Skin spots and vitiligo

Brown spots can come from the sun (lentigines), hormonal changes (melasma) or after acne and irritation. White spots may be caused by vitiligo, a fungal infection or loss of colour after inflammation. Knowing exactly what kind of spot it is matters before treatment.

Brown spots

• Sun spots (lentigines)
• Melasma: symmetrical patches on the cheeks, forehead and upper lip
• Post-inflammatory pigmentation: marks left after acne and injury
• A new or changing dark spot is always checked with dermoscopy

White spots and vitiligo

In vitiligo the skin loses its pigment cells and sharply defined white patches appear. It is not contagious. Treatment uses topical medicines and phototherapy, aiming to stop the patches spreading and help colour return. Small white spots on the back and chest are often pityriasis versicolor.

Treatment options

• Topical products that reduce pigment
• Chemical peels or laser, depending on the type of spot
• Broad-spectrum sunscreen every day
• For vitiligo, topical treatment and referral for phototherapy when needed