The Different Types and Forms of Benign Pigmented Lesions
Skin colour is the result of many substances in the body together with genetics passed down by parents. The most influential substance in darker skinned individuals is the amount of melanin produced within skin cells. Lighter skin, although containing melanin, is the result of connective tissue and haemoglobin located in and around the dermis. An individual’s skin colour is never entirely uniform and can also change markedly when exposed to UV radiation. Affected skin can transform into patchy or blotchy pigmented lesions.
Pigmented lesions often involve melanin (brown pigment), resulting in small or large areas of the skin appearing brown, black or even blue in colour. Although most often benign (harmless), pigmented lesions can also be malignant (cancerous) in some cases. It’s advisable to consult with a dermatologist for an accurate diagnosis of pigmented lesions.
Pigmented Lesion types
Benign pigmented lesions can take several different forms, including:
Freckles
Freckles are small flat brown marks arising on the face and other sun exposed areas. They are most often seen in fair skinned people, but they are an inherited characteristic that sometimes affects darker skin types as well. As the person ages this type of freckle generally become more noticeable. It can be lightened by avoiding sun exposure and with the regular use of sunblocks and whitening creams. They can be safely removed by intense pulsed light therapy (IPL) or pigment laser therapy. We do not offer laser therapy or IPL at present time but we can suggest experienced cosmetic dermatologist/ surgeon whom would be able to help you if the above methods are not effective.
Lentigines
Larger flat brown spots on the face and hands arising in middle age also result from sun damage
exposure. Commonly known as age spots or liver spots, the correct term for a single lesion is solar
lentigo (plural lentigines). Lentigines are due to localised proliferation of melanocytes. It is important to distinguish the harmless solar lentigo which does not turn cancerous from an early malignant melanoma (skin cancer). Similarly, they can be lightened by avoiding sun exposure and with the regular use of sunblocks and whitening creams. They can also be safely removed by intense pulsed light therapy (IPL) or pigment laser therapy. We do not offer laser therapy or IPL at present time but we can suggest experienced cosmetic dermatologist/ surgeon whom would be able to help you. If the above methods are not effective.
Melasma
Appearing as a light or dark brown skin discolouration. Melasma can affect anyone although it is more common in women.
Post Inflammatory Hyperpigmentation
More common in darker skinned people, resulting from an injury which stimulates increased melanin production.
Seborrhoeic keratoses
Seborrhoeic keratosis are superficial skin overgrowth which are brown and slightly raised. They are due to aging and sun exposure. They can be seen on the face as well as the sun exposed areas as the limbs. They do not transform to skin cancer. Treatment includes liquid nitrogen and electrocautery.
Skin Tags
Skin tags are skin-coloured or brown growths which commonly occur on the neck, underarms and face. They are harmless and do not transform into skin cancer. They can be easily removed by
snip-excision and electrocautery.
Moles
Moles are due to abnormal collections of pigment cell (melanocytes) in the skin. They occur in childhood, adolescents and early adulthood. Most moles are dark and pigmented. Moles are small, flat and pigmented when they appear but with aging, they become raised, dome-shaped and often appear lighter. Moles that develop irregular borders, bleeding or sudden increase in size are a cause for concern and a dermatologist should be consulted early. Small flat moles can be treated with laser whilst bigger ones should be exised.
There are a wide variety of treatments for benign pigmented lesions. A consultation with your dermatologist at Pymble Dermatology will help ascertain the appropriate treatment method for every individual circumstance.
Malignant (cancerous) pigmented lesions can take several forms, including:
- Basal Cell Carcinoma – one of the most common forms of skin cancer, has a pigmented variant and can be misdiagnosed
- Melanoma – commonly caused by UV exposure, although approximately 25 percent of melanomas begin as moles. The visual appearance of melanoma is variable, with progressive changes in colour and size often noticeable over a short period of time.
Although most pigmented lesions aren’t cancerous it’s still advisable to consult with your dermatologist for an accurate diagnosis. This is particularly the case if the lesion changes colour, shape, is bleeding or is constantly itchy. Your dermatologist can perform a simple biopsy in most cases, involving removal of a small part of the lesion for analysis.
