Guide to Identifying Different Types of Brown Spots on Skin

Identifying Different Types of Brown Spots on Skin

As we age, brown spots and other skin discolorations become increasingly common. But not all brown spots are created equal. Some are harmless lentigos or liver spots, while others may be a sign of sun damage or skin cancer.

By looking closely at the appearance, texture, location and behavior of brown spots, you can get good clues about what type it may be. Comparing your skin to pictures can help determine if a spot seems typical or atypical.

This guide covers how to identify the differences between common brown skin spots like lentigos, sun and age spots, melanoma and more. Recognizing the warning signs to watch for is key for getting unusual growths evaluated promptly.

Lentigines (Lentigos)

Lentigines, also called liver spots or lentigos, are very common benign brown spots that emerge as people age. They are associated with cumulative sun exposure, but also occur in areas protected from the sun.

Lentigines range in size from 1 to 10+ mm and are flat, oval-shaped spots with well-defined edges. Their color ranges from tan to dark brown. Typically they appear on the face, chest, shoulders, hands and arms - areas frequently exposed to the sun.

On darker skin tones, lentigines tend to be black rather than light brown. The spots are harmless, but some people seek removal for cosmetic reasons. Using sunscreen helps minimize new formation.

Solar Lentigines (Sun Spots)

Solar lentigines, also known as sun spots, are similar to regular lentigos but more directly linked to UV sun exposure. They develop from accumulated photodamage to skin cells and increased pigment production.

Sun spots appear as flat, light to dark brown spots with irregular borders. They commonly form on the face, hands, chest, shoulders and other frequently sun-exposed areas. Sun spots are harmless growths but can be removed for cosmetic reasons.

Age Spots (Liver Spots)

Age spots, or liver spots, refer to flat, brown skin spots that arise as part of the natural aging process. They form gradually over time on sun-exposed areas like the face, hands, shoulders and arms.

Despite their name, age spots have nothing to do with the liver. The macules are typically small, ranging from 2 to 20 mm. Their brown color results from increased melanin concentrated in one area of skin.

Age spots are harmless, but some individuals opt to have them removed if desired for cosmetic purposes. Using sunscreen and avoiding tanning can help minimize additional spot formation.

Melasma (Chloasma)

Melasma is a common condition characterized by tan or brown patches on the face. The hyperpigmentation is thought to result from sun, hormones, and genetics. Melasma is much more common in women, especially during pregnancy.

The brown spots tend to appear symmetrically on the forehead, cheeks, nose, chin and upper lip. Melasma spots can be light brown or grey-brown with indistinct borders that fade into normal skin.

While harmless, melasma is sometimes treated for cosmetic purposes. Sun protection, chemical peels and laser therapy may improve appearance. The birth control pill can worsen melasma for some women.

Seborrheic Keratosis

Seborrheic keratoses are very common noncancerous skin growths that people tend to develop as they age. They appear as brown, black or tan growths that commonly form on the chest, shoulders, face, and back.

The spots have a “stuck-on” warty appearance ranging in size from 1 mm to several cm. Their surface may be smooth, rough, or slightly scaly. Seborrheic keratoses do not turn into skin cancer, but can be removed if desired.

Actinic Keratosis (Solar Keratosis)

Actinic keratoses, also called solar keratoses, are rough, scaly patches caused by damage from sun exposure. They occur on frequently sun-exposed areas and are considered precancerous.

The spots appear as tan, pink or red lesions that may reach 1 cm in size. Their surface is often bumpy, dry and crusty. Actinic keratoses can progress to squamous cell carcinoma in some cases if not properly treated.

Lentigo Maligna (Melanoma in Situ)

Lentigo maligna is an early form of melanoma confined to the outermost skin layer. Spots form on chronically sun-exposed areas like the face, ears, arms and neck.

They appear as flat, mottled tan, brown or black macules with irregular borders. The lesions slowly enlarge and change over the years, eventually developing into invasive melanoma without proper treatment.

Melanoma

Invasive malignant melanoma is a serious skin cancer. It often first appears as an unusual mole or spot that looks different from other marks. Caught early, melanoma is highly treatable.

