Causes and Treatments for Skin Discoloration

A person's skin color can change throughout their life for a variety of reasons. Certain health conditions can cause changes to a person's skin color such as hypopigmentation, which is the whitening or lightening of the skin, or hyperpigmentation, the darkening of the skin. Skin discoloration can affect large or small areas of skin, and it can be a natural part of aging or the sign of an underlying condition that needs medical attention.

Sun Spots 

Sunspots, also called age spots, are harmless flat and brown spots that develop over time, typically due to prolonged exposure to sunlight. They are sometimes referred to as liver spots, but the liver is not involved in the development of the spots, nor is it affected by them. Age spots appear when melanin, which gives the skin its color, becomes clumped in the skin or is produced in high concentrations, like when the skin is exposed to a lot of ultraviolet light.

Sunspots are often confused with freckles, which are inherited and often more noticeable when they are activated by exposure to the sun. Sunspots don't need to be treated, but many people opt to remove them because they don’t like the way they look on their skin.

Signs and Symptoms

Sunspots mostly appear in adults aged 50 or over. The main symptoms of sunspots include:

• Flat, oval areas that are typically tan to dark brown in color
• They typically occur in areas that are most often exposed to the sun, including the backs of the hands, tops of the feet, face, and shoulders
• The spots are typically painless

Treatment

Age spots are not likely to fade with time. They are not harmful, but some people may want to remove them for cosmetic reasons. Some treatments can include:

• Prescription lightening creams (hydroquinone) used alone or with retinoids (tretinoin) and a mild steroid may gradually fade the spots when used for several months.
• Laser and intense pulsed light therapies can target melanin granules and melanin-producing cells (melanocytes) without damaging the skin’s surface.
• Freezing, also called cryotherapy, involves applying liquid nitrogen or another freezing agent to the age spots to destroy the extra pigment.
• Chemical peels gently remove the uppermost layer of skin.

Over-the-counter fade creams and lotions can also be used to lighten age spots.

Vitiligo

Vitiligo is a chronic skin condition that presents with pale white patches on various areas of the skin. The most commonly affected areas are the face, neck, hands, and creases of the skin. The condition occurs when melanin cells die or stop functioning. It is considered an autoimmune condition, where the immune system attacks healthy tissues in the body.

There are several forms of vitiligo, including generalized vitiligo and segmental vitiligo. Variations in over 30 genes, occurring in different combinations, have been associated with an increased risk of vitiligo. Vitiligo is a common disorder, affecting between 0.5% and 1% of the population worldwide.

Signs and Symptoms

The main symptoms of vitiligo are white patches that can appear in the mouth, eyes, fingers, wrists, armpits, groin, genitals, and inside the mouth. It can also occur on the scalp, and can lead to patches of gray or white hair.

Treatment

The skin patches that vitiligo causes are not harmful, but some people may decide to seek treatment for cosmetic reasons.

Some treatment options for vitiligo include:

• Skin camouflage creams can cover up small patches.
• Steroid creams can be used in efforts to restore pigment to the affected areas.
• Phototherapy, or light therapy, may be used to try to help restore color to the skin.
• Surgery can be used to remove skin with your natural color or skin cells and place them where you need color.
• Depigmentation removes the remaining pigment from the skin.
• Oral steroids are sometimes used to slow the spread, but it is not a long-term solution.

Treatments available will not be able to stop the condition from spreading to other parts of the body.

Birthmarks

Birthmarks are discolored parts of the skin that can be found at birth. Sometimes, birthmarks begin to fade as a person ages, but they may become more visible with age.

The cause is thought to be an overabundance of pigment-producing cells (pigmented birthmarks) or blood vessels (vascular birthmarks). There are many different types of birthmarks, including strawberry hemangioma, deep hemangioma, salmon patch, and moles.

Signs and Symptoms

Birthmarks can be of many different colors, from tan to brown, gray to black, or even blue. They can also come in different shapes, sizes, and consistencies, depending on the type of birthmarks. For example, a strawberry hemangioma birthmark usually looks like a strawberry-colored lump that feels firm and rubbery while a deep hemangioma birthmark looks like a lump that sits deep in the skin.

