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Not all skin spots are the same. If they are pigmented, they can be age spots, birthmarks, freckles or other, less common pigmentations.

Many people have had pigmented (brown) spots on their skin since birth or develop them in the course of their lives. They can be a health risk or completely harmless and may only be cosmetically annoying. The causes of their development are very different and every pigment spot that is not caused by external influence (e.g. tattoo or after healing of a burn), but that has always been there or seems to have developed on the skin all by itself, should be checked.

Age spots appear from the age of 35 - 40 in areas that have been exposed to sunlight for years. They therefore occur particularly frequently on the face, the backs of the hands, the sides of the forearms and the décolletage. They are similar to age warts, which are slightly raised, but unlike these they remain flat throughout life. In contrast to biological (endogenous or intrinsic) skin ageing, age spots are a typical phenomenon of sunlight-induced (exogenous or extrinsic) skin ageing and an expression of an irregular pigment distribution in the covering cells of the epidermis. This means that age spots are not - like the moles or pigmented birthmarks described below - based on a proliferation of pigment cells. Age spots are always benign and always remain benign, i.e. transformation into malignant skin changes cannot occur with age spots. They have nothing in common with birthmarks (liver spots, melanocytic nevi).

Fazit: Age spots (sun spots) are harmless. They are a typical feature of sun-damaged ageing skin and can - if desired - be excellently treated with a pigment laser (e.g. NdYAG or ruby laser). Alternatively, age spots can be lightened by very consistent and long-term local applications of vitamin A or vitamin C sera.

Usually pigment cells (melanocytes) are isolated and alone at the border between epidermis and dermis. They produce pigment (melanin) and release it to the epidermal cells, which can then protect their sensitive cell nuclei from the sun's harmful UV rays. Birthmarks (moles, melanocytic nevi) are usually brown or brown-reddish pigmented (more rarely skin-coloured) and are caused by the fact that pigment cells (melanocytes) do not lie individually but close together in groups in the skin. A distinction is made between congenital and acquired moles. Moles are usually harmless and most people have one or two moles, some extremely many. The problem is that a melanoma (black skin cancer) can be very similar to a harmless mole and some moles can also change in the course of life and turn into a melanoma.

Conclusion: Leberflecken bzw. pigmentierte Muttermale sind in der Regel harmlos, müssen aber in regelmäßigen Abständen kontrolliert und bei Auffälligkeiten oder Veränderungen herausgeschnitten und im Labor untersucht werden.

Freckles are genetically caused spot or dot-like brown or red-brown pigmentation of the skin facing the sunlight. They usually occur in younger people who tend to have blond-reddish hair and skin colour, are completely harmless and cannot transform. A therapy is difficult with the currently available possibilities and should therefore be avoided. From most people's point of view, freckles represent individual beauty attributes of youthfulness in sunlight-sensitive people. It is interesting that those affected nevertheless suffer from them relatively often. Of course, in such cases they can be excellently made up.

Conclusion: Sommersprossen können nicht gut behandelt werden und sollten daher toleriert werden.

Summary:

Pigmentflecken
sind nicht
all the same
and must
always be
dermatologically assessed
in case of doubt.

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