Skin Discoloration

What is skin discoloration?

Skin discoloration is when the color of your skin is different from what’s normal for you. Skin discoloration looks different on everyone, too. Discolored skin patches or spots can appear brown, red, white, pink, purple or black depending on your skin tone and the reason for the discoloration. Many things cause your skin’s pigment or coloring to change.

Some types of skin discoloration are caused by melanin production. Your body’s cells produce melanin, which gives your skin (and hair and eyes) its color. Sometimes, these melanin-containing cells get damaged and begin producing too much or too little melanin. If your body makes too much melanin, your skin gets darker. If your body doesn’t make enough melanin, your skin gets lighter.

Discolored skin can be caused by:

• Skin disorders.
• Birthmarks.
• Infection.
• Skin cancer.
• Injury or trauma (like burns or blisters).
• Allergic reactions.
• Medications.
• Chemicals.
• Health conditions.

Some skin conditions cause your skin to become dry, scaly and itchy. Others only affect your skin’s color. Many skin discoloration issues are treatable and don’t cause long-term harm.

If you have discolored skin, notice any changes in the coloring of your skin or develop new rashes or markings on your skin, contact a healthcare provider or dermatologist.

What causes skin discoloration?

Many things can cause discolored skin. Some of the most common are birthmarks, moles, infections, trauma or medical conditions.

Birthmarks or moles

Birthmarks are areas of skin discoloration that appear at birth or shortly after. Some birthmarks fade over time, while others are permanent or darken with age. Birthmarks are either vascular or pigmented. Vascular birthmarks are caused by irregular blood vessels. Pigmented birthmarks are caused by irregular melanin production.

Some of the most common birthmarks are:

• Strawberry hemangiomas: A clump of tiny blood vessels that form under your skin. It causes a raised red skin growth that resembles a strawberry. They typically go away by the time your child is 10.
• Port wine stain: A flat, dark red or purple birthmark caused by swollen blood vessels. It gets its name because it looks like red wine spilled on the skin. Port wine stains don’t go away, but lightening treatments may help fade them.
• Café au lait spots: Coffee-colored, flat spots or patches that typically appear at birth. They’re usually harmless but can indicate genetic conditions.
• Mongolian blue spots: Blue or gray patches on an infant’s skin at birth. They typically appear on the buttocks or back. They usually fade over time.
• Salmon patch (stork bites): A cluster of pink to reddish-purple blood vessels (capillaries) that appear on a newborn’s skin on the back of their head or forehead. It typically fades by the time your child is 2.

Moles (nevus or nevi) are brown or black growths on your skin. They usually appear as circular or oval spots but can also appear in groups. Moles can change in appearance over time or disappear. You can also develop new moles. 

Moles can lead to skin cancer, so it’s always a good idea to note any changes in their shape, size, texture or color. The ABCDEs are important signs of moles that could be cancerous.

Skin rashes and infections

Some skin rashes and infections cause your skin to change color. They are treatable with over-the-counter or prescription medication. Some examples of the most common infections or rashes are:

• Eczema: A common skin condition that causes dry skin and itchiness. There are at-home treatments like lotions and creams or prescription medications to help the symptoms of eczema.
• Psoriasis: A skin condition that causes thick, scaly patches called plaques. Psoriasis treatment often involves creams and ointments.
• Contact dermatitis: A skin rash that is red, burning, itchy or blistering. You get contact dermatitis from coming into contact with an allergen (like poison ivy) or an irritant (like a chemical). Anti-itch creams and steroid medication can offer relief.
• Rosacea: It causes small, red bumps on your nose, cheeks, chin and forehead. The condition worsens when the blood vessels in your face expand. Rosacea is treated with topical medication or laser therapy.
• Tinea versicolor: These are patches of discolored skin caused by a yeast infection. It’s treated with topical or oral antifungal medication.
• Ringworm: A circular, ring-shaped rash caused by a fungal infection. It’s treated with topical or oral antifungal medication.

