The Doctor Is In: Understanding Skin Discolourations

By Alix Fuller

Cosmetics: There are several types of skin discolouration which, although embarrassing, are harmless. Can you describe some of them, explain their causes and suggest some treatments?

Dr. Lisa Kellett: There are a number of “normal” dis­colourations and their causes and treatments vary. Some can’t be treated and will only, with any luck, fade in time.

• Melasma is also known as the mask of pregnancy and gen­erally appears on the cheeks, forehead, nose and around the mouth, but it could turn up anywhere. The cause is a com­bination of hormones and the sun; no matter how much sun protection you use, you could still get it. The pigment cells are also heat sensitive, so if you go out in very warm weather, you’re at risk. It’s more common in pregnant women because they have high estrogen states, but it can happen to anyone. The treatment is a combination of light treatments and top­ical bleaching creams or agents, like azaleic acid, arbutin and hydroquinone. It’s often very difficult to remove. But it may fade in time.

• Post-inflammatory hyper-pigmentation is found in people who have darker skin types, after a burn, acne or any other trauma, even a scratch or irritation. The skin reacts by produ­cing spots of dark pigment. In Caucasians, the skin can turn red. Treatment is usually bleaching creams and Lumenis 1 treatments (light treatment). Untreated, it can fade, but that might take months or years.

• Lentigines or sun spots appear on the face, shoulders or back, hands and arms; anywhere exposed to sun. Simply put, it’s sun damage and, although they can be lasered off, the best cure is prevention as they’re permanent.

• Seborrheic keratoses are also known as liver or age spots and you see them on the back of your hands or your trunk. They start off as flat brown spots and become raised and quite warty. They can be burned off with electrodessication.

• Nevi (birth marks) are collections of mole cells which de­velop in the fetal stage; it’s all pre-programmed. They’re usually flat, and they can be excised or lasered off.

• Port wine stains are a collection of blood vessels. You might be born with it, or it might develop in infancy. These, too can be lasered off.

C: How do you know when a skin discolouration is not so harmless?

Dr. L.K.: If it’s new, changes in size, shape or colour, or bleeds, it should be seen by a dermatologist. That way, you get a prop­er diagnosis and appropriate treatment.

C: What’s the best way to keep your skin free of discol­ourations?

Dr. L.K.: Prevention. Many skin discolourations are caused by the sun, so wear a sunscreen with SPF 30 or higher every day, a broad brimmed hat, and protective clothing. Also, beware of heat because it can often stimu­late the pigment cells.