Why pigment spots appear on the face: causes of pigmentation, types of pigmentation and treatment

Milium (horny cyst, whitehead, “millet”) is an epidermal cystic formation at the mouth of the hair follicle, looking like a small white grain. Typically, milia are localized on the face in areas with relatively thin skin, very rarely on the body, and exist for a long period without any changes. Milia are a fairly common cosmetic problem and can occur at any age. Whiteheads appear especially often during puberty; also often found in newborn babies (neonatal acne). Female representatives are more susceptible to the appearance of milia.

How is it formed

Every person from birth has a genetically determined skin color - the so-called permanent pigment.
When exposed to external and internal factors, an additional one is produced, which can be either a temporary physiological phenomenon (natural tanning) or a pathological one, difficult to remove even with special lasers (lentigo, vitiligo, etc.). The formation mechanism itself occurs in the epidermal layer. Here are located keratinocytes - epidermal cells. Their life cycle is up to 60 days, so they are constantly updated. To protect young and vulnerable cellular structures from sun exposure, melanocytes exist. They belong to the nervous system and are called upon to produce melanin, which absorbs ultraviolet radiation.

If the body is healthy, there is no overdose of solar radiation, melanocytes will produce a sufficient amount of protection. However, if there are failures, the “protectors” begin to be distributed unevenly, which leads to the formation of hyperpigmented areas.

Causes of hyperpigmentation

An increase in melanin production can be associated both with physiological changes occurring in the body and as a result of pathologies. The most well-known factors influencing the occurrence of stains are:

• endocrine diseases;
• hormonal changes during pregnancy or menopause;
• diseases of the gastrointestinal tract and adrenal glands;
• metabolic disorder;
• vitamin deficiency or hypervitaminosis;
• helminthic infestations;
• severe intoxication of the body;
• trauma or inflammatory processes;
• prolonged exposure to the sun;
• taking medications - antibiotics of the tetracycline group, gentamicins, erythromycins, as well as some NSAIDs, salicylic acid, antidepressants, diuretics, sleeping pills and sedatives, antihistamines, St. John's wort extract, etc.;
• heredity.

Changes can also appear due to prolonged stress. Since melanocytes belong to the nervous system, any fluctuations and unstable conditions lead to serious pigmentation disorders.

Causes

The main reasons for the appearance of red spots on the skin of the face:

• Direct skin contact with an allergen (cream, face mask, decorative cosmetics, soap, jewelry, etc.);
• Food allergies;
• Allergy to medications;
• Allergy to sun or cold;
• Eczema1.

To prevent the appearance of a rash in the future, it is necessary to accurately determine the cause of the allergy and eliminate contact with this substance.

Localization of spots

They can have different sizes, both with clear contours and blurry ones, merge together or not grow at all. Depending on the differential diagnosis and the type of hypermelanosis, they can be located both in certain areas and without specific boundaries, covering absolutely any area of ​​the body.

On the face

One of the most common sites of localization of many hyperpigmentations. This is due to the fact that the skin here is thin enough so that negative factors can attack them faster. Among the common phenomena are freckles, which can decorate the face all year round and also appear and disappear after exposure to the sun. They are also localized over the entire surface or located pointwise in the area of ​​the cheeks, eyes, and forehead.

Anti-age drugs

Bb Laboratories – Delicate oil for deep cleansing

Laennec – solution for injection

Bb Laboratories – Two-phase serum concentrate

Two-phase placental serum concentrate

On the body

Namely on the arms, shoulders, chest, back, groin area. For each individual disease, there are areas where pigment accumulation is observed. For example, senile hyperpigmentation is typically located on the hands, forearms, and upper back.

There are various causes of hypopigmented spots on a child's face, ranging from conditions that resolve on their own within a few weeks to conditions that can last a lifetime.

Causes of white spots on a child's face

White spots can be caused by the following skin conditions:

Milia

Milia are also called milk spots. These tiny white bumps usually appear on the face and rarely on the upper torso or limbs. Although milia can be seen at any age, it is common in newborns.

Causes and diagnosis of milia

Milia occurs due to entrapment of keratin (skin scales) beneath the surface of the skin. If there is no improvement after a couple of weeks, you should consult a doctor. Diagnosis is made by visual examination and no tests are required.

Prevention and treatment of milia

There is no cure for milia and it often goes away within a few weeks or months. There is no need to treat milia in children.

How can you reduce milia at home?

• Wash your child's face daily with mild soap and water.
• Pat your face dry after washing.
• Be careful not to scratch the milia to prevent skin damage and infection.
• Do not apply lotions or oils to your baby's face.

Note: Some may confuse baby pimples or Epstein pearls with milia. However, acne can cause red bumps and pustules on the face. Epstein's pearls are small, white-yellow cysts that often resemble milia, but they appear on the roof of the mouth and gums.

Pityriasis alba (lichen alba)

Pityriasis alba is a self-limiting skin condition that causes dry, thin, scaly and pale patches on the face. It is common in children and adolescents and is considered a type of eczema or dermatitis.

The name of this condition comes from the characteristic appearance of the skin.

Causes of white ptyriasis

The causes of white ptyriasis have not yet been clarified. However, atopic dermatitis and dry skin often coexist with it. Exposure to the sun can make it more visible by tanning the surrounding skin.

Suspected causes such as under- or over-bathing, low serum copper levels, ultraviolet radiation, or Malassezia yeast have not yet been proven to cause hypopigmentation.

Symptoms and signs of ptyriasis alba

One or more white spots, varying from 0.5 to 5 cm in diameter, are a characteristic sign of pityriasis alba. It may also cause mild itching in some children.

Diagnosis of pityriasis versicolor

The condition can be diagnosed through a physical examination by a doctor. A skin biopsy may show mild spongiotic (fluid accumulation between cells) dermatitis with decreased melanin pigment. A skin scraping may also be taken to rule out a yeast infection.

Treatment of white lichen

Treatment is not recommended in asymptomatic cases. Moisturizers are helpful for dry skin, and mild hydrocortisone (topical steroid) creams can help reduce itching and redness in the area.

Tacrolimus ointment, pimecrolimus cream, and calcineurin inhibitors have been shown to be effective in the treatment of pityriasis alba.

The appearance of the skin may gradually return to normal over several months or two to three years.

Prevention of white deprivation

Limited sun exposure may help reduce your risk of developing this disease.

Vitiligo

Vitiligo is a depigmentation of the skin due to the loss of melanocytes, which are the cells that produce the skin pigment called melanin. Vitiligo can affect both sun-exposed and unprotected areas of the body. Also, with the disease, depigmentation of the lips and gray hair are often observed.

Causes of vitiligo

The exact causes of vitiligo are unknown. The disease may be associated with dysfunction or loss of melanocytes (the cells that produce the pigment melanin), which give the skin its color. This may be due to genetic factors or an autoimmune condition in which the immune system attacks the melanocytes.

Vitiligo can occur at any age, but the onset of the disease is typical in children and adolescents.

Diagnosis of vitiligo

Vitiligo can be diagnosed through a physical examination. Rarely, a skin biopsy is performed to help confirm the diagnosis by the absence of melanocytes (pigment cells) on the skin. Thyroid disease and diabetes are checked as these may increase the risk of vitiligo in many people.

Treatment of vitiligo

Mild vitiligo may not require treatment: the spots will disappear over time. However, there are several treatments available to make your skin tone even.

Corticosteroid creams, photochemotherapy (PUVA), narrow band ultraviolet B (UVB) therapy, and depigmentation are a few treatment options. Using sunscreen can reduce tanning of the skin around vitiligo patches, and concealers can hide white spots on the skin.

Although vitiligo can be distressing to many people due to its appearance, it is not a medically dangerous condition. Vitiligo is not an infection, skin cancer, or a contagious disease.

Shingles

Shingles is a fungal skin infection that causes lighter or darker patches on the skin. The disease occurs at any age, but is most often seen in adolescents and young adults.

Causes of herpes zoster

Shingles is caused by a yeast that is usually present on the skin. Their excessive growth under the influence of environmental factors can lead to the appearance of spots on the skin. Malnutrition and excessive sweating (hyperhidrosis) can also lead to yeast growth.

Note: Shingles cannot be passed from one person to another (not contagious) since most people have Malassezia yeast on their skin. This condition is not caused by poor hygiene.

A weak immune system, oily and moist skin, or hot and humid climates may increase the risk of contracting shingles. Children taking corticosteroid medications may also be susceptible to this condition.

Signs and symptoms of shingles

Although white patches can appear on the face, they are often found on the chest, back, and forearms. The spots may be pink or light brown and have scales. Skin changes are usually limited to the outer layer of the skin and often do not cause any pain or itching.

Diagnosis of herpes zoster

A physical examination is sufficient to diagnose shingles. In rare cases, doctors may collect a skin scraping to confirm the diagnosis.

Treatment of herpes zoster

Shampoo containing selenium sulfide is the main treatment method. If the condition does not go away, then you can use antifungal or anti-dandruff shampoos. The skin may improve over a short period of time in many children. However, it may take several months to achieve an even skin tone. To prevent relapse of the disease, monthly use of shampoo is recommended.

Idiopathic guttate hypomelanosis

Idiopathic guttate hypomelanosis (IGH) is a skin condition with small, white, oval patches.

IGH is more common in older, fair-skinned people than in children and often goes undetected.

Causes of idiopathic guttate hypomelanosis

The exact cause of hypomelanosis is unknown. Although this has not yet been proven, it is believed that it may be related to sun exposure.

Diagnosis of idiopathic guttate hypomelanosis

A physical examination is sufficient to determine the condition. Rarely are biopsy samples taken. There is usually a decrease in the number of melanocytes in the affected areas, although they are not completely absent as in vitiligo.

Treatment of idiopathic guttate hypomelanosis

IGH spots are benign and do not require medical treatment. Most procedures are aimed at improving the cosmetic appearance of the skin.

Home remedies may include regular use of sunscreen and physical barriers to prevent sun exposure, as it can promote or accelerate hypomelanosis.

References:

1. Milia; Healthychildren; The American Academy of Pediatrics
2. Milia; MedlinePlus; The United States National Library of Medicine
3. Pityriasis alba; DermNet NZ; The New Zealand Dermatological Society
4. Donald N. Givler, et al.; Pityriasis Alba; The United States National Library of Medicine
5. Pityriasis alba; C. S. Mott Children's Hospital; The University of Michigan 6. Pityriasis alba; The Australasian College of Dermatologists (ACD)
6. Vitiligo; The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases
7. Vitiligo; National Health Service
8. Diagnosing Vitiligo; NYU Langone Medical Center
9. Vitiligo: Diagnosis and Treatment; The American Academy of Pediatrics
10. Tinea Versicolor; Harvard Medical School
11. Pityriasis Versicolor; National Health Service
12. Falon Brown and Jonathan S. Crane; Idiopathic guttate hypomelanosis; The United States National Library of Medicine
13. Idiopathic guttate hypomelanosis; DermNet NZ; The New Zealand Dermatological Society

Types and symptoms of age spots

Let's consider the most characteristic signs of hypermelanosis, as well as control methods that are relevant for each specific type of pathology.

Freckles

The most common type of melanin accumulation. They are mainly located on the face, in the cheek area. In advanced cases, they can completely cover the entire surface of the skin with small distances between the spots. And also have a round or oval shape, small diameter, clear contours.

Genetic predisposition plays a major role, so freckles can appear in childhood. People with red and blond hair are most susceptible to them. This is due to the need for high melanin production to protect the skin.

Freckles can be easily distinguished from other types of spots by the complete disappearance of pigmentation in cold weather, and the appearance of a whole scattering on the face with the arrival of warmth. Therefore, to combat them, creams with maximum sun filters are used throughout the year, as well as lightening cosmetics.

Melasma

Spots without clear boundaries and endings, varying in shade from bronze to dark brown. They have the ability to stretch, grow, and merge with each other into huge pigmented areas that occupy a large surface of the body. The main provoking factor is considered to be hormonal disorders caused by menopause, pregnancy, and the use of oral contraceptives. Treatments include peeling methods and procedures that promote cell renewal. When the root causes are eliminated, the stains quickly disappear.

Melasma

The second name is melanosis. It can be acquired or hereditary, manifests itself in the form of an accumulation of melanin with uneven but clear boundaries and localization in open areas of the body. May occur as a result of Addison's disease, hemochromatosis, due to sensitivity to ultraviolet radiation, anthracene or acridine substances, diseases of the pituitary gland, ovaries, adrenal glands, syphilis, tuberculosis, malaria, treatment with hormones. Pigmentation is accompanied by redness, itching, peeling, and roughening of the skin.

To prevent progress, sunscreens are used, drug therapy is prescribed with steroid groups, retinoids, hydroacids, and vitamins B (1.6) and C are additionally used.

Becker's nevus

A characteristic defect in men, it is much less common in women. The first manifestations can be as early as 10 years of age. It is a hyperpigmented area protruding above the surface of the skin, on which dark long hairs grow. It occurs both as a result of genetic factors and can appear after sun exposure, changes in hormonal levels, in particular androgens. The location most often is the upper back and chest; it is not often found on the legs, groin, or head. It has a warty surface on which acne or comedones can be seen. Does not respond well to any cosmetic procedures or medications. An argon laser is used to minimize the aesthetic defect.

Secondary

Occurs at the site of mechanical damage. They can be either deep cuts, scratches, or acne, comedones, ulcers and other superficial causes that trigger the inflammatory process in the skin cells. There is an excess of melanin, resulting in staining. They are localized where the damage was and go away after the area returns to normal and the inflammation disappears. To speed up the lightening process, you can use special lightening creams or cosmetic procedures aimed at renewing the epidermal layer.

Age

As we age, the negative effects of ultraviolet radiation lead to increased melanin production in certain areas of the body. These are usually open areas that have been exposed to a lot of sunlight during their lifetime. With age, spots appear with a diameter of 1 to 5 cm, which are darker in color than the entire surface of the skin.

Berlocc's dermatitis

Refers to contact types of immune response to irritants. Usually due to contact with perfumes, colognes, and deodorants. It is located where the skin came into contact with the substance. Symptoms may include not only a change in the color of the dermal layer, but also itching, peeling, and swelling. It disappears quickly, just stop using perfume and in a few days everything will return to normal.

Chloasma

Large spots can merge into one large skin defect. They do not have a clear contour or boundaries and can grow and increase in size throughout life. Among the provoking factors are pregnancy and lactation, menopause, changes in hormonal levels due to diseases, stress, taking oral contraceptives, steroids, the use of hormone-containing ointments and some cosmetics.

Ulcers caused by oral diseases

White sores in the mouth can appear due to diseases of the oral cavity. The most common cause is stomatitis. It comes in several types:

• aphthous;
• herpetic;
• bacterial;
• fungal.

What causes pigment spots to appear on the face after sunbathing?

Most manifestations of hyperpigmentation occur after the negative effects of ultraviolet rays. Among those that immediately appear are freckles, various melasma and chloasma. There are also those that have a cumulative effect, for example, lentigo.

Also, if during the summer vacation there were inflammatory processes in open areas of the body, most likely after they heal, a change in shade can be clearly observed.

Prolonged exposure to the hot sun with the presence of existing tumors and increased pigmentation can be fraught with the degeneration of harmless spots into aggressive cancer - melanoma. Therefore, you should limit your tanning time and use special cosmetics for protection.

Age spots and peeling

Melanin accumulation occurs in the upper layers of the epidermis. In order to remove unaesthetic problems, products that stimulate the renewal of the dermis are used. The most effective peelings are: chemical, mechanical, laser. They promote the regeneration of epidermal cells, forcing keratinocytes to produce new ones as quickly as possible, which will not have a large accumulation of coloring pigment. When eliminating the root causes of hyperpigmentation, there is a chance that you will forget about various spots for a long time.

Causeless manifestations

It happens that people try to protect their skin, use special sunscreens, but hyperpigmented areas still appear. It's like it happens for no apparent reason. However, for melanocytes to malfunction, even a small but prolonged stress or temporary hormonal imbalance is enough.

It is also worth noting the cumulative negative effect of ultraviolet radiation, which can manifest itself over the years on areas of the body that received sunburn in early childhood. Therefore, only at first glance it seems that hypermelanosis arose without provoking factors. In fact, he has hidden reasons.

Liver pigment spots

Deterioration in the functionality of internal organs can also lead to the formation of aesthetic defects. The liver plays the role of a filter, retaining and processing all dangerous substances, and then removing them from the body. In cases where she fails to cope with her duties, slow but sure intoxication occurs, which is manifested not only by internal, but also by external pathologies.

Metabolic processes in tissues are disrupted, including the normal distribution of melanin; it accumulates in certain areas. Most often it appears on the face. The contours of such spots are not uniform, they do not have a clear boundary. The color can also vary from light to dark brown.

Lentigo

The phenomenon is popularly known as “senile ripples.” Appears in older people in areas of the body that have been exposed to intense ultraviolet rays throughout their lives. The pigment usually appears on the arms from the hands to the top of the shoulders, upper back, décolleté, and face. It is distinguished by its small size, different diameters and chaotic arrangement of spots.

The first manifestations can be noticed after 40 years; they noticeably age the appearance, so many people at this stage turn to cosmetologists to eliminate the defect. During menopause, hormonal changes lead to an increase in the amount of pigment. Chemical, mechanical and laser peels are used for treatment. Cosmetics and whitening creams will not cope with the problem.

Contact dermatitis

Contact dermatitis rashes are most often localized on the hands or face. An allergic reaction can be triggered by:

• Skin care products. It is important to pre-test creams, masks, lotions and other new products by applying a small amount of product to the inner surface of the forearm for 15-20 minutes.
• Decorative cosmetics. Contains a large number of coloring pigments, fragrances and preservatives. People with sensitive skin prone to dryness and irritation are more prone to allergic reactions.
• Plant pollen. When pollen from plants to which a person is allergic comes into contact with the skin, a rash, itching and other unpleasant symptoms may appear.

Red spots may appear either immediately after contact with the allergen or after some time (usually within 24-48 hours). If you find the cause of the allergy in time and stop using the inappropriate product, then no negative health consequences will be noted.

Solarium - is it harmful?

It is also a mistake to think that sun tanning is harmful, and nothing will happen in specialized salons in a few minutes. On the beach, the skin gets a lot of heat, but this happens gradually. In the booths, a loading dose of ultraviolet radiation is given in a few minutes, which is difficult to obtain outdoors even in a whole day.

People with a fair skin type, with the presence of moles and nevi, freckles, existing aesthetic defects in the form of increased melanin production, need to get rid of the habit of visiting a solarium. The consequences can be expressed both in the progression of unsightly changes in the epidermal layer, and in their degeneration into malignant neoplasms.

Allergies to foods and medications

Food allergies on the face are quite common, especially in children. The most allergenic foods are peanuts, eggs, seafood, citrus fruits, and dairy products. However, in the presence of individual intolerance, an allergy can develop to any other food product.

Main symptoms:

• blotchy rash on the face or body;
• Severe itching;
• Peeling of the skin;
• Nausea, vomiting;
• Stool disorders;
• Abdominal pain.

Another important problem is drug allergies. An allergic reaction may occur to a medicine in the form of a tablet, injection, or ointment. Allergies to antibiotics, antiseptics, and nonsteroidal anti-inflammatory drugs are common. The symptoms are the same as those of a food allergy. In severe cases, complications such as angioedema or anaphylactic shock may develop2. You need to know what drugs you are allergic to and warn doctors or medical staff about it.

Diagnostics

To accurately determine the type of hypermelanosis, as well as to identify effective means of control, you need to contact a dermatologist. At the initial visit, the doctor will collect the patient's medical history to determine the most likely internal and external factors that will indicate a certain type of disorder. He will examine the skin and also prescribe a number of tests:

• AOK and OAM;
• blood biochemistry;
• Wood's lamp tests;
• scraping;
• biopsy.

If a malignant neoplasm or fungal infection is suspected, referrals will be given for the last two procedures on the list. As a result, the specialist will be able to accurately determine the type of illness and prescribe therapeutic or cosmetic procedures.

Anti-age drugs

Bb Laboratories – Hyaluron-elastin-collagen extract

Laennec – solution for injection

Curacen Essence (20 fl x 2 ml)

Two-phase placental serum concentrate

How to fight

Among the modern and effective methods of struggle, it is worth highlighting:

• cosmetic preparations;
• laser peeling;
• phototherapy.

Depending on the variety, medications may be prescribed to address the underlying causes. However, to remove an aesthetic defect, it will be necessary to wait for the cell surface to renew itself, or to help it renew itself faster with the help of additional deep peeling and cosmetic photorejuvenation procedures.

Cosmetic preparations

Among the popular drugs that give noticeable results in the fight against hyperpigmentation are placental products with a high content of natural peptides, amino acids and hyaluronic acid, as well as vitamins, micro- and macroelements. Injection product Curacen (Curasen) and non-injection drug Curacen Essence (Curasen Essence) are the ideal choice of cosmetologists for triple action: brightening, moisturizing and eliminating wrinkles. You can also use specialized cosmetics from the Laennec Skincare brand - LNC. This line offers to transform the skin at the cellular level, eliminating and preventing hyperpigmentation.

Now you know about the main causes of pigmentation, as well as what causes the appearance of age spots on the face, and you can easily answer the question - what to do when pigments have already appeared. Dermatologists recommend not only limiting time spent on the beach and using sunscreen in summer, but also year-round use of skin protection from the negative effects of ultraviolet radiation. It is this that becomes the main catalyst, and in combination with internal disorders of the body can lead to serious changes in the epidermal layer.

Treatment of milia

Milia do not go away on their own; it is almost impossible to get rid of them with the help of cosmetics. Under no circumstances should you squeeze out milia yourself, as this will damage the hair follicle and sebaceous gland. Such self-medication often leads to the subsequent formation of a larger acne or the addition of an infection, which can cause the formation of a rough scar.

Treatment of milia is carried out by a dermatologist and consists of opening and removing the cyst capsule with its contents. The choice of removal method depends on the location, number, size and depth of the milia. For single milia, mechanical removal is carried out (using a sterile needle and curettage) with preliminary and subsequent antiseptic treatment of the skin. Small wounds left after such a procedure heal on their own without leaving a trace.

For multiple whiteheads, modern methods are used - removal of milia with a laser, radio wave method or electrocoagulation. The crusts formed at the cauterization site disappear on their own within 10-14 days. Removing more than 10 elements at one time is not recommended to avoid significant trauma to the skin and disruption of the sebaceous glands.