The most commonly treated conditions of Pigmented Lesions are solar lentigines,
also known as "age spots," "liver spots" or "sun spots"; " birthmarks"; and freckles.
These benign pigmented lesions are due to an excess of pigment in the skin, usually due
to sunlight exposure and congenital factors.
The mechanism of pigmented lesion removal is based on selective destruction
of melanocytes and melanosome-containing epidermal keratinocytes. The lesion darkens and crusts after
treatment, and is naturally sloughed off the skin within two-three weeks.
Freckles (also known as ephelides) are small flat brown spots that appear on sun-exposed skin,
especially the face and arms. Freckles are inherited and become darker with consistent sun exposure.
Ultraviolet rays from the sun activate pigment producing skin cells (melanocytes) to produce pigment (melanin).
Increased melanin is manifested as dark or brown spots on the skin.
Although freckles themselves are harmless, it is important to distinguish between freckles and a type of skin
cancer called melanoma. If you have freckles, you have a higher risk of melanoma. Also, if your freckles are growing
or changing, it is important see your physician for a skin check.
Age Spots increase with age and with increased sun exposure. They are more common in people who freckle and
who burn easily. It is important to know that if you've had enough sun to develop age spots, you have a higher
risk of developing skin cancer.
Age spots are also known as sun spots, liver spots, lentigos, or lentigines. These lesions are flat, tan, brown,
or dark brown spots on sun-exposed skin. As people age, sun spots most commonly appear on the backs of the hands,
the forearms, neck, chest, and face. Sun spots are associated with cumulative sun exposure.
The pigment producing cells in the skin (called melanocytes) are activated to produce more pigment (melanin) by ultraviolet rays.
While these spots are not themselves cancerous, you may be at risk for skin cancer if you have them.
Age spots are flat and vary in size from a small pea to a dime. They usually are somewhat round and have irregular borders.
They are found on chronically sun-exposed areas such as the shoulders, upper back, face, forearms, and the back of hands.
Melasma, also known as cholasma, is characterized by irregular patches of dark skin on the face
and can sometimes be mistaken for a suntan that appears around the cheeks, forehead, upper lip, nose,
chin, and jawline. It can also show up on the forearms, but this is quite rare. Within a patch of melasma,
pigment producing cells (called melanocytes) are increased in number and each melanocyte produces more pigment
(called melanin). Increased melanin in the skin leads to the tan or brown coloration.
Melasma is a common condition and is found more often in women. Those with darker skin types (including Indians,
Hispanics, Middle-Easterners, and North Africans) are more prone to melasma than those with lighter complexions.
The cause of melasma is not fully understood. However, genetics, hormonal changes, and sun exposure are known to
play important roles. For example, melasma often occurs with pregnancy, hence the term “mask of pregnancy.” Oral contraceptives
can also trigger melasma. Sun exposure is a big culprit. Melasma tends to darken in summer after sun exposure, and fade in winter
when the sun is a rare treat. Skin inflammations from allergic reactions, or waxing of facial hair especially above the lip,
can also be a trigger. Some medications can also cause melasma such as the antibiotics tetracycline and minocycline,
and some anti-seizure and anti-malarial drugs.
Although there are some diseases that cause similar changes in the skin, melasma itself has no association with internal disease.
Melasma doesn’t really have a cure. In many cases associated with pregnancy, the discoloration fades away after
delivery but it may persist for longer or indefinitely. The good news is that there are treatments that
can minimize the visible effects and keep them at bay. There are a number of treatments available for melasma.
They include: topical bleaching creams, sunscreens (products), chemical peels, and laser therapy.