Pigmented lesions arise from an accumulation of melanin, the pigment responsible for skin colour. Understanding the different types is key to proper skin care.

Types of Pigmented Lesions:

  1. Cafe-au-lait Spots: These light brown, coffee-milk-colored spots can vary in size and appear anywhere on the body.
  2. Nevus of Ota: A larger pigmented birthmark, predominantly found on the face and more common in Asian skin.
  3. Freckles (Ephilides): Small, sun-stimulated concentrated pigment spots, stable in location, and typically found on sun-exposed areas.
  4. Age Spots (Lentigines): Resulting from prolonged sun exposure, these spots are concentrated pigment accumulations in the skin's top layer, appearing on the face, neck, chest, back, forearms, and hands.

Causes of Pigmented Lesions

Pigmented lesions develop from an excess concentration of melanin. Factors influencing melanin concentration include genetics, aging, and sun exposure. Your physician can provide a detailed assessment and diagnosis of the specific type of lesion you have.

Diagnosing and Treating Pigmented Lesions

Identifying Your Pigmented Lesion

Correctly classifying pigmented lesions is crucial for effective treatment. Various terms like hemangioma, nevus flammeus, and port-wine stains have been used historically, sometimes leading to confusion.

  1. Hemangiomas: Typically appearing a few days to weeks after birth, these lesions grow rapidly and are often red and raised. They generally stop growing after the first year and may reduce by half by age five.
  2. Vascular Malformations: These include port-wine stains, present at birth and persisting throughout life. They're characterized by enlarged blood vessels in the dermis and often appear on the head and neck.

Laser Treatment for Pigmented Lesions

Laser therapy is a common treatment for certain pigmented lesions, including:

  1. Solar Lentigines (Age Spots): Commonly caused by sun exposure, manifesting as enlarged freckles on the face and hands.
  2. Cafe-au-lait Birthmarks: Light brown markings that can be large and appear anywhere on the body.
  3. Freckles: Due to an excess of pigment, usually from sunlight exposure.

Available Treatments

Before choosing a treatment, consult with a dermatologist. Options include:

  • Pigment-specific Laser Treatment
  • Carbon Dioxide Laser Treatment
  • Chemical Peel

Will the Pigmented Lesions Return?

While most pigmented lesions, if completely removed, will not return, new age spots and freckles can develop over time. Permanence cannot be guaranteed, especially for cafe-au-lait spots that may reappear after sun exposure.

Alternatives to Laser Treatment

For those seeking non-laser options, consider:

  • Topical Treatments: Tretinoin (Retin-A), topical vitamin-C, or fade creams.
  • Cryotherapy: Can improve lesions but may leave white spots or small scars.
  • Makeup: A non-invasive option for covering pigmented lesions.