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The vast majority of pigmented spots are harmless — what counts is not the single appearance but the change over time and the spot that stands out from the rest.
Also known as: mole · nevus · naevus · freckles · ephelides · age spot · liver spot · solar lentigo · seborrhoeic keratosis · café-au-lait spot · melasma · chloasma · mask of pregnancy · pigmented spot · brown spot · ABCDE rule · ugly duckling sign · skin check · screening · dermatoscope · dermoscopy
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Skin colour comes from melanin, made by pigment cells in the epidermis and passed to the surrounding skin cells. Where there are more pigment cells or more melanin is released, a spot appears. A mole is a cluster of pigment cells; most arise up to about the age of 30, and an adult has 20 to 40 on average. Freckles are inherited, come out in the sun and fade in winter. Age spots, formally solar lentigines, build up over years where sunlight falls most — backs of hands, face, décolleté — and stay. Seborrhoeic keratoses are not pigment spots but raised outgrowths of the epidermis; they feel rough and look stuck on. Café-au-lait spots are flat, evenly milk-coffee coloured and usually present from birth; in a child, six or more larger than five millimetres prompt a look for a genetic cause. Melasma appears as a broad, blurred discolouration on forehead, cheeks and upper lip and is linked to oestrogen and sun — in pregnancy, on the pill, more often in darker skin types. For checking there are two aids: the ABCDE rule looks at asymmetry, an irregular border, more than one colour, a diameter beyond about five millimetres and above all evolution, that is change over weeks to months. The ugly duckling sign means the spot that looks unlike all the others on the same person — in studies this picks out suspicious lesions more reliably than size alone. With the naked eye the detection rate is lower than with a dermatoscope, a lit magnifier; with it, detection rises by about 10 to 25 percentage points in studies and fewer harmless lesions are excised. Repeated screening finds more early melanomas; whether it means fewer people die of them has not been conclusively measured in controlled trials, and some of what is found would never have become noticeable. Have a spot looked at if it changes over weeks to months, bleeds, weeps or crusts, itches or hurts, if it is new and dark after the age of 40, or if there is a dark streak under a nail — the last of these even when nothing hurts.
Many small patches on the trunk that do not tan along and scale finely when scratched. The yeast is gone quickly, the colour needs months.
On the upper back, blurred at the edges, at a place that has itched for years: then the patch is the consequence and not the cause.
Bluish, later brownish marks exactly where itching wheals sat before are a finding in their own right, not a coincidence. They speak for an inflammation of the smallest skin vessels and deserve a look.
Asymmetry, blurred border, several colours, diameter over five millimetres, change over time. One single point is no cause for worry, three are a reason for an appointment.
One’s own moles resemble each other. If one stands out because it looks different from all the rest, that is exactly the pointer — regardless of its size.
A photo with a ruler or a coin beside it, the same lighting, every three months. That turns the feeling “it was smaller” into a statement one can check.
Dark, velvety thickened skin on the neck, armpits or groin is not dirt and does not wash off. It points to insulin resistance and is thus a reason to look at the sugar.
Sharply bordered, pigment-free areas, often on the hands, around the mouth or the eyes, need above all consistent sun protection — otherwise they burn first.
Weeks to months after a journey to the Mediterranean or the tropics: a painless nodule that breaks open into a flat ulcer. It heals slowly and with a scar.
An age spot forms over years through sun and changes slowly. Anything that grows quickly, changes colour, has irregular edges or measures over six millimetres is looked at — as is any spot that looks different from the person’s others. A mole that changes within weeks to months is the case that matters. After an inflammation a dark mark needs three to twenty-four months to fade.
Lightening creams with hydroquinone, azelaic acid or vitamin C fade dark marks over eight to twelve weeks — they work only if sun protection is used consistently at the same time, otherwise the colour returns faster than it goes. In melasma no treatment lasts while sun and hormones keep acting. What no cream does: judge a mark. A spot that changes is looked at, not lightened.
Size, shape, colour, border, surface over weeks to months. A spot that has looked the same for twenty years is something different from one that has changed since the summer.
A spot that newly itches, bleeds when touched, forms a crust that keeps coming back, or does not heal after weeks — regardless of size and colour.
Age warts that look stuck on, moles that have not changed for years, red vessel dots on the trunk, white spots on the lower legs. They are benign — knowing them helps to see the others better.
Most moles appear up to young adulthood. A genuinely new, dark mole after that deserves more attention than one that has always been there.
Brown marks on palms, scars, gums and hand creases, together with tiredness, craving for salt and low blood pressure: that is the picture of an underactive adrenal gland — rare, treatable and dangerous untreated.
Belongs to the same picture: a low sodium with a raised potassium. This combination is the fastest hint.
A marked shortage can cause dark marks on hands and feet — a little-known but readily correctable cause.
White, sharply bordered patches often occur together with a thyroid illness. The value belongs alongside then.
Skin and lining renew themselves quickly and need zinc for it. With places that heal badly, cracked corners of the mouth and frequent skin infections a lack is a serious possibility.
Without vitamin C no stable collagen forms — the wound closes but holds less well. With a very one-sided diet, smoking and alcohol the intake is often tighter than assumed.
Steers the horn-forming of the skin. Too little makes it rough and dry, too much over longer periods harms liver and bone — and in pregnancy a strict upper limit applies.
Every healing needs building material. Anyone eating little during an illness loses exactly that — a sufficient amount spread across the day belongs to the treatment.
A patch is not just a patch, and the answer depends entirely on which one: pale patch, brown patch, red patch and scaling patch have four different causes. No preparation stands before that distinction — the question of change, edge and growth comes first.
In the white patch condition a low level is more common than average, and replacement after measurement belongs. That the patches recede from it is not shown — light therapy achieves that sooner.
A case of its own: taking in a great deal of carrot, squash or their juice over weeks gives an orange-yellow colouring on palms, soles and the tip of the nose — the white of the eye stays white. Harmless, goes away by itself, and it is the only yellowing that is not a liver matter.
A lot of carrots, pumpkin or sweet potato over weeks turns palms and soles orange. This is harmless and fades over weeks — unlike jaundice, the white of the eye stays white.
Vitamin C as a serum on the skin lightens pigment spots slightly over months. As a tablet it does not act on the spots — the route makes the difference here.