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When Dark Spots Destroy Your Skin's Even Tone

Some are there at birth and some are born much later in life, but any sort of dark mark on the skin can run the gamut from disturbing to disfiguring. "People are very bothered by skin discoloration," offers Lynn McKinley-Grant, M.D., a doctor in Washington, D.C., who is board-certified in dermatology and internal medicine. "Whatever kind of discoloration it is — from melasma to age spots, people want it gone," says the private-practice dermatologist. For the most part, any type of discoloration — if it's that bothersome — can be rectified, with the arrival of the latest lasers and other innovative medical treatments.

Off-Color Skin Problems

From age spots to vitiligo, unsightly skin color changes can embarrass even the most thick-skinned among us. These are some of the most common skin-souring marks:

  • Birthmarks. The dark marks come in various shapes and sizes, appearing at birth or soon after in shades of red and brown. The exact causes are not known, but some are related to blood vessel deformities occurring as early as the embryo's first month. Today's Treatments. Some types disappear during childhood — for other, lasers (including those called the Flash Pump Dye and the Q-Switch Ruby) can often reduce or obliterate the blobs).
  • Moles. Medically known as pigmented naevi, the brown-to-blackish blemishes can be flat or raised and can grow or disappear with age. Moles are formed when the skin's natural pigment (melanin) coagulates. Today's Treatments. The Ruby laser can remove moles (proven benign in biopsies).
  • Age Spots. These spots, which often appear on the face, chest and hands as we age, are technically known as solar lentigo. Don't mistake them for freckles — age spots tend to be larger and more irregular in shape. Age spots appear when sun damage throws off the patterns of pigment-producing melanocytes. Today's Treatments. Lightening creams, chemical peels and laser procedures can help make age spots a problem of the past.
  • Melasma. These brown stains on the face or chest are most common in women during the second half of pregnancy and those taking the birth control pill. Hormones from pregnancy or the pill can increase the body's production of melanin, which can land unevenly in different areas. Sunbathing can enhance the staining effect — staying out of the sun is best, and using an SPF 15+ sunscreen is the next-best thing. Today's Treatments. Options range from topical creams, to light glycolic acid peels, to the Ruby laser for resistant remnants.
  • Vitiligo. This total loss of skin pigment, which some say accounts for changes in Michael Jackson's skin color, affects 1 percent of the population. People may be at higher risk for this skin bleaching if they have thyroid disorders, pernicious anemia, decreased adrenal gland function or a condition called alopecia areata that causes hair loss. Possible causes include abnormal nerve cells that hinder the body's production of pigment or an autoimmune or autotoxic reaction in which the pigment cells are attacked. Today's Treatments. There are two ways to go: When a high percentage of pigment has been lost, an oral medication can rid the body of the remaining pigmentation to achieve a uniform lighter look. For those with less pigment loss, a type of so-called ultraviolet therapy sometimes restores a significant amount of pigment to the white patches.
  • Thread Veins. These are dilated veins that manifest as fine red traces on the cheeks or legs. More common in women than in men, contributing causes might include heredity, hormones, skin type, photo-damage, injury, long periods of sitting or standing and other things that could increase pressure within the veins. Today's Treatments. Lasers are used a lot these days, but another option is a procedure called sclerotherapy, in which saline solution or another chemical is injected into the vein, shutting off the blood supply. But because of sclerotherapy's risks, especially around the face and ankles, vascular lasers are the treatment of choice for these areas.


Choose your treatment — there's no need, anymore, to let unsightly blotches impose on your otherwise even skin tone. The last few years have brought to life lasers that lighten and color-changing creams, as well as other cosmetic procedures that in yesteryear were the stuff of cosmetic dreams.