Skin conditions

Some skin conditions are genetic or caused by hormonal changes beyond your control. Some common skin conditions that cause your skin to get darker or lighter are:

• Vitiligo: An autoimmune condition that causes your skin to lose color, resulting in light patches on your skin. Common treatments include camouflage therapy, repigmentation therapy, light therapy and surgery.
• Albinism: This genetic condition means you have lower melanin levels in the skin, hair and/or eyes. It’s a lifelong condition that doesn’t go away.
• Melasma: Brown or gray patches of skin caused by hormonal changes (like pregnancy) or medications. It’s typically found on your face. It usually fades over time, but some people use topical lightening creams or seek laser treatment from a healthcare provider.
• Age spots (or liver spots): Flat marks that develop on your skin, typically after sun exposure (also called sun spots). They appear in different shades of brown, tan or black. Topical creams, laser treatments or other skin resurfacing procedures can help fade age spots.

Skin cancer

Skin cancer most often develops on your face, arms, hands and neck due to sun exposure. Skin cancer occurs when cancerous cells form in the tissues of your skin. 

• Actinic keratosis: Rough, scaly patches that can lead to skin cancer. They may first appear with a yellow or brown crust on top.
• Basal cell carcinoma: This is the most common type of skin cancer. It causes lumps or bumps on the skin that are shiny. The patches may be red or itchy or bleed.
• Squamous cell carcinoma: This is the second most common skin cancer. It causes red bumps, sores or scaly patches that often bleed, heal and return.
• Melanoma: This is the most invasive form of skin cancer. It can appear in existing moles or new dark spots.

Health conditions

Some health conditions cause hyperpigmentation (darkening of the skin) or hypopigmentation (lightening of the skin): 

• Inflammation: Swelling and redness due to burns, sun exposure, blisters or other skin trauma.
• Lupus: If you have lupus, you may develop a rash on your nose and cheeks after sun exposure.
• Addison’s disease: It causes patches of dark skin around skin folds or joints.
• Diabetes rash: If you have diabetes, you may develop discolored skin patches or spots.
• Medications: Some medications can cause your skin to lighten or darken.
• Cancer: Certain cancers or paraneoplastic syndromes can cause pigmentary changes.

How do doctors diagnose skin discoloration?

A healthcare provider will ask questions like when the discoloration started, if it’s changed, how it feels or if you have other symptoms or medical conditions. They diagnose skin coloration disorders or conditions by:

• Examining your skin.
• Looking at your skin under a Wood lamp.
• Taking a biopsy of your skin and examining it under a microscope. 
• Ordering blood work.

How is skin discoloration treated?

It depends on the cause. If a medical condition is causing the skin discoloration, treating the underlying issue may fix the skin discoloration. If the skin problems or moles are cancerous, you’ll need surgery to remove areas of your skin or begin radiation therapy or other cancer treatment. Some discoloration goes away on its own or with minor treatment.

Some skin pigmentation issues can be treated at home or with topical medication available at the drug store. Others require stronger topical or oral medications from your healthcare provider.

Some common treatments for skin discoloration issues are:

• Antifungal ointments, creams and shampoos.
• Creams or lotions to lighten or fade dark spots or patches.
• Chemical peels.
• Laser skin treatments.
• Dermabrasion.
• Makeup to hide the discoloration.
• Surgery.
• Prescription oral or topical medication like antibiotics, antifungal medications or steroids.

What are ways to prevent skin discoloration?

Some causes of skin discoloration (like birthmarks or genetic conditions) are beyond your control. However, if you have skin discoloration caused by a condition or infection, there may be steps you can take to reduce your chances of future cases. These may be things like avoiding things that irritate your skin or practicing good hygiene.

There are also steps you can take to reduce your risk of conditions like skin cancer or sunburn:

• Always apply sunscreen when spending time outdoors.
• Avoid using tanning beds or sun lamps.
• Cover your skin with loose, comfortable clothing when you’re outside.
• Avoid the sun between 10 a.m. and 4 p.m. (when ultraviolet, or UV, rays are strongest).

When should this symptom be treated by a doctor or healthcare provider?

You should see a healthcare provider for a skin check every year. But you should also look over your skin regularly and call a provider if you notice any:

• Spots on your skin that look different from others, itch or bleed.
• Moles or lesions that change shape.
• A sore that doesn’t heal.