What causes of brown spots?

What is age spot or brown spot?  How does the body make brown spots?  How does melanin determine our skin type?  There are many disorders of pigmentation, but for now we will focus on hyperpigmentation and lightly touch on an unfortunate condition called Vitiligo, the opposite of hyperpigmentation.  We will also look at the causes of hyperpigmentation or brown spot and hopefully provide some answers on how to treat it.  Let’s get into it!

Age spots, liver spots, sun spots and melasma are unpleasant phenomena known as hyperpigmentation which is caused by the amount of melanin produced by the melanocytes in the body.  Melanocytes look like an octopus with long arms or dendrites.  They are found in the basal layer of the epidermis and hair follicle, and extend upward into the stratum spinosum layer.  Everyone has 800-1000 melanocytes per square millimeter of epidermis.

Melanocytes contain melanosomes which are granules containing the enzyme tyrosinase.  Tyrosinase helps change tyrosine to melanin which is then taken up by the prickle cells in the epidermis of the skin.  This multistage chemical process is called melanogenesis.

The colour of our hair, eyes, and skin are all determined by the amount of melanin in the special cell melanocytes.  They are not determined by the number of melanocytes (one for every 36 keratinocytes) which is the same in everyone.  The skin’s colour and intensity (how dark or how light) depends also on the type of melanin (eumelanin or yellow-red pheomelanin).  It also depends on the size and number of the melanosomes and their distribution in the epidermis. In darker skinned people, the melanosomes are larger and carry more melanin than in lighter skinned people.

Melanin can be both good and bad.  It protects, but it can also do harm.  Melanin blocks UV radiation from damaging DNA, but it also has the potential to cause skin cancer like melanoma.

There are three main forms of abnormalities in pigmentation of the skin.  First, hyperpigmentation or brown spot (increase in pigmentation or melanin).  Second, hypopigmentation (decrease in pigmentation or melanin).  Thirdly, achromia (no colour, pigmentation or melanin).  These conditions can be either localized in one area or generalized (the whole body).

Hyperpigmentation occurs when the melanocytes are more active or there is an increased number of melanosomes, thus producing more melanin. an example of the opposite of hyperpigmentation is a condition called Vitiligo which occurs when there is a loss of pigment or melanin. 

Vitiligo is the result of melanocytes being destroyed.  It is cosmetic and affects all races equally, but it is more noticeable in dark skinned people.

Treating abnormal pigmentation can be simple most of the time, because usually it is cosmetic.  There is anecdotal evidence, for example, that vitamin C can increase melanin.  Eating foods like green leafy vegetables, berries, and citrus fruits as well as taking vitamin C supplements will increase melanin. 

There are many factors that can cause hyperpigmentation.  Drugs like oral contraceptives, physical or chemical (burns, chronic scratching), endocrine (eg., hypothyroidism), pregnancy(chloasma), tumors (malignant melanoma), genetic (ephelides ie., freckles), and nutritional (Pellagra).

Hyperpigmentation, on the other hand, responds well to laser Therapy if it is localized.

In short, melanin is responsible for causing age spots, sun spots, liver spots and even melasma.  This brown spots or reddish pigment produced by melanocytes, and how much of it is present, will determine your skin type.  Laser Therapy, such as that offered at Nell Laser Clinic, is a good option for someone trying to treat hyperpigmentation, as is the moderate use of lightening creams.  Adding vitamin C to your diet and getting a little more sun will increase the amount of melanin in your body.  Whether you have too much melanin or too little, never give up.  There is always hope.

In Part 2 of this blog we will take an in depth look at some disorders of pigmentation.  These include Ephelides, Lentigo, Chloasma, Phyto-photo dermatitis, Pigmented naevus, Malignant melanoma, and Ochronosis.

For a complementary consultation call us at 416-228-0011

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