Treatment

Most birthmarks are not likely to pose any health risks, but some may cause a problem later. For example, if a mole birthmark begins to change, it could indicate skin cancer and has to be surgically removed.

Treatments are typically only used for cosmetic reasons and include:

• Laser therapy
• Propranolol to prevent hemangiomas from growing
• Corticosteroids to help shrink hemangiomas
• Interferon for treatment of life-threatening birthmarks
• Surgical removal

Injury or Trauma

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Injuries, including sunburns, rashes, wounds, and burns can change skin color. Sunburns are caused by overexposure to the sun without proper protection, and burns, wounds, and rashes have a variety of causes. Each specific type of trauma or wound may present with different discoloration patterns on the skin.

Signs and Symptoms

Typical signs of sunburn include:

• Red skin that is warm and tender to touch
• Skin that peels off days after the initial sunburn
• In more serious cases, blisters can develop in the affected areas
• In the most severe cases, sunburns can be accompanied by sun poisoning which leads to fever, chills, nausea, and a rash

The symptoms of burns include:

• Blistering skin
• Pain in the affected area that is not dependant on the severity of the burn
• Red skin
• More serious burns can become numb
• Skin that peels
• Swelling
• White, red, or charred skin
• In serious cases, shock can be a symptom and could present with pale and clammy skin, bluish lips, a lack of alertness, and weakness

Rashes will often present with symptoms such as:

• Itchy skin
• Redness
• Dry and crusted skin can become further damaged by scratching
• Small fluid-filled blisters
• Infection in areas where the skin was broken

Wounds will vary in appearance throughout the healing process. Factors that affect skin appearance include the type of wound, where it is on the body, and how well it was cared for.

Different types of scars will present with different symptoms, including:

• Flat scar: Pink or reddish coloring that could be painful or itchy
• Raised scar: Raised above the skin and firm to the touch
• Depressed scar: Sits under the surface of the skin and most likely to occur on the face
• Keloid: Above the skin’s surface and larger than the initial wound
• Contracture scar: A scar that limits movement due to scar tissue overabundance

Treatment

The treatment of an injury-related skin discoloration will vary depending on the injury. For sunburns, healing typically occurs on its own over time. Aloe vera can be used to help relieve symptoms of pain during the healing process.

Treatment for burns include:

• Lotions and creams to help alleviate pain and burning sensations
• Water-based treatments
• Pain medication to help cope with the pain during the healing process
• Wound dressings to help speed up the healing process and protect the burn from further infection
• In serious cases, skin grafts or plastic surgery may be required to replace scar tissue or improve the appearance of burn scarring

Rashes usually heal on their own. A visit with your healthcare provider will help identify the cause and guide appropriate treatment. Wound treatment will also depend on the type, and will generally include pain medications.

Melasma

Also known as chloasma, melasma presents with dark, uneven, and blotchy skin in areas that are exposed to sunlight most often. The condition is not life-threatening, although the brown or gray patches it causes, usually on the face, can be difficult to cope with. It occurs when the skin has too much melanin and it often affects people with darker skin tones, women during pregnancy, and those taking certain medications.

Signs and Symptoms

The main sign of melasma is hyperpigmentation that can be just slightly darker than the skin surrounding it or much darker.

Areas most commonly affected include:

• Cheeks
• Forehead
• Bridge of the nose
• Above the upper lip
• Chin

Treatment

Treatment is often sought for cosmetic reasons. In some instances, such as if the condition occurred during pregnancy, the discoloration may fade over time. For people who wish to treat the condition, their options include:

• Hydroquinone, which lightens the skin
• Corticosteroid, which enhances the skin-lightening effects of hydroquinone
• Azelaic acid or kojic acid, which can help lighten melasma 
• Procedures, including a chemical peel, microdermabrasion, dermabrasion, laser treatment, or a light-based procedure

The best way to prevent melasma is by protecting yourself from the sun. This means covering up when possible, wearing a sunscreen with a high SPF, and avoiding long bouts of sun exposure.

Tinea Versicolor

Tinea versicolor, also called pityriasis versicolor, is a skin pigmentation disorder caused by a yeast infection. When yeast on the skin grows in overabundance, it can lead to a skin rash. The condition is not contagious and unlikely to cause serious health risks. It is common in tropical and subtropical areas of the world.

