The main factors for the appearance of spots on the skin

The doctor Miguel Sanchez Viera warns that “both the passage of time such as exposure to UV radiation are the most common factors when stains skin make their appearance“.

As he explains, there are two types: vascular and pigmented. “The former are due to vascularization problems, while the latter have their origin in an accumulation of melanin (nevus, freckles, lentigines, melasma and hyperpigmented scars)”, he comments.

So for slow down its appearanceremember the importance of prevention through photoprotection. As Dr. Josep González Castro, also from GEDET, explains, “we must sun exposure responsiblysince the tan is the body’s reaction to an attack and a notice that skin cells produce more pigment after injury“.

In addition, it is necessary avoid the hours of maximum radiation (between 12 and 4 p.m.), expose yourself progressively, wear sunglasses and always use a high-index sunscreen (there are specific ones for pigmented skin) applying it generously and every two hours (even if the day is cloudy), since the water, the sweat and the rubbing of the towel reduce the level of protection.

If you take any medicine that can cause photosensitivity, is pregnant or has undergone a skin treatment, it is important to take extreme precautions. “It is preferable to apply the protector half an hour before and do not do without it even if the skin is already tanned“, according to Dr. González Castro.

“In regarding ingredients included in cosmetic formulas when it comes to prevention is vitamin C, E and niacinamide. They must be prescribed by a dermatologist, since the time of use and the dose varies according to the skin, “he recalls.


On the other hand, the diagnosis is “fundamental” to differentiate if a stain is benignpotentially malignant or malignant, and therefore the diagnosis must be performed by a dermatologistwho has the tools to do it.

“The dermatoscopy digital is the most precise, since it manages to make a microscopic image that allows any anomaly to be seen in the spots that are impossible to visualize with the human eye, in addition to be able to store them to see if it appears some change that tells us that it should be monitored or removed,” says Sánchez Viera.

Secondly, self-examination is also very important. The ABCDE rule is the most effective: A for asymmetry, B for irregular edges, C for color, D for diameters (more than 6 millimeters) and E for evolution. “And, of course, go to the dermatologist periodically and if any change is observed in any of the spots, with the aim of rule out possible skin cancer“, explains Dr. Sánchez Viera.

As for treatments, three stand out: laser, peeling and cosmetics. Regarding the laser, Dr. Isabel del Campo explains that it acts on the darkened areas, breaking up the pigments.

“These are reduced with each session and are expelled by the body through the lymphatic system. Most stains can be removed without leaving a trace,” he says. The best suitable for the spots that the dermatologist treats the mostsolar and senile lentigines, are, according to the expert, “those of Alexandrite; also those of fractionated CO2 or Erbium, but these can cause more damage to adjacent tissues.”

Intense pulsed light is effective, although more sessions are required. Whether treats melasma, acne marks or post-inflammatory hyperpigmentation, “the usual thing is to combine several types of lasers”, he comments. On the other hand, laser treatment for blemishes is safe if the right technology is used and is virtually painless. In some cases, such as melasma or acne marks, it is complemented with peeling and/or cosmetics.

As for side effects, note that superficial scabs usually appear that disappear in 5-7 days, leaving possible redness for 4-7 weeks. “During that time you have to avoid sun exposure,” she warns. As for the number of sessions, in some cases one session will suffice, while in others more will be needed.

For its part, the peeling allows forcing cell renewal in the epidermis, and therefore replace cells with a large amount of melanin for others. At the same time, it provides an improvement in the skin’s texture and luminosity.

According to Dr. Vicent Alonso, a GEDET member dermatologist, it is the technique of choice for hormonal spots such as melasma, and can be useful for others such as solar lentigines. “For melasma, you use salicylic acid, alpha hydroxy acids, retinoic acid, tranexamic acid, or combinations thereof,” he explains.

These acids are almost always combined with depigmenting agents such as hydroquinone, kojic acid, vitamin C and others. In the case of lentigines, the acid trichloroacetic, although laser is more effective. For pigmentation associated with aging, there is the option of combining alpha hydroxy acids or retinoic acid.

“Although the improvement can be complete with peeling, the tendency of melasma is to reappear, but we can control it with maintenance treatment. The same thing happens with lentigines with successive sun exposures if there is no adequate photoprotection”, adds Dr. Alonso.

With regard to side effects, it is necessary to highlight a greater or lesser peeling and more or less intense redness depending on the ‘peeling’ that can last between 5 and 12 days. Therefore, it is advisable to hydrate, use creams depigmenting and photoprotecting. It is also recommended to leave it for a time with less sun. It usually takes between 3 and 10 sessions, depending on each case.

As for cosmetics, dermatologists point out that hydroquinone, retinol, kojic acid and tranexamic acid are the active ingredients “the most studied, effective and used in the spot treatment“. However, they remember the need to be recommended by a specialist in dermatology.

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