also possible.
The causes of such a "disorder" can be excessive sun exposure, the female hormones, the contraceptive pill, hormone preparations, pregnancy, medication, burns, skin diseases, metabolic disorders, a gluten intolerance, folate or vitamin B12 deficiency, tumors and much more be. In the following lines, the various causes are examined in more detail.
Disrupted melanin formation - sun exposure
The sun has a major impact on melanin production. How much melanin is formed and stored is individual and differentiates between the different skin types. The fact is that exposure to the sun stimulates melanin production - the skin turns brown. However, the sun can also act on the coloring cells and damage them. In this way, pigment spots can arise.
Hormones can disrupt the skin's metabolism
Large pigment spots on the face, which appear like masks, are common during pregnancy. This is due to the hormonal change. However, this pigment disorder, which is called melasma or chloasma gravidarum in technical terms, can also be caused by taking the pill (this is then called chloasma hormonal). As a rule, the spots regress after childbirth or after the pill has been discontinued - but unfortunately not always.
Healthy skin depends on a healthy metabolism and a well-functioning hormone system. Therefore changes in the hormonal system or the intake of hormones can change the skin's metabolism and cause pigment spots.
After taking certain medicines, brown spots can occur as side effects. Some medications mainly react with sunlight, make the skin more sensitive to light and leave pigment spots. Anti-rheumatic drugs that contain gold salts, cytostatics, antimalarials with the active ingredient chloroquine, some antibiotics and neuroleptics can cause annoying stains, especially in combination with sun exposure. St. John's wort should not be used in the summer months because the substance contained hypericin makes the skin very light-sensitive and tends to form brownish spots as a result.
Essential oils are highly concentrated and should only be applied to the skin in homeopathic doses. It is important here to pay attention to good, pure quality. However, a high quality essential oil in combination with the sun can lead to brown spots on the skin. This is also possible if perfume was applied before sunbathing.
Injuries to the epidermis: burns, skin diseases
Pigment spots can result from injuries to the epidermis. This is caused by burns or skin diseases such as neurodermatitis, lichen planus (lumpy nodule) and psoriasis (psoriasis). Another skin condition that is accompanied by brown spots is urticaria pigmentosa. Sufferers suffer from small, itchy reddish-brown spots or nodules. Pigment spots are also possible after insect bites or skin inflammation.
In Asians in particular, skin injuries or inflammations often cause very unattractive pigment spots, post-inflammatory hyperpigmentation.
People with fair skin, blondes and redheads tend to get freckles. These are caused by the uneven distribution of the pigment melanin. The freckles fade in winter and start to sprout under the sun's rays. The face, upper arms and décolleté are particularly affected.
Not only the sweet freckles bloom under the sun, but also age spots, so-called lentigines solares (sun spots that are lenticular), multiply when the skin is exposed to the sun again and again over the years. The age spots belong to the chronic light damage of the skin. These occur primarily from the age of 40 and prefer skin areas such as the back of the hand, forearms, décolleté and face. The unsightly small pigment spots can even be a few centimeters tall. In contrast to freckles, age spots hardly fade in the winter months.
Birthmark or mole, both are colloquial expressions. In technical jargon such pigment spots are called nevus. This is flat or raised, pink, brown to black and can be several centimeters tall. As a rule, a birthmark is a harmless affair. However, if this changes (see “when to see a doctor”), a specialist examination is necessary.
Liver spots are innate or develop over the course of life. Hormonal influences, UV radiation, especially in childhood, a massively weakened immune system, for example as a result of chemotherapy - all these factors can promote an increase in liver spots.
Café au lait spots
Café-au-lait spots are pigment spots with a color similar to that of milk coffee, hence the name. The spots are not raised and reach a size of up to 15 cm. The number is different - everything is possible from one spot to multiple occurrences. These skin symptoms often exist from birth or develop in infancy. If a child has a large number of these pigment spots, it should be clarified by a specialist to rule out neurofibromatosis.
Peutz-Jeghers syndrome is an inheritable disorder that manifests itself primarily with multiple polyps in the gastrointestinal tract. Pigment spots also form on the skin as well as on the mucous membrane, especially in the lip red, around the mouth and in the car mucous membrane.
Brown spots due to small bleeding
Minor bumps and dull injuries can result in injuries to the small veins and arteries. This is then visible as a bruise or hematoma. The colors change from red, purple to yellow-brownish. The blood pigment in the blood, iron, is responsible for the color.
Unfortunately, pigment spots are not always harmless. In the worst case, it is skin cancer. The most malignant variant is malignant melanoma, the black skin cancer. This type of cancer can metastasize relatively early, even without symptoms. The timely removal of the tumor is crucial for a good prognosis.
The causes of malignant melanoma are heredity and frequent regular sunbathing in childhood, in connection with sunburns.
