Irregular Brown Spots: Causes, Diagnosis & Treatment

What are irregular brown spots?

Irregular brown spots can describe a wide variety of dermatological conditions, each with different causes and degrees of medical seriousness. For this reason, it is always recommended to have any new or changing spots evaluated by a board-certified dermatologist, as they can represent everything from cosmetic sun damage to a more concerning condition like melanoma.

While it is normal to be concerned about skin changes, especially those with an irregular appearance, a professional diagnosis is the only way to confirm the spot’s origin and create a proper treatment plan.

Irregular brown spots or skin discoloration can describe the following conditions:

Freckles
Sunspots
Melasma
Post-inflammatory hyperpigmentation
Seborrheic keratoses
Moles (melanocytic nevi)
Café-au-lait spots
Lentigo simplex
Becker’s nevus
Melanoma

Causes of irregular brown spots

There are numerous causes of irregular brown spots. The most common include the following factors:

Sun Exposure

Sun exposure is among the leading causes of skin discoloration and irregular brown spots.

Skin Cancers: Melanoma, a serious form of skin cancer, often presents as a new or changing irregular brown spot.

Solar Lentigines (Sun Spots/Age Spots): Prolonged or intense exposure to ultraviolet (UV) radiation from the sun or tanning beds accelerates the production of melanin in certain areas. Over time, this leads to the formation of flat, tan to dark brown spots, particularly on sun-exposed areas like the face, hands, and shoulders.

Hormonal Changes

Fluctuating or decreasing hormone levels can also increase skin sensitivity to UV light and affect melanin production, leading to pigmentation concerns.

Melasma: Often called “the mask of pregnancy,” melasma is a type of hyperpigmentation linked to increased levels of female hormones like estrogen and progesterone. It can be triggered by pregnancy or hormonal birth control and commonly appears as symmetrical, grayish-brown patches on the face.

Inflammation

Inflammation due to skin injury can frequently result in irregular brown spots or discoloration.

Post-Inflammatory Hyperpigmentation (PIH): This condition results from an injury or inflammation to the skin, causing the skin to overproduce melanin as it heals. Common causes include acne, eczema, burns, rashes, cuts, insect bites, or cosmetic procedures. People with darker skin tones are more susceptible to PIH because their melanocytes are more reactive.

Genetics

Your genetic makeup influences your skin type and sensitivity to UV light, which can determine your likelihood of developing conditions like freckles, moles, or melasma. Other heritable conditions include the following:

Freckles (Ephelides): These small, flat brown spots are exacerbated by sun exposure but are also a genetic trait.
Café-au-lait spots: Flat, light brown patches on the skin.
Becker’s nevus: Thought to be an inherited condition, this is a pigmented lesion with a significant overgrowth of hair affecting primarily males.
Lentigo simplex: Flat, brown spots resembling moles that are often present at birth but can develop in early childhood.

Aging

Aging can cause melanocyte (pigment) cells to clump together, leading to concentrations of dark spots. Additional skin disorders that are common amongst older people include the following:

Seborrheic Keratoses: These common, benign skin growths can appear tan, brown, or black, and are linked to both aging and genetics.

Other Factors

Reactions to medications and certain medical disorders can contribute to skin changes. These factors might include the following:

Fungal Infections: Some fungal infections, such as tinea infections, can cause pigmentation changes in the skin.
Diabetes: Certain changes in skin pigmentation have been linked to diabetes.
Nutrient Deficiencies: In some cases, a deficiency in certain vitamins, like B12 or folic acid, can contribute to hyperpigmented spots.

Treatment options

The treatment to remove dark spots on the skin depends on the underlying cause and the specific type of dark spots.

Here are some common treatments to address dark spots:

Topical Treatments

Hydroquinone is a common skin-lightening agent that can help fade dark spots over time. It works by inhibiting melanin production.
Prescription retinoids like tretinoin can help exfoliate the skin and promote the growth of new, evenly pigmented skin cells.
Topical vitamin C serums can help brighten the skin and reduce the appearance of dark spots.
Like hydroquinone, kojic acid can inhibit melanin production and lighten dark spots.

Chemical Peels

Chemical peels involve applying a chemical solution to the skin to exfoliate the outer layer. This can help reduce the appearance of dark spots and promote the growth of new skin cells.

Laser Therapy

Lasers can target and break down pigmented cells in the skin, reducing the appearance of dark spots. Different types of lasers, such as fractional or intense pulsed light (IPL), may be used depending on the specific condition.

Cryotherapy

Cryotherapy involves freezing the dark spots with liquid nitrogen, causing the spots to peel off as the skin heals.

Prescription Medications

For specific conditions like melasma, your dermatologist might prescribe medications like topical corticosteroids or combination creams to help lighten dark spots.

