A doctor explains the types of blemishes and how to recognize them in an easy-to-understand manner.

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The following is an easy-to-understand explanation of the characteristics, causes, and treatments for six typical types of blemishes from a medical standpoint.

Six types of blemishes

There are six main types of stains, and we have briefly organized each of them in terms of their characteristics.

(1) Senile pigmentation (so-called "age spots")

The majority of what are commonly referred to as age spots are senile pigmented spots. They are characterized by their brown to black color, round shape, and well-defined outline.

It occurs most often on the face, back of the hands, and arms, which are exposed to more sunlight. As they age, the color gradually becomes darker.

(2) Seborrheic keratosis

Seborrheic keratosis" is a blemish found on the face and other parts of the body of the elderly. They are brown to black in color, raised all over, and have a slightly rough surface.

They vary in shape, some are gently raised, while others pop out like warts. It is also characteristic in that it often appears in combination with senile pigmentation*.

(iii) Chloasma

Melasma is a light brown spot that often appears symmetrically along the cheekbones. It is most common among women in their late thirties to fifties, and is sometimes described as a "map-like spot" because of its shape.

This spot is easily mistaken for senile pigmentation, but it is characterized by a vague, indistinct outline.

(4) Sparrow spots (so-called freckles)

The "Jakuran-han" is a blemish commonly referred to as a freckle. They are about half the size of a grain of rice and light brown in color. They appear scattered on the face, arms, hands, and shoulders.

They begin to appear in childhood and tend to become more prominent during puberty. Another characteristic is that the color darkens in summer and lightens slightly in winter.

5) Acquired dermal melanocytosis (ADM)

Acquired dermal melanocytosis differs from common spots in that pigment cells increase in a deeper part of the skin called the "dermis," and melanin, the pigment that causes the black color, accumulates there. Because it occurs in the dermis, it is medically classified as a birthmark.

These spots develop from the late teens to the thirties and are more common in women. It tends to appear on the cheekbones and lower eyelids of the face and, unlike other blemishes, is gray or bluish brown in color. In some cases, it appears together with melasma and freckles, and is easily confused with other blemishes.

(6) Inflammatory hyperpigmentation (PIH)

Inflammatory hyperpigmentation is a spot that forms when a portion of the skin turns brown to black after inflammation from trauma, burns, acne, or rashes has subsided.

Causes and treatment of each blemish

The following are the causes and treatments for six different types of spots.

(1) Senile pigmentation (so-called "age spots")

<Cause
When the skin is exposed to ultraviolet rays, melanocytes inside the skin are stimulated to produce melanin in order to prevent damage. The melanin produced is expelled as the skin is renewed.

However, prolonged exposure to ultraviolet rays changes the genes of skin cells, resulting in excessive melanin production that cannot be eliminated. As a result, melanin accumulates in the skin and becomes a blemish.

<Treatment
The main treatments are drug treatments, chemical peels, laser treatments, and photofacials. Each of these is explained below.

Treatment with medication
This treatment method uses oral and ointment medications such as hydroquinone, which suppresses the formation of melanin, and tretinoin, which promotes the elimination of melanin.

Chemical peels
A special medication peels off the surface of the skin and promotes the renewal of skin cells. As a result, melanin is actively expelled.

Laser Therapy
This is a treatment in which a medical laser is irradiated onto a blemish, destroying melanin with thermal energy and shock waves.

Photofacial
This is a treatment in which special light is shone on the skin to damage melanin.

(2) Seborrheic keratosis

<Cause
The main causes are increased melanin due to ultraviolet rays and proliferation of skin cells due to aging.

<Treatment
Cryotherapy" is a common treatment for seborrheic keratosis. Cryotherapy is a treatment that uses liquid nitrogen to freeze the tissue where seborrheic keratosis is occurring, causing necrosis and then removing it.

Other treatments include laser therapy and surgery to remove the raised area.

(iii) Chloasma

<Cause
The cause of melasma is not clear, but it is often caused by pregnancy, pills, and female hormones. Irritation from ultraviolet rays or friction may also be a possible cause.

<Treatment
Treatment is generally by means of an ointment such as hydroquinone, and oral medications such as vitamin C and tranexamic acid, which have the effect of suppressing melanin formation. In some cases, the condition may be cured due to changes in the balance of female hormones caused by childbirth or other factors.

If medication is not effective, a laser with low energy, called "laser toning," may be applied to the area. In the case of melasma, it should be noted that general laser treatment stimulates melanocytes, which in turn darkens the color.

(4) Sparrow spots (so-called freckles)

<Cause
The main cause of freckles is heredity. There are two types of melanin: eumelanin, which is black, and pheomelanin, which is yellow to red. People with high levels of pheomelanin are fair-skinned and prone to freckles. Since the amount of pheomelanin is determined by heredity, it is thought that a disposition to freckle easily is inherited.

UV light may also cause excessive melanin production, resulting in freckles and darkening of the skin.

<Treatment
Major treatments include treatment with drugs that act on melanin such as tretinoin and tranexamic acid, chemical peels, laser therapy, and photofacials.

5) Acquired dermal melanocytosis (ADM)

<Cause
The cause is not clear, but it is believed to be related to female hormones and ultraviolet rays. It is caused by some stimuli that activate the "dermal melanocytes," which are pigment cells located deep in the skin.

<Treatment
The main treatment method is the irradiation of a "Q-switched laser" that reaches deep into the skin. The laser improves spots by destroying the causative dermal melanocytes.

(6) Inflammatory hyperpigmentation (PIH)

<Cause
When the skin is irritated by inflammation, melanocytes become more active and produce more melanin. In addition, when melanin cannot be eliminated by the skin's renewal process, melanin accumulates and spots form.

<Treatment
There are a variety of treatments, including drug therapy with hydroquinone, which prevents the formation of melanin, and tretinoin, which promotes the elimination of melanin, chemical peels, laser therapy, and photofacials.

summary

Each type of blemish has different causes and treatments. To eliminate blemishes, it is important to correctly identify the type of blemish and treat it appropriately.

It is difficult to identify the type of blemish on your own, and treatment with medication or laser is necessary to remove it. If you are concerned, see your doctor.