Most women have some form of skin pigmentation, which they often worry about the depth or amount of. The most well-known types are freckles and hormonal spots. Skin pigmentation refers to an overproduction of melanin in certain areas of the skin, and the cause and distribution of melanin affect the type of pigmentation and treatment methods.
Some may wonder why melanin is considered a nuisance when it’s responsible for the skin’s self-protection. When the skin is exposed to ultraviolet radiation, melanocytes release melanin to block harmful UV rays, but excessive accumulation of melanin results in skin pigmentation. Various types of pigmentation have different causes, but UV radiation is often the main culprit. Let’s examine some common types of pigmentation:
Freckles are the most common type of pigmentation. They are small, irregularly shaped, light brown spots that appear on the cheeks, nose, eyelids, or forehead. Freckles are caused by UV radiation and are more likely to occur in those who have inadequate sun protection or have family members with similar conditions. Treatment for shallow pigmentation is relatively easy and can involve various methods.
Sunspots or lentigo is another form of pigmentation caused by UV radiation. Like freckles, melanin is found in the epidermis, but the spots are larger and darker. If the pigmentation appears uneven and enlarges, a doctor should be consulted as it may be a form of melanoma called lentigo maligna. Shallow pigmentation like freckles can be treated relatively easily.
Café au lait spots are named after the color of coffee mixed with milk (light brown). These pigmentation spots are unrelated to UV radiation and are caused by congenital pigment deposition. Although they may be present from birth, they can become more prominent and may be a sign of congenital genetic diseases, such as neurofibromatosis. Treatment for café au lait spots is more challenging and usually involves laser treatment with a high risk of recurrence.