It’s important to note that the effectiveness of treatments can vary based on factors like the type of dark spots, their severity, and an individual’s skin type. Consulting a dermatologist is crucial to determining your condition’s most appropriate treatment.

Prevention tips

Preventing dark spots on the skin involves a combination of protective measures, lifestyle choices, and skincare practices.

While complete prevention might not be possible in all cases, especially if genetics are involved, you can reduce your risk of developing dark spots on the skin by adopting the following habits:

Applying sunscreen with broad-spectrum protection (against UVA and UVB rays) and high SPF daily, even on cloudy days.
Wearing protective clothing, such as wide-brimmed hats, sunglasses, and long sleeves, to shield your skin from direct sun exposure.
Limiting your time in direct sunlight, particularly in a high-altitude or reflective surface environment.
Avoiding tanning beds.
Maintaining a healthy diet rich in antioxidants, vitamins, and minerals to support overall skin health.
Staying hydrated by drinking plenty of water.
Using a gentle cleanser and avoiding harsh scrubbing or abrasive skincare products that might irritate the skin.
Incorporating exfoliation into your routine to remove dead skin cells and promote even skin tone.
Scheduling regular visits with a dermatologist to monitor your skin’s health and address skin changes early.

Remember that prevention is vital, especially since exposure to sunlight is a significant factor in developing dark spots.

FAQs about irregular brown spots

When should I worry about a brown spot?

In general, you should be concerned about a brown spot and see a dermatologist if it is new, changing, or exhibits any unusual characteristics. While most brown spots, like freckles or age spots, are harmless, some can be signs of more serious skin conditions, including melanoma.

Because early detection is crucial for successful treatment, particularly for melanoma, it is important to be vigilant and regularly examine your skin for changes.

A simple strategy for assessing potentially concerning skin changes is the “ABCDE” method. This shortcut was structured to remind you of the characteristics to note when checking your skin. These characteristics include the following:

Asymmetry: Asymmetrical spots merit examination.
Border irregularity: Ragged edges; the borders aren’t smooth.
Color changes: The spot has color variations or changes color.
Diameter: Pencil eraser-sized (or larger) skin growths should be checked.
Evolving in shape, size, or color

Can irregular brown spots turn into skin cancer?

Yes, some irregular brown spots can turn into skin cancer, while others may be cancer from the start.

Not all brown spots are cancerous, but the key is to monitor any spot that is new or changing and to have it examined by a dermatologist, especially if it has irregular characteristics. The deadliest form of skin cancer, melanoma, often presents as an irregular brown or black spot.

What treatments can fade dark spots?

At Advanced Dermatology, P.C., our experts offer a wide array of advanced dermatological treatments to effectively fade dark spots and revitalize your skin.

Whether your dark spots are the result of sun damage, hormonal changes, or acne scarring, we can provide a customized solution for your needs:

Microdermabrasion: This minimally abrasive treatment exfoliates the skin, helping to smooth mild skin blemishes and improve overall tone.

Laser and Intense Pulsed Light (IPL) Therapy: These treatments use targeted light energy to break down melanin in dark spots, helping to fade sunspots, melasma, and other forms of hyperpigmentation.

Chemical Peels: We offer a variety of medical-grade chemical peels that use solutions to exfoliate the top layers of skin, promoting new cell turnover and revealing a brighter, more even complexion.

Microneedling: By creating controlled micro-injuries in the skin, this procedure stimulates collagen production and improves overall skin texture, which can reduce the appearance of dark spots and acne scars.

Topical Prescription Medications: A dermatologist can prescribe potent topical medications, including retinoids and other bleaching creams, to help lighten persistent dark spots.

Cryotherapy: For certain types of dark spots, a dermatologist may use liquid nitrogen to freeze and destroy excess pigment.

How can I tell if an irregular brown spot is cancerous?

Look for the following characteristics in any mole or spot:

Unevenness: The halves of the spot don’t mirror each other.
Irregular Edges: The perimeter of the growth is jagged, scalloped, or blurred.
Variable Tones: The lesion features inconsistent coloring, with various shades or spots of different colors.
Size: A spot larger than a standard pencil eraser should be examined.
Transformation: The growth is noticeably changing in its appearance, including size, shape, or shade.

Do irregular brown spots always require medical treatment?

Medical treatment is not always required for irregular brown spots, but a thorough assessment by a qualified dermatologist is essential to determine if treatment is necessary.

Many brown spots, such as sunspots and freckles, are benign, but only an expert can distinguish them from more serious conditions like melanoma, which can be life-threatening if not caught and treated early. For this reason, we emphasize that any new or changing spot with irregular features should be evaluated as soon as possible.