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A Dermatologist’s Guide To Brown Spots

Brown Spots

Brown spots can come in many different shapes and sizes. Some are sun related, some are present from birth, and most are just plain annoying! Brown spots on the face and hands are a common complaint in the office, as they cause an aged appearance of the skin. Let’s explore the causes of brown spots, what you should be worried about, and what you can do to get rid of them. Simply getting rid of brown spots can dramatically change your look!

Sun Spots

Other names for these are liver spots, age spots, or lentigo/lentiginies. While people believed in the past that these were associated with liver problems, it is now known that they are due only to sun damage, not liver damage! These marks are found in sun-exposed areas, such as the face, chest, arms and legs. UV damage from sun exposure in these areas causes brown spots, red spots, and wrinkles due to collagen breakdown. All of these factors contribute to the aging process of the skin. There are many options to get rid of these sun spots and reverse the damage to give your skin a more youthful appearance. The first and most important part of any good skin routine is to wear sunscreen every day, regardless of whether you plan to go to the beach or be in the sun. Daily sun exposure, such as driving in your car, can cause substantial damage. Brown spots are often more common on the left side of someone’s face, or on the top of their hands from driving in the car. Another option is a photofacial, which is a light treatment that uses a special beam of light that targets and breaks up pigments. We also offer specially compounded high strength prescription lightening creams, such as Hydroquinone or Kojic Acid, to decrease the production of pigment in the skin.

Seborrheic Keratoses

Seborrheic keratoses (SKs) are common benign growths that form on the skin during the aging process. They can be anywhere on your body, and often look scaly, rough, or warty. Often, SKs are worrisome to patients. However, they are completely harmless. I usually tell my patients that everyone older than 30 has at least one, but people can have a range from a few to hundreds, and this is usually determined by genetics. While they are harmless, people often hate them and want to get rid of them, as they can be itchy, annoying, and simply unattractive. They can be removed by destructive techniques, such as freezing with liquid nitrogen or electrodessication. Another method is to simply remove them with a biopsy. A new, exciting product on the dermatology scene is called Eskata. This is a great option for SKs in cosmetically sensitive areas, such as the face and chest. It is a high concentration of hydrogen peroxide that is applied by a soft tip pen by your dermatologist in the office. The Eskata works to dissolve the rough area of the SK with minimal pain and side effects. It is best used in cosmetically sensitive areas, because it is less likely to leave behind a white or dark mark, which can be seen after liquid nitrogen treatment.


Moles are also called nevi, and they are common to all ages and skin types. They can come anywhere on the body, even those areas that are not exposed to the sun, such as the palms and soles. Some are present are birth, while others may form during childhood and early adulthood. Usually, a benign mole should be uniform in color and shape. If a mole appears during childhood, it often grows with a child (in proportion to their growth) but should not change drastically in size or color. It is important for your dermatologist to examine your moles to look for any suspicious irregularities, which could be a sign of a serious form of skin cancer, called melanoma. Monthly self skin exams, as well as regular full body skin screenings with your dermatologist, are an extremely important part of detecting melanoma early, when it has a favorable prognosis and cure rate. When evaluating moles, we recommend using the ABCDE rule, which outlines the warning signs of melanoma:

  • Asymmetry: One half does not match the other half.
  • Border Irregularity: The edges are ragged, notched or blurred.
  • Color: The mole has different shades of tan, brown or black, along with dashes of red, white, and blue.
  • Diameter: While melanomas are usually greater than 6mm in diameter when diagnosed, they can be smaller.
  • Evolving: A mole or skin lesion that looks different from the rest or is changing in size, shape or color.

If you notice any moles on your body with these warning signs, please make an appointment to see us as soon as possible.


Melasma is a common skin condition that causes brown-grey patches in sun-exposed areas, usually on the face, such as the forehead, cheeks and upper lip. It is often caused by hormones, such as birth control or pregnancy, and some refer to it as “the mask of pregnancy.” Melasma is distressing to women cosmetically, especially when it affects the upper lip, because they feel it makes them look like they have a mustache. We are here to help! The first, and most important step is sun protection, especially in Florida, The Sunshine State. This includes sunscreen daily with zinc and wide brimmed hats. We also offer a variety of treatment options to combat melasma both in our office and at home. Lasers such as IPL and microneedling to break up pigment are great options to treat melasma in the office. In addition, prescription strength lightening creams (hydroquinone) and kojic acid to stop pigment production, vitamin C serums for anti-odxidant effects, and retin-a to exfoliate the skin are important parts of any skin care regimen that can help treat remaining pigment keep it away.

If you are concerned with the appearance of any of your brown spots, schedule a mole check with your dermatologist and/or a free cosmetic consultation with one of our aestheticians. Give us a call today and schedule your consultation at either our Boca Raton or Boynton Beach offices.