Pigmented Skin Spots: Types, Causes, and When an Examination Is Needed

You usually notice a brown spot on the skin by chance — at the mirror, adjusting a collar, or at the end of summer, when the skin on your hands darkens faster than usual. Then questions arise: what is this spot, where did it come from, and should it be shown to a doctor. Below is a calm breakdown: how hyperpigmentation is described, why it occurs, and when a dermatologist examination is needed.

What pigmented spots and hyperpigmentation are

Pigmentation is coloring. Skin color depends on melanin, which is produced by special skin cells. When such cells are damaged or function abnormally, melanin production changes: with an excess, the skin becomes darker. Hyperpigmentation, or melanosis, is described as increased formation and increased deposition in tissues of dark brown or black pigment from the melanin group, which is normally present in the skin, the retina of the eye, and the meninges. Some pigmentation disorders affect only certain areas of the skin, others affect the entire body.

What brown spots on the skin can be: names and appearance

Hyperpigmentation can manifest as freckles or pigmented birthmarks. Names that describe brown spots include age spots (also called liver spots), lentigines, melasma, post-inflammatory hyperpigmentation, acanthosis nigricans, and café-au-lait spots.

Why spots appear: sun, age, hormones, inflammation

Sunlight is one of the main causes of skin aging: under its influence the skin darkens, age spots appear on it, it thins, loses fat, and heals more slowly. Hormonal changes work differently: when the function of endocrine glands — the adrenal glands, pituitary gland, and gonads — changes, pigmentation can be diffuse, as in Addison's disease, or limited, as during pregnancy on the face and around the nipples. A separate story is toxic melanoderma, associated with general intoxication by hydrocarbons, and darkening of the skin from physical, mechanical, or chemical irritation: light, heat, coal tar distillation products. Inflammation also leaves a mark — the skin at the site of damage may become darker.

When to see a dermatologist

Reasons for a consultation may include:

• the spot appeared during pregnancy or hormonal changes — involving the adrenal glands, pituitary gland, or gonads;
• darkening of the skin occurred at the site of inflammation;
• the spots are combined with a general health disorder, for example in Addison's disease;
• the cause of the spot is unclear.

Among the examinations for pigmentation disorders is an examination under a Wood's lamp.

Pigmented spots are a matter of details and time; if something about their appearance or how you feel raises questions, it is better to discuss it with a doctor.

A pigmented spot by itself is not a reason to call an ambulance; 103/112 — if a life-threatening condition develops against its background, for example signs of stroke or heart attack.

This material is for reference: it describes the types of spots, the causes of their appearance, and what a doctor assesses, but does not replace a dermatologist consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer