Dark Spots: Causes & Types

Out dark spot! Said the queen in Macbeth. It’s true. Nobody likes to see dark spots and blemishes on their skin. Immediately, the anxious mind looks towards the online search for a remedy. Please remember, not all the so-called doctors or wanna-be therapists thrown up on an online search are qualified! Taking advice from beauty parlours or marketing websites is not really wise. 

To look for qualified doctors to treat your problem, always look up the Maharashtra Medical Council website, which lists the names of skilled physicians and surgeons. Dark spots can be moles, freckles or age-related changes in the skin, sun damage such as keratosis and sometimes even cancer of the skin, like Melanoma. 

Moles

• They are of different sizes and thickness. Nature has bestowed the skin with cells that can manufacture dark pigment. Such cells, called melanocytes, are located in the lower layer of the skin. These cells store bags of melanin, the dark pigment. The more such bags, the darker the skin. 
• In regions with exposure to bright sunlight for most of the year, the skin is endowed with many such cells to protect it from sun damage and cancer. Does this not make you realize how foolish it is to judge beauty from skin colour? In fact, the dark pigment melanin is nature’s bounty for your protection. Collections of such melanocytes are called moles. 
• Some moles are thick and may rise above the surface of the skin. These are congenital mixed moles. They contain oil and sweat gland openings as well as hair follicles. When do they need to be removed?
  
  If you notice the following: 
  • Moles have started growing in size or are becoming darker. 
  • their borders are not clear, or 
  • the borders are merging and becoming difficult to discern from the neighbourhood skin
  • if they start itching, then that is the time to remove them. 

Sometimes, people feel like removing moles for their appearance, yet are worried about scars left behind by surgery. 

Keratosis

• These arise as part of aging or due to sun exposure. They can be brownish, dark, rough on the surface, and thick. They may look like a patch on the skin from above. Even though they are not malignant, they still represent an unregulated or excess growth of cells. Sometimes, they may resemble some types of skin cancer, and a biopsy may be required to distinguish them. 
• Common places where keratosis can develop are the face and the arms. Plastic surgeons perform skillful surgery to remove unwanted moles or keratosis while leaving the least possible scar. If any scar remains, it can be cleared by using a fractional carbon dioxide laser. 
• However, if there is any suspicion of malignancy, then they remove an additional 2-5-millimetre border of skin around the lesion and send it for biopsy. This procedure is called excisional biopsy. While sending the tissue as a whole, sutures are kept in the tissue as indicators of direction. This helps the surgeon know in which direction to remove further skin if cancer is discovered. This allows a total removal. 
• Some people apply lime or nirma powder mixed with jaggery to remove unwanted moles. This causes burns to the skin and leaves an unsightly ulcer or black scar. Such damage can be very difficult to treat. 

Procedures to Remove Moles

Laser treatment or fat transfer are some procedures tried by plastic surgeons to reduce such scars, but complete success cannot be guaranteed. Dark brown moles are present in the upper layer of the skin. Q switched ND Yag laser machines are used by dermatologists and plastic surgeons to treat them. 

Several sittings are required to get rid of such moles using lasers, usually at monthly intervals.

Verrucous Nevus

• Some children are born with dark, rough spots. These grow with the child. If they are not removed at the right time, they can sometimes get infected or bleed. 
• It is not wise to postpone surgery for removal of the nevi. Postponement achieves nothing; as the child grows, the nevus grows and leads to an even more extensive surgery in the future. 
• So when the child is of an age that he can sustain anaesthesia and surgery, the procedure should be done by qualified plastic surgeons who have the training and experience for such operations. 

Skin Cancer

• There are many types of skin cancer. Squamous cell carcinoma appears like a dark spot. Basal cell carcinoma arising from the lower layer of the skin is a dangerous disease. Excision biopsy can remove it. 
• Protection from sunlight is necessary to avoid this cancer. Sunscreen with an adequate SPF value is recommended for all exposed to sunlight. 
• It is better to use clothes that cover the body properly, plus caps and umbrellas when you visit regions with bright sunlight, tall hills or beaches, and snowy regions where reflected sunlight is a problem. 
• Melanoma and squamous cell carcinoma can spread and become life-threatening. Many new types of treatment are available for these malignancies, but they can still be difficult to get rid of if they have spread. 
• There are many other types of dark spots on the skin, apart from moles and melanomas. Very often, inflammation of the skin is followed by dark-pigmented areas. Hence, burns, pimples, insect bites, and skin irritation due to the application of some balm or ointments can also be followed later by black or dark pigmented areas. 

Hemosiderin

Sometimes, dark areas may result after trauma or skin infections. When there is inflammation or allergy in the skin, new blood vessels develop, or the old ones open and expand. Such blood vessels leak haemoglobin into the skin and under the fat layer. Such leaked hemoglobin can decompose into a dark pigment called hemosiderin. 

Some people apply balm to the face or forehead and then take steam inhalations to treat their common cold. This also can be followed by unwanted darkness of the face. 

Melasma

Hormones that accumulate in the body during pregnancy or even by intake of contraceptive pills can cause dark grey, brown, or blackish spots on the face. These are particularly visible on the cheeks, nostrils, forehead, and chin. On exposure to sunlight, such spots become darker. This is known as melasma, or the mask of pregnancy. 

Solar Lentigines or Sunspots

Sunlight has marked effects on the skin. Unless you use an effective sunscreen, gradually, you may develop small brownish blemishes on the skin. 

When sunspots gradually spread and become darker and thicker, they may lead to keratosis or some types of skin cancer. 

Therefore, it is always better to take proper specialist opinion when black spots are of a small size and not to be afraid of surgery if advised. It is easier to remove without leaving a significant scar or deformity if it is operated in time. A stitch in time saves a life. To get more information about the dark spots you have or basically to identify the type of dark spot and its suitable treatment, consider consulting the best plastic surgeon in Thane, Mumbai, Dr. Medha Bhave, at Laser Cosmesis Clinic.