Warning signs to watch for include: asymmetry, irregular borders, uneven color, large diameter (6 mm+), rapid growth or changes in size, shape or color. Melanomas may be various shades of brown, black, red, blue, white or even skin-colored.

If you notice any atypical spots that are changing or don’t heal, seek prompt dermatology evaluation. Spotting melanoma early is crucial for proper treatment and outlook.

Characteristics that Suggest Cancer Risk

While most brown skin spots are harmless, unusual moles or marks warrant medical evaluation. Be on the lookout for spots with these red flag characteristics:

Asymmetry

Benign moles tend to be symmetrical. Melanoma spots often lack symmetry and have irregular, uneven shapes.

Irregular Borders

Harmless moles generally have smooth, well-defined edges. Melanoma lesions often have notched, blurred or ragged borders.

Diameter Changes

Rapid growth or changes in size can signal cancer development. Large diameter (6 mm+) also raises concern compared to small lentigos.

Color Variations

Multi-colored spots or moles with shades of brown, black, tan, red, white or blue warrant a closer look compared to uniform coloring.

Elevated Surface

Most benign spots are flat to the touch. Raised surface texture or bumps may suggest something more abnormal.

Scaly, Crusty or Bleeding

Those with rough, scaly, crusty surfaces or that bleed easily have higher risks of being precancerous or cancerous changes.

Spreading Colors

Benign spots typically have solid borders and uniform colors throughout. Melanoma often shows colors spreading out into normal skin in an irregular pattern.

Notify Your Doctor About Changing Spots

Keep an eye on existing spots and note any that appear abnormal or are evolving. Bring up spots of concern at your next skin check. Regular self-exams and professional screening are key for early detection.

When to Seek Evaluation for Brown Spots

Schedule a prompt dermatology appointment if you notice any of the following warning signs:

• New brown spots that are changing or evolving
• Spots that look different from others on your body
• Large brown spots (>6 mm diameter)
• Irregularly shaped or pigmented spots
• Dark brown, black, red, white or blue spots
• Raised, uneven textured spots
• Spots with scaliness, itchiness, oozing or bleeding
• Brown spots on the palms, soles, fingernails or mouth

For high risk individuals with many moles or atypical nevi, regular total body exams by a dermatologist are recommended. This can help detect any concerning changes early on.

Treatment Options for Benign Brown Spots

When brown skin spots are bothersome for cosmetic reasons, several treatment options are available to remove them. Discuss the pros and cons of each approach with your dermatologist:

• Cryotherapy - Freezing with liquid nitrogen
• Chemical peels - Application of acid solution
• Laser therapy - Targeted light energy destroys pigment
• Dermabrasion - Controlled surgical scraping
• Excision - Surgical cutting and removal

Procedures are usually done right in a dermatologist’s office. Downtime, cost, side effects, and results vary for each method. Sunscreen use after treatment helps prevent new brown spots from forming.

When to Seek Urgent Care

While most brown skin spots are harmless with monitoring, any mole or mark that changes quickly or looks suspicious needs immediate medical attention. Seek emergency care if you notice:

• Rapid change in a mole’s appearance, size, shape or symptoms
• New swelling, lump or bleeding from a brown spot
• Brown spots spreading quickly or forming open ulcers
• Significant pain, itching or burning from a suspicious mole

Catching melanoma and other skin cancers early is crucial for the best prognosis and survival. Don’t wait with worrying changes - seek same day evaluation to get concerning spots biopsied as needed.

Protecting Your Skin from Damage and Spots

While many benign brown skin spots are harmless, measures like these can help minimize sun damage contributing to their development and evolution:

• Use broad spectrum sunscreen daily
• Avoid prolonged sun exposure
• Wear protective clothing and hats
• Don’t use tanning beds
• Examine skin regularly for changes
• Get annual skin cancer screenings
• See a dermatologist for suspicious spots

Being sun smart and aware of your skin health can help catch developing issues early. Consult a doctor right away about concerning skin changes for optimal outcomes.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.