Signs and Symptoms

The main symptom of tinea versicolor is the appearance of spots that can occur on any part of the body. The dry and scaly spots could be either lighter or darker than the skin around it, with a patchy appearance.

They may also:

• Cause the affected area to itch
• Become more noticeable when you have a tan (the yeast prevents the skin from tanning)
• Grow slowly
• Grow together, forming patches of lighter (or darker) skin
• Disappear when the temperature drops and return in the spring or summer when the air turns warm and humid

Treatment

The first-line treatment for tinea versicolor is over-the-counter antifungal medications. This can be in the form of soap, shampoo, or creams. In more severe cases, treatment may include prescription antifungal medications. The skin may stay lighter (or darker) for weeks or months, but it will eventually return to its normal color.  You should protect your skin from the sun and not tan while recovering from this condition.

Tinea versicolor can recur. If that does happen, it can be treated the same way as first time around.

Addison's Disease

Addison’s disease is a rare disorder that affects the adrenal glands. It’s also known as hypoadrenalism or primary adrenal insufficiency, and occurs when the adrenal glands fail to make enough of the hormones cortisol and aldosterone. The disorder is caused by an autoimmune response within the body that damages the adrenal glands or by other diseases such as autoimmune adrenalitis, tuberculosis, systemic fungal infections, and an advanced HIV infection.

Signs and Symptoms

The most notable symptoms of the disease are:

• Extreme fatigue
• Irritability
• Abnormal menstrual periods
• Loss of appetite
• Unexplained weight loss
• Light-headedness or dizziness when getting up
• Depression
• Abdominal pain
• Joint and muscle pain
• Darkening of the skin, most notably in the creases of the skin or scars, inside the cheek, nipples, or palms of the hands

Treatment

The best treatment for Addison’s disease is hormone replacement therapy with medications like hydrocortisone and fludrocortisone acetate.

Dermatitis

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Dermatitis is a non-dangerous skin irritation that can occur in many forms and for many reasons. Forms of the condition include contact dermatitis, eczema, and seborrheic dermatitis (dandruff). Eczema is typically caused by dry skin coupled with one or more of the following: a dysfunction in the immune system, a skin infection, or contact allergens. Contact dermatitis is attributed to coming into contact with a skin irritant. Dandruff is caused by fungal growth on the scalp.

Signs and Symptoms

In the case of contact dermatitis, some typical symptoms include:

• A red itchy rash that may sting or burn
• Blisters
• Excessively dry skin
• Cracking or tender skin
• Hives could be present
• Fluid-filled blisters
• Blisters that ooze and could be crusty and scaly

Symptoms of eczema include:

• Redness of the skin
• Itchiness
• Fluid leaked from the skin when scratched
• Crusted over skin

Symptoms of seborrheic dermatitis include:

• Scaly patches of skin on the scalp that are red underneath and look greasy or moist
• Scales that flake off and are white or yellow in color

Treatment

Some treatment options for people with dermatitis include:

• Corticosteroid creams, ointments, lotions, or gels
• Calcineurin inhibitors (creams that affect the immune response)
• Phototherapy
• Oral corticosteroids or injectable monoclonal antibodies in more severe cases

For those with mild cases of dermatitis, at-home remedies have been shown to be effective, including:

• Moisturizing routines to prevent skin dryness
• Over-the-counter hydrocortisone creams to help with itching that could make the condition worse
• A cold compress to soothe the skin
• A warm bath with colloidal oatmeal to help relieve dryness
• Medication shampoos
• Avoid skin irritants
• Stress management, since some types of dermatitis can flare up during bouts of stress

Rosacea

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Rosacea is a skin condition that primarily affects the face and sometimes the eyes. It is most common in people with fair skin. It is not clear what causes rosacea, but some researchers believe that it could be genetic and triggered by environmental factors.

Rosacea can flare up at any time, and it is typically cyclical. Not everyone with the condition will experience flare-ups with the same lifestyle factors.

