There are a multitude of conditions that result in discoloration to the skin; ranging from simple to complex in their treatment. Some skin discoloration is easily treated with use of creams alone, while other pigmentation problems may require peels, lasers, or may be considered a permanent condition with no treatment available. SUNSPOTS (also referred to as liver spots) Sunspots only appear on sun exposed skin, such as the face, back of hands, arms, chest, and neck. These lesions are generally flat, have sharp borders, and range in size and shape. Sunspots may enlarge slowly. Sunspots are different from flat pigmented moles, as sunspots often appear after age 40.
Treatment of sunspots is simple. Use of certain medicated creams is the first step in treatment, followed by laser treatment or peels if necessary.
FRECKLES Freckles are flat, light to dark brown in color and generally appear on the face or other sun exposed area. Freckles are more common in fair skin (those who do not tan) and individuals with light colored hair. Freckles usually appear in childhood.
Treatment for freckles consists of bleachers and tretinoin. Exfoliative peels can be done if necessary. There is always the possibility that freckles may return. Sun protection can help in preventing the appearance of freckles.
MOLES Keratosis are benign lesions that may be flat or raised and look like warts. Seborrheic keratosis usually appear after age 50 and could be light or dark in color and vary in size from a few millimeters to one centimeter. Keratosis generally appear on the chest, back, hands, arms, or face. It is not uncommon for the surface of the keratosis to dry up and appear crusted. In certain ethnic groups, (Asian, African American) keratosis are seen predominately on the face, but could involve the neck and look like small black or brown warts. Keratosis can easily be removed without residual scarring by either shaving them or removing them with a hyfrecator (hot needle type device). Sometimes a stimulation peel is performed in conjunction with their removal.