Spots on the skin, dyschromia: What's it, causes, symptoms, diagnostics, treatment, prevention

Patchy skin color; Dyschromia; Mottling

Spots on the skin, also known as dyschromia, is a term, used to describe skin color changes. It usually appears as a local area of ​​discoloration., darker or lighter, than the surrounding skin. In some cases, mottled skin may also have an irregular pattern and may appear to be a "spot" or "bleed" on other areas of the skin.. It often happens suddenly and can affect both men, and women of all ages.

Mottled or speckled skin refers to changes in the blood vessels in the skin, that cause a spotty appearance.

Causes of dyschromia

There are many possible causes of patchy skin color.. These include:

sun exposure

Prolonged exposure to ultraviolet (UV) sun rays can cause, that uneven patches of pigmentation appear on the skin, known as solar lentigo or "liver spots". These dark spots, usually, appear on the surface of the skin as a result of sun damage and are especially common in people with fair skin.

Medication

Reactions to certain drugs, including some antibiotics, can sometimes cause patchy skin. This pigment change usually disappears after the medication is stopped..

Hormonal changes

Changes in hormone levels due to pregnancy, menopause or taking birth control pills can sometimes cause patchy skin.

Inflammation and infection

Inflammation or infection of the skin can also cause patchy skin color.. Common causes of this type of skin discoloration include:

• • Eczema
  • Psoriasis
  • Vitiligo
  • Fungal infections.
  • Viral infections.
  • Bacterial infections.

Genetic factors

Certain genetic conditions, such as albinism, can cause patchy skin color. For Example, with albinism, the skin lacks pigment, which results in white or light patches on normally pigmented skin.

Then, How much skin pigmentation do you have?, can help determine, Which skin conditions are you most likely to develop?. For Example, fair-skinned people are more sensitive to sun exposure and damage. It increases the risk of skin cancer. But even in dark-skinned people, excessive sun exposure can lead to skin cancer..

Examples of the most common types of skin cancer are basal cell carcinoma. , squamous cell carcinoma and melanoma .

Usually, skin color changes are cosmetic and do not affect physical health. But mental stress can come from pigment changes. Some pigment changes may be a sign, that you are at risk for other medical problems.

Diseases and disorders, which can cause dyschromia

Causes of pigment change may include any of the following:

• Black acanthosis
• Acne
• Places of coffee with milk
• Cuts, scratch, wounds, insect bites and minor skin infections
• Erythrasma
• Melasma (chloasma)
• Melanoma
• Moles ( nevus ), bathing trunk nevi or giant nevi
• Cutaneous melanocytosis
• white lichen
• Radiatsionnaya therapy
• Rash
• Sensitivity to the sun due to reactions to medications or certain medications
• Sunburn or tan
• Chromophytosis
• Uneven application of sunscreen, what causes burns, tan and no tan
• Vitiligo

Symptoms of dyschromia

The most common symptom of patchy skin color is a dark or light area on the skin., which is different from the surrounding skin. In some cases, the area may look like a "spot" or "bleed" into other parts of the skin. In other cases, the discoloration may have a "mottled" or "banded" appearance..

The affected area of ​​skin may also be rough or thick to the touch.. In some cases, people with patchy skin patches may also experience itching or burning in the affected area..

When to see a doctor

If you notice any changes in skin color or texture, it is important to see a doctor to assess the condition. This is especially true, if the spots are new or growing in size, or if they are accompanied by other symptoms, such as itching or burning.

Questions, which your doctor may ask for dyschromia

Your doctor may ask various questions, to help identify the cause of patchy skin color. These may include:

• When did you first notice changes in skin color??
• Has it been before?
• Do you have other symptoms in the area?
• Have you had a history of eczema, psoriasis or other skin conditions?
• Are you taking any medications or supplements?
• Have you ever had any drug allergies??
• Have you been out in the sun lately?

Diagnosis of dyschromia

In most cases, skin patchiness can be diagnosed based on a medical history and physical examination.. Your doctor may also order tests, such as a skin biopsy, to help diagnose the cause of discoloration.

Tests, which can be fulfilled, include:

• Scrapings from skin lesions
• Skin biopsy
• Wood's lamp (ultraviolet light) skin examination
• Blood tests

Treatment will depend on the diagnosis of the skin problem..

Treatment of dyschromias

Treatment for mottled skin depends on the underlying cause.. In some cases, discoloration may disappear without treatment.. In other cases, treatment may be recommended, including:

• Medicines for topical use, such as corticosteroids, to reduce inflammation and even skin tone.
• Light therapy, e.g. broadband UV and excimer laser, helps reduce discoloration, caused by exposure to sunlight or certain skin diseases.
• Oral formulations, e.g. antibiotics, to treat bacterial or fungal infections.
• Medicines, e.g. hormones, which help regulate the production of melanin pigment.
• Creams and serums for skin whitening, to reduce the appearance of discoloration.

Home treatment for dyschromia

In addition to any medical treatment, recommended by your doctor, there are also some home remedies, which can help reduce patchy skin color. Some of these tools include:

• Avoid exposure to the sun, wear protective clothing and use a broad-spectrum sunscreen with an SPF (SPF) no less 15.
• Use skin care products, containing such ingredients, like vitamin C and retinol, to remove discoloration.
• It is necessary to drink plenty of water, keep the skin well hydrated.
• Eat a balanced diet, containing plenty of fruits and vegetables, to nourish the skin.
• Use mild soaps and moisturizers, to keep skin healthy and hydrated.
• Avoid certain skin products, which can cause allergies or skin sensitization.

You can use medicated creams, that whiten or lighten the skin, to reduce discoloration or even out skin tone, when areas of hyperpigmentation are large or very visible. Consult a dermatologist first about using such products.. Follow the instructions on the package for, how to use such products.

Selenium Sulfide Lotion (Selsun Blue), ketoconazole or tolnaftate (tynaktin) may help treat pityriasis versicolor, fungal infection, which may appear as hypopigmented macules. Apply as directed to the affected area daily., until the discolored spots are gone. Pityriasis versicolor often returns, even with treatment.

You can use cosmetics or skin dyes, to hide skin color changes. Makeup can also help hide skin blemishes., but it won't solve the problem.

Prevention of dyschromia

The best way to prevent patchy skin color is to take steps to protect your skin from sun damage.. This includes wearing protective clothing., using a broad-spectrum sunscreen with an SPF of at least 15 and avoiding prolonged sun exposure.

It is also important to avoid certain medications or skin care products., which can cause patchy skin color. If you are taking any medications or using any skin care products, it is recommended to talk to your doctor or dermatologist, To make sure, that they do not cause skin discoloration.

Used sources and literature

Calonje E, Brenn T, Lazar AJ, Billings SD. Disorders of pigmentation. In: Calonje E, Brenn T, Lazar AJ, Billings SD, eds. McKee’s Pathology of the Skin. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 20.

Patterson JW. Disorders of pigmentation. In: Patterson JW, ed. Weedon’s Skin Pathology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 11.

UBRIANI RR, Clarke the, Ming ME. Non-neoplastic disorders of pigmentation. In: Busam KJ, Goldblum JR, eds. Dermatopathology. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 7.