All Types of Skin Spots and How to Treat Them
What are spots on the face and skin, what causes skin spots, what types are they and how are they treated? How about looking at the answers to these questions from the Women’s Alphabet archive? If you’re ready, let’s start…
The spots that appear in various parts of the body, especially in the face area, can affect our psychology badly. No demoralizing though; If you do not stop the treatment and do what your doctor says, your spots may be history.
Sun, age and wound; We can show this trio as the source of the spots on our skin. Although from different sources, there is a common feature of skin spots, their recurrence despite treatment. For this reason, many people are unhappy with their spots and do not approach the treatment. However, the correct detection of the skin spots, the selection of the appropriate treatment and the continuity of the treatment allow you to get rid of the spots.
What are skin spots?
The pigment melanin, which gives the skin its color, is formed in cells called melanocytes. While the number of melanocytes in the skin is less in light-skinned people, the number of these cells is higher in dark-skinned people.
As the number of melanocytes in the skin increases, more color pigments are produced and the skin color becomes darker. In the formation of spots, the number of melanocyte cells and/or the amount of melanosome (color pigment) released from the melanocyte cells increase, and this is called increased pigmentation. Sometimes it can be the result of the accumulation of substances that give color to the skin applied externally.
How to treat skin spots?
Due to the length of the treatment period and the high recurrence rates after the treatment of skin spots, the treatment process is tiring and requires continuity. Since it is a problem with a high recurrence rate, it can also be a wearing process for patients.
In addition, since there are many mechanisms involved in the formation of the spot it is necessary to combine several different methods and drugs in the treatment. In individuals with skin spots, the stain has negative psychological and sociological effects on the person. In this period when patients are psychologically sensitive, they need to be careful not to be fooled by exaggerated promises on social media and the internet.
When a patient comes across with a spot, the first and most important step of the treatment is to determine the cause, depth and type of the spot in the dermatological examination. Since there is an increase in the melanocyte cells that give color to the skin in some spots, it is not possible to go away with creams alone. Laser systems should definitely be used in these patients. However, cream treatments are sufficient only in cases where the pigment of the spot increases without cell increase such as pregnancy spot. For this reason, identifying the type of spot is the first and most important step of the treatment.
What are the types of spots?
Although there are many types of skin spots, we can collect spots under a few headings.
1. Spots due to sun
- melasma
- solar lentigo
- freckles
Melasma (chloasma, pregnancy mask): Melasma is irregularly circumscribed, symmetrical patches seen on the cheeks, upper lip, forehead, nose. It is a type of spot that is more common in women between the ages of 20-40 and people with dark skin tones. It is usually caused by pregnancy, the use of birth control pills, hormonal drugs, endocrinological disorders (thyroid dysfunction).
Processes such as waxing, epilation and peeling applied to the face in the summer months cause melasma to be triggered. While darkening after sun exposure in summer, the color tone becomes lighter in winter. Some heart medications, antibiotics, and blood pressure medications can also increase sensitivity to the sun and cause staining. There are types of melasma with different depths; It is important to determine the depth of the lesion before treatment.
The depth of the lesion is determined with the help of a special instrument called Wood’s light. Treatment is planned according to the depth of the lesion. Complete recovery in melasma is quite difficult. Especially in dark-skinned patients, recurrence rates are high in the summer months. Laser in the treatment of melasma; Although it is a frequently used method, it is possible for the laser to increase melasma and the redness and irritation after the laser may worsen the melasma. It is correct to avoid very radical methods that cause excessive irritation, crusting and redness and to be applied by a dermatologist experienced in lasers.
Ephelid (freckle): In light-skinned people, freckles that start in early childhood are in light or dark brown tones, 1-3 mm in diameter, on places that are more exposed to the sun (face, hands, shoulders). In summer, their numbers increase and become darker with the effect of the sun. In the winter, they wither. They can be removed in two or three sessions with Q-switched lasers. However, despite the treatment, the probability of recurrence is high in the summer months.
Solar lentigo: Light brown-yellow spots a few millimeters in size. It usually occurs in areas of the body that are exposed to the sun after the age of 40, such as shoulders, back, and hands. They are good-natured; There is no harm in terms of health except that the image disturbs the patients. It can be easily removed with fractional lasers or cryotherapy.
2. Postinflammatory Hyperpigmentation
Skin spots remaining during the recovery period after the sensitivity caused by irritation of the skin for many different reasons (wound, burn, laser, acne…). It is more common in people with dark skin.
3. Spots occuring on the skin due to aging
- solar lentigo
- seborrheic keratosis
- actinic keratosis
Solar lentigo: The most common type of spot seen with aging is lentigos, which are popularly called age spots. They are more common in fair-skinned people. In addition, people who have been exposed to the sun frequently for many years, such spots are more common when they get older. Most of the time, we hear defenses such as “I don’t go out in the sun so that these spots can be caused by the sun” in elderly patients. However, sunspots that occur in old age are not caused by sun exposure at that age, but by the sun’s damage to the DNA in our skin since youth and even early childhood, and this damage accumulates over the years. This effect is called cumulative damage from the sun. For this reason, sun protection starting from an early age can be easily removed with fractional lasers or burning with liquid nitrogen (cryotherapy).
Seborrheic keratosis: Benign, skin-colored or brown patches of skin. They are raised from the skin and vary in size from a few millimeters to a few inches. It is most commonly seen on the face, scalp and trunk. Over the years they tend to grow and enlarge with an uneven surface like a cauliflower. It is more common in some people due to genetic predisposition. In its treatment, methods such as lasers, burning with liquid nitrogen (cryotherapy), cauterization (burning with electrical energy) are used.
