Skin Discoloration

Skin discoloration can have many causes. Sometimes, it's annoying but nothing to worry about. But it can also signal a more dangerous condition.

Normal skin is smooth and uniform in color. You'll see darker, tanned skin in sun-exposed areas, of course, and the palms and soles are usually lighter than the rest of the skin. But sometimes discolored areas appear. You might see:

• Areas of darker skin which may be dry or rough.
• Flat patches of lighter skin.
• Reddened areas on the face.
• Lighter or darker areas left by cuts, scratches, or other injuries.

Skin darkening can have many causes. Diagnosis depends on where it appears, what the skin surface looks like, whether it's itchy or painful, and what other conditions the person has.

Possible causes include:

• Venous stasis. The term "venous stasis" describes a decrease in blood flow in the veins, usually in the legs. It tends to occur in people with congestive heart failure and may also appear in people with varicose veins. Its affect on the skin is called "stasis dermatitis." Symptoms and signs include leg swelling, the development of sores and deep ulcers, and a gradual thickening and darkening of the skin. The ankles are a common site for this skin discoloration.
• Melasma. Melasma is a darkening of facial skin. It often accompanies pregnancy, and sometimes it appears in women taking birth control pills. Young women with dark skin and people who live in sunny climates are also at higher risk, but anyone can develop melasma. Treatment includes sun protection and gentle bleaching creams.
• Birthmarks. A life-long patch of darkened skin may be a birthmark. Café au lait spots are the color of coffee with cream. They can appear anywhere on the body and are usually harmless. However, multiple café au lait spots can signal a genetic problem and should be checked by a doctor.

Common causes of lighter skin discoloration include infection and aging. Some types of skin lightening aren't well understood. Causes of light patches include:

• Vitiligo. Vitiligo is a skin disorder involving the gradual lightening of patches of skin. It may involve just one small area, large patches, or even most of the body. It's not dangerous, but the discoloration can be upsetting. Doctors think the cause may be a problem with the immune system. Treatments include steroids, special lights, and creams to calm the immune reaction.
• Tinea versicolor. This condition may look like vitiligo, but it's caused by a fungal infection. The fungus prevents skin from tanning normally, so that lighter patches appear. Antifungal creams and prescription pills can help.

Reddened skin usually signals skin irritation, damage, or an allergic rash. Staying away from the irritant and allowing skin to heal usually makes the redness go away. However, some causes of red skin discoloration are more difficult to treat.

• Rosacea. This common skin disorder is most common in fair-skinned people, but anyone can develop it. It begins as increased facial flushing—like a deep blush—and proceeds to permanent reddening, sometimes with prominent blood vessels and thickened, bumpy skin. Treatment includes avoiding triggers (such as spicy foods, certain lotions, or extremes of temperature), wearing sunscreen, and using both prescription and over-the-counter medicines.
• Birthmarks. Several types of birthmarks cause red or wine-colored skin. "Stork bites" are pale red patches on the back of the neck. They often disappear in childhood, but can remain into adulthood, too. Similar marks can appear on the forehead and eyelids; these usually fade by age two. Port-wine stains, red or dark purple marks caused by improperly formed blood vessels, are lifelong. They sometimes signal underlying diseases, so they should be discussed with a doctor.

Skin damage can lead to patches that are lighter or darker than surrounding skin. Blisters, burns, and acne can all leave skin discoloration. Some of these patches are permanent scars, which may fade but will never disappear. Luckily, the damage is often temporary. Dark spots left by acne, for example, usually clear up with about a year.

Many types of skin discoloration are harmless. However, any change in the skin is reason to check with a doctor, especially if it doesn't go away. Any new mole in an adult should be checked for skin cancer.

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