Skin cancer can develop from an existing mole. Here it is very important to have a regular look at your own body. If a stain changes, a dermatologist should be consulted.
Kaposi's sarcoma is a malignant tumor that mainly occurs in connection with AIDS. This affects the skin, mucous membrane and internal organs. Typical are brownish skin changes, which usually appear on the legs at the beginning.
Contact with aggressive substances such as acetic acid and phenols can also lead to pigment spots. Other causes are liver diseases, autoimmune diseases such as sarcoidosis or iron storage disease.
In addition, contact with various plants, such as meadow claw, can cause color changes on the skin.
Prevention - correct sun protection
Proper sun protection is important to protect yourself from most forms of pigment spots. How long the sunbath can last depends on the skin type. But even tanned skin needs a suitable sun cream at the latest after twenty minutes of intensive sunbathing. Sun protection is not only needed on the beach or in the swimming pool, but also when strolling through the city, in a convertible, while exercising or cycling. This is often forgotten and then the unpleasant, painful sunburn threatens.
It is up to you whether you choose oil, cream or lotion. The ingredients have to be right. Test results help with the selection. The sun protection factor is selected to suit the skin type. Those who are not sure prefer to use a high factor.
When it comes to sun protection, the principle applies: “A lot helps a lot.” The amount of sunscreen should not be saved. The whole body needs about three tablespoons of sunscreen. That sounds a lot - but it has to be - even if the sky is cloudy. The face, neck, shoulders, décolleté and the back of the feet even have to be applied more often than the rest.
The skin can also be protected from the inside. Dietary supplements that contain vitamin E, natural beta-carotene and polypodium help here. Vitamin E and beta-carotene are radical scavengers and protect the cells from oxidative stress. Polypodium is one of the types of fern, protects against free radicals and light. In addition, a diet rich in beta-carotene can help. These include red, yellow and orange foods, such as peppers, carrots, apricots, basil, chicory and Swiss chard.
Some home remedies can be used to try to lighten pigment spots. For example, lemon juice works similarly to a fruit acid peeling, only more gently. The spots are dabbed off with a cut lemon half several times a day. Vinegar is an alternative. Buttermilk, which is also applied to the pigment spots, is also recommended as a natural bleach. Other home remedies are the juice from parsley and / or a cut clove of garlic.
A mixture of the vegetable juices of bedstraw and ginger in a ratio of 8: 2 can lighten the pigment spots. An alternative to the juice is a tea made from 20 g ginger root and 80 g bedstraw. A teaspoon of the mixture is placed in a cup with 150 ml of boiling water. The whole thing should take about 10 minutes. The affected areas are then dabbed with the decoction several times a day.
Another home remedy for pigment spots is a porridge made from magnesium sulfate, also known as Epsom salt. This is normally used for purging, but is only used externally here. A paste of Epsom salt and water is applied to the stains and washed off after about fifteen minutes.
Another variant is the laying on of freshly grated horseradish. This is packed in a cloth and brought to the affected area. After a contact time of twenty minutes, the whole thing should be washed off thoroughly and the skin treated with calendula ointment. Less skin irritating, but just as helpful, is the papain contained in the pulp of the papaya. With a cut fruit, the pigment spots are rubbed in and washed off after half an hour.
As soon as skin irritation occurs with the home remedies mentioned, the treatment should be stopped immediately.
Schüssler salts can help with pigment spots, namely number 6 potassium sulfuricum and number 12 calcium sulfuricum. Especially after sunbathing, it is recommended to take the salts. The number 6 is the liver remedy of the Schüssler salts and ensures that the liver can better remove toxins. Number 12 is a great deacidifying and detoxifying agent - so this is exactly the right place.
When to the doctor?
In general, the skin should be checked regularly. This is advisable every two years. However, if the following changes or symptoms occur, the dermatologist should be consulted very promptly:
- If an existing pigment stain changes shape,
- if the edges become irregular, jagged, uneven or rough,
- if the color of the pigment spot changes,
- when the size increases
- or if the stain is itchy, wet, or even bleeding.
Uncritical pigment spots can be removed with the help of a laser if they are quite annoying for the patient. However, this is only possible if the stains are absolutely harmless. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Susanne Waschke, Barbara Schindewolf-Lensch
- Shinjita Das: Hyperpigmentation, MSD Manual, (accessed August 22, 2019), MSD
- Thomas Vogt et al .: S1 Brief Guideline Angiosarcoma of the Skin and Kaposi Sarcoma, German Cancer Society / German Dermatological Society, (accessed August 22, 2019), AWMF
- Elliot M. Livstone: Peutz-Jeghers Syndrome, MSD Manual, (accessed 08/22/2019), MSD
- Thomas Dirschka, Roland Hartwig, Claus Oster-Schmidt: Clinic Guide Dermatology, Urban & Fischer Verlag, Elsevier GmbH, 3rd edition 2010