Signs and Symptoms

The main symptom of rosacea is frequent redness and visible blood vessels on the face. In some cases, other symptoms can be present, including:

• Red, swollen bumps that resemble pimples
• Small, red lines under the skin
• Acne
• Dry, irritated, swollen, and red eyes known as ocular rosacea
• Swollen nose

Treatment

Since there is no cure for rosacea, treatment is heavily focused on relieving the symptoms and controlling flare-ups. The two main factors when it comes to managing skin disorders are proper medication and a good skincare routine.

Treatment options include:

• Topical medications that relieve redness by constricting blood vessels
• Oral antibiotics
• Isotretinoin in severe cases 
• Laser therapy

For those with rosacea, home remedies may be helpful when coupled with medical treatment. To avoid flare-ups, a person with rosacea can:

• Figure out what triggers them and avoid those triggers
• Wear sunscreen daily
• Avoid touching or rubbing the skin on the face too often

Psoriasis

Psoriasis is a type of autoimmune disorder that affects the skin. It is caused by immune dysfunction that occurs when the body’s immune system identifies healthy skin cells as threats and begins attacking them.

Signs and Symptoms

There are different types of psoriasis, and each type will present with different symptoms. The main symptom of the condition is a red and scaly rash, which is typically found in cases of plaque psoriasis. The five other types of psoriasis are guttate psoriasis, nail psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis.

Other common symptoms include:

• Red patches covered with scales that may be silvery or white in color
• Dryness
• Itching
• Cracking

Treatment

Treatment options for psoriasis will depend on the type and severity of the disease. Milder forms of the disorder can be managed with home remedies such as a good skincare routine and itch relief creams or ointments.

There are also many over-the-counter medications that can provide relief from psoriasis, such as anti-itch medications, hydrocortisone cream, and salicylic acid. Prescriptions can be used to help battle more serious cases of the disease. Corticosteroid creams or ointments, vitamin D analogs that slow down skin cell growth, and topical immunomodulators may be effective.

Skin Cancer

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Skin cancer refers to the uncontrollable growth of skin cells. Skin cancer can be a mild and easily treatable condition. If left untreated, it can lead to more serious complications if cancer spreads to other areas of the body. The three main types of skin cancer are basal cell carcinoma. squamous cell carcinoma, and melanoma.

Skin cancer is generally caused by overexposure to the sun, although some can be caused by other factors such as exposure to x-rays, burn, disease scars, or continuous exposure to chemicals over time.

Signs and Symptoms

The symptoms of skin cancer will vary depending on the type and progression of the disease. The signs of basal cell carcinoma include:

• A bump that appears pearly or waxy
• A scar-like lesion that is flat and either flesh-colored or brown
• A bloody or scabbed over sore that continues to reappear after healing

The typical symptoms of squamous cell carcinoma include:

• A nodule that is red and firm
• A lesion that is flat and could be scaly with a crusted surface

Signs of melanoma include:

• Brownish spots with darker speckles within them
• Moles that begin to change color, size, or feel
• Lesions with irregular borders
• They can be red, pink, white, blue, or blue-black in color
• Lesions that burn, itch, or are painful
• Dark lesions found on the palms of the hands, soles of the feet, fingertips, toes, or within the mouth, nose, anus, or vagina

Treatment

The treatment for skin cancer varies depending on how advanced the cancer is. For example, in the initial stages, removal of the growth or mole is enough.

Treatment options for skin cancer include:

• Excisional surgery to remove the growth and any cancerous tissue surrounding it
• Mohs surgery, which involves taking the cancerous tissue out while preserving the skin around it
• Curettage, electrodesiccation, or cryotherapy, which involve the removal of the growth and the scraping away of any layers of cancer cells that remain
• Radiation therapy
• Chemotherapy
• Photodynamic therapy, which is the destruction of skin cancer cells using lasers and medications
• Biological therapy to help the immune system destroy the cancer cells

A Word From Verywell 

Having a chronic skin condition can be difficult to cope with. At-home management is a viable treatment option for many skin conditions, and you can usually keep your disease under control by keeping up with certain medication or cream regimens. In the event that your skin condition worsens or you start to notice changes, such as new growths, bleeding, or signs of infection, you should call your healthcare provider right away. A chronic skin condition can be distressing, but with the right tools and tips, you can minimize the impact it has on your appearance and quality of life.