What are brown spots on the skin?

While “brown spots on the skin” is not a medical term, it is something that patients often ask about. There are different causes of brown spots on the skin. The most serious cause of a brown spot on the skin is malignant melanoma. This is a dangerous form of skin cancer. It very often presents as a changing, enlarging brown spot on the skin. This presentation should always be checked by a doctor as soon as possible because early diagnosis in malignant melanoma is crucial. Early diagnosed melanomas are often cured by simple excision of the lesion whereas delayed diagnoses result in far greater morbidity and mortality for the patient requiring extensive surgery and immunotherapy. So don’t bury your head in the sand and get that changing brown spot checked. Other more frequent causes of brown spots are solar lentigos and seborrhoeic keratoses and pigmented actinic keratoses.

How are brown spots on the skin treated?

That depends on the diagnosis. If the lesion is malignant e.g. malignant melanoma then it will require surgery and possibly immunotherapy. If however the lesion is benign such as solar lentigo or seborrhoeic keratosis or actinic keratosis then it can be treated with lasers or cryotherapy. Generally lasers give a more aesthetic result. Cryotherapy can often leave unsightly hypopigmentation. Hypopigmentation after cryotherapy often depends on the skill of the cryotherapist and on the skin type of the patient. Some types of skin are easily hypopigmented and recognising these patients is in itself a skill. Suitable lasers depending on the aetiology of the brown spot include Sciton BBL Heroic or Candela V beam for solar lentigos or Sciton Contour TRL for pigmented keratoses or pigmented actinic keratoses. Another option for treatment of brown spots is chemical peeling agents. TCA is a suitable treatment for solar lentigos and phenol peels are a suitable alternative treatment for actinic keratoses.