Common Acquired Facial Pigmentation

Freckles

Freckles are small flat brown marks arising on the face and other sun exposed areas. They are most often seen in fair skinned people, but they are an inherited characteristic that sometimes affects darker skin types as well. As the person ages this type of freckle generally become more noticeable. It can be lightened by avoiding sun exposure and with the regular use of sunblocks and whitening creams. They can be safely removed by intense pulsed light therapy (IPL) or pigment laser therapy.

Lentigines

Larger flat brown spots on the face and hands arising in middle age also result from sun damage exposure. Commonly known as age spots or liver spots, the correct term for a single lesion is solar lentigo (plural lentigines).

Lentigines are due to localised proliferation of melanocytes. It is important to distinguish the harmless solar lentigo which does not turn cancerous from an early malignant melanoma (skin cancer). Similarly, they can be lightened by avoiding sun exposure and with the regular use of sunblocks and whitening creams. They can also be safely removed by intense pulsed light
therapy (IPL) or pigment laser therapy.

Seborrhoeic keratoses

Seborrhoeic keratoses are superficial skin overgrowth which are brown and slightly raised. They are due to aging and sun exposure. They can be seen on the face as well as the sun exposed areas as the limbs. They do not transform to skin cancer. Treatment includes liquid nitrogen and laser therapy.

Skin Tags

Skin tags are skin-coloured or brown growths which commonly occur on the neck, underarms and face. They are harmless and do not transform into skin cancer. They can be easily removed by snip-excision, electrocautery and laser therapy.

Moles

Moles are due to abnormal collections of pigment cell (melanocytes) in the skin. They occur in childhood, adolescents and early adulthood. Most moles are dark and pigmented. Moles are small, flat and pigmented when they appear but with aging, they become raised, dome-shaped and often appear lighter.

Moles that develop irregular borders, bleeding or sudden increase in size are a cause for concern and a dermatologist should be consulted early. Small flat moles can be treated with laser whilst bigger ones should be exised.