Actinic keratosis: Damage to skin cells, especially on the face and hands, as a result of prolonged sun exposure. Lesions of dark color on the skin, slightly raised on the surface and with a rough surface. Since these lesions are likely to turn into cancer, they must be treated. In the treatment, one of the methods such as lasers, burning with liquid nitrogen (cryotherapy), cauterization (burning with electrical energy) is used by the physician.
Methods used in skin spots treatment
Which method to use in the treatment of skin spots varies from patient to patient. In fact, some treatments can make the spots worse, making them worse than before. In order to avoid such situations, spot treatments should be performed by dermatologists who are experts in the field.
The first and most important step in spot treatment is sun protection. It is not enough to use only sunscreen cream for sun protection. In addition, the use of a visor hat, sitting under an umbrella, not going out when the sun is high, not entering the solarium are the cornerstones of the treatment. If a patient does not use sunscreen regularly or does not limit his physical exposure to the sun, no treatment method and no physician can remove the spots of that patient.
A more important nuance than the practices performed by the physician in the treatment of skin spots are that the patient carefully uses the home care creams given by the physician and fulfills all the conditions for sun protection. The spot treatment process is not one-time, just like a chronic disease, it can recur when the recommendations are not followed, and may worsen over time. For this reason, trust, communication and easy access of the patient to the physician are important between the patient and the physician. The methods used in the treatment of skin spots are:
1. Mesotherapy
Mesotherapy is called injecting the substances needed by the skin with fine-tipped needles into the middle layer of the skin. It is used not only in spot treatment, but also in skin rejuvenation, skin tightening, slimming, jowl erythema and some skin diseases. In the treatment of skin spots, it is based on the principle of applying some spot lightening agents (such as kojic acid, tranexamic acid, vitamin C, arbutin, niacinamide) under the skin at regular intervals and at certain number of sessions. Compared to the application of these skin spots lightening agents to the skin as a cream, it is seen that it is more effective when applied directly under the skin. Spot mesotherapy is planned as a minimum of four sessions with two-week intervals.
2. PRP (Platelet rich plasma)
In PRP, the person’s own blood is taken into special tubes, the tubes are placed in devices called centrifuges at high speeds, and the plasma part in the blood is separated from the cells. The resulting plasma is rich in cells called platelets, which are actually responsible for coagulation. Plasma is injected under the skin with the help of tiny needles, and some substances released from platelets trigger regeneration and healing in the skin tissue.
In the treatment of spots, PRP applications should be planned to be a minimum of four sessions with two weeks intermediate. The number of sessions can be increased according to the needs of the patient. PRP treatment is not only used in spot treatment, but also in skin tightening, hair loss, removal of wrinkles, skin cracks and scars, as well as in the treatment of some diseases in knee joint degeneration, in dentistry, and even in obstetrics in recent years.
3. Treatment with lightening creams
In the treatment of skin spots, active ingredients such as hydroquinone, azelleic acid, licorice extract (Licorice), niacinamide, retinoids, soy, ascorbic acid, kojic acid, corticosteroids, arbutin, resveratrol, tranexamic acid, antioxidant flavonoid in cream form, alone or in combination It is the cheapest and most effective treatment option. However, cream treatments should be used regularly for at least six months.
4. Chemical peelings
Alpha hydroxy acids (AHA) and beta hydroxy acids (BHA), lactic acid, salicylic acid, trichloroacetic acid and jessner solution can be used. Appropriate patient selection and post-procedure care are very important for chemical peeling. Redness, irritation, burning in superficial skin spots are the side effects of the process. Unfortunately, after these side effects, the spot may become worse. The incidence of side effects is higher in people with dark skin. Chemical peels can be applied in four to six sessions, at intervals of two to four weeks.
5. Enzyme peeling
It is a special mask that is applied to the face and used in the treatment of skin spots. After the mask is applied by the doctor, the patient goes home and washes his face with warm water after about 8-10 hours. While redness and peeling on the face continue for about a week, a fresh and spotless skin is achieved afterwards.
6. Laser and light therapies
Yag lasers, fractional lasers, IPL (intense pulsed light), PDL (Pulse dye lasers), picosecond lasers, Thulium laser laser and light systems used in spot treatment. The ideal time for laser treatments is the winter months. Because after the laser treatment, the skin becomes sensitive.
If there is sun exposure during this time, there may even be darker spots after the procedure than before. There is no definitive guide on which laser system to use in spot treatment. When choosing the type of laser to be applied, principles such as a short recovery time, less damage to the surrounding tissue, and not triggering the formation of new skin spots due to post-procedure irritation are taken into account.
The most commonly used laser system in spot treatment is Q-switched lasers. Because these lasers make strong pulses in a short time and quickly break down the target tissue, the melanocytes, so there is very little heat escape to the normal tissue around the melanocyte, so while the surrounding tissues are less damaged, redness and irritation are less after the laser procedure. Treatment with Q-switched lasers is usually performed between four and six sessions with an interval of two to three weeks.
7. Combined treatments
At the last point, it can be said that the best treatment option is combination therapy. Because the causes of the skin spots are often not the only one, and one method may not be sufficient in the treatment. Spot treatment should be done by a dermatologist who has full knowledge of all treatment options and can decide which combination to apply in which situation.