Board-certified dermatologist Dr. Naomi Brooks provides effective skin care treatments for various forms of hyperpigmentation, such as uneven skin and brown spots, to Boise, ID, and surrounding area patients.
Hyperpigmentation typically results from the over-production of melanin by pigment-producing cells in the body known as melanocytes. Melanin is the pigment that provides our hair and skin with their color, and helps protect the skin against the sun's harsh ultraviolet rays.
The quantities of melanin in the skin correspond to how dark our skin is, and varies from person to person depending on genetics, sun exposure, and any pre-existing skin conditions. When our body produces too much melanin (typically triggered by excessive exposure to sun rays, scars, or hormonal imbalances), it can result in hyperpigmentation of the skin, which can make it look blotchy and uneven in tone.
A lentigo is a brown spot that appears on the skin from sun exposure. Multiple brown spots are called lentigines.
These brown spots are often referred to as "sun spots" or "age spots." Brown spots develop due to damage from UV rays rather than the aging process – but naturally, as we grow older, we experience the effects of years' worth of sun exposure as an increased number of brown spots.
Consequently, brown spots occur on the more sun-exposed areas of our skin, such as the face, chest, arms, backs of hands, upper back, and shoulders.
While excess sun exposure is a risk factor for skin cancer, such brown spots themselves are not cancerous. However, a brown spot that changes in any way (for example, it thickens, darkens, or develops an uneven shape or color) will require a biopsy to check for the presence of skin cancer.
The most important aspect of treatment is prevention. This includes steps such as using adequate sunscreen (broad spectrum physical blocker such as zinc oxide or titanium dioxide with SPF 30 or higher) on all areas of the skin that may be exposed to the sun, reapplying such sunscreen every two hours, and wearing wide-brimmed hats and other sun-protective gear.
For cosmetic purposes, there are various methods our practice provides that can diminish the appearance of brown spots. These include prescription bleaches, liquid nitrogen cryotherapy, retinoid cream, or chemical peels. It is important to note, however, that even with treatment, brown spots can darken, and new spots can appear with sun exposure.
Uneven skin tone or larger brown spots that appear patchy or splotchy can occur due to melasma, a condition in which melanocytes produce excess pigment.
The patches typically affect both sides of the face, with the most common sites affected being the cheeks, nasal bridge, forehead, upper lip, and jawline.
The exact cause of melasma is unknown, but individuals with a family history of melasma, hormonal imbalances, and/or excess sun exposure can develop it. The condition is more common in females and individuals with darker skin types. Pregnancy and hormonal contraceptives can trigger or worsen melasma.
Prescription creams can improve the appearance of melasma. Gentle skincare and sun protection is essential, as products that irritate the skin may worsen the condition. Even with successful fading of brown patches, skin can quickly darken again with sun exposure.