Q: I have developed brown spots on my legs and I hate them. They seem to be growing and getting more of them as I get older. What can be done for them?
A: When patients use the term, ‘brown spots’, that can be referring to a variety of colored or pigmented skin conditions. Most commonly, these can be sun or age spots where an excess pigment reaction develops in the upper most layer of the skin. These brown spots are flat in appearance. Other brown spot conditions could be keratoses or thickening of the outer skin layer which appear as raised and rough textured skin areas. These are known as keratoses. Occasionally patients may also be referring to more congenital light-colored brown areas known as cafe-au-lait spots or patches.
The success of brown spot removal depends on what type they are and what your ethnicity is. For flat brown spots as a result of sun and aging, broad band light (BBL) therapies (also known as intense pulsed light or IPL) can be very effective. This is a simple office that can significantly reduce them in or two visits. Raised brown areas like keratoses, however, do not respond to light therapies and require scalpel shaving. congenital birth marks such as café-au-laut spots can not be removed without leaving a lot of scarring and they are best left alone.
In dark-skinned patients (Asians, Hispanics, or African-Americans,) all such treatments could result in potential loss of pigment. This could create the look of white patches which may not be a good trade-off. The treatment of brown or dark patch areas should be approached with caution in darker pigmented patients and often are better left alone.