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Discoloration of the Skin

Actinic Damage: Red and Brown Spots

Red and brown spots are commonly seen on the sun exposed areas of the face, chest and arms, and is the result of the ultraviolet rays that you have received over a lifetime. Those sunny winter vacations, and days by the beach may be a distant memory, but the discoloration occurs years later. This is very different from a sunburn occurring at the end of the day on unprotected areas, where the damage occurs within hours, fading and peeling over the next several days. After the burn, you may think that your skin has healed and forgotten the neglect, but the brown and red spots will tell the story! That doesn’t mean that if you had excessive sun exposure as a child and young adult that there is no point in developing good habits now. Your skin will benefit from the protection of sunscreen and shade, activating repair mechanisms, decreasing the risk of skin cancer and improving the appearance of the skin.


Melasma refers to grey-brown patches, most commonly on the face, due to the pigment cells (melanocytes) overproducing pigment in these areas.

Women are much more likely to develop melasma, which is also called the “mask of pregnancy” when it is triggered by the changing hormones of pregnancy. Other sources of hormones, including birth control pills and hormone replacement can similarly trigger melasma.

People with darker skin are more likely to develop melasma, and there is also a genetic tendency, so if you have relatives with melasma, you are at greater risk for them as well.

The greatest trigger is ultraviolet (UV) light. Sunscreen is critical to preventing flares of melasma, as well as prevention of recurrence following successful cosmetic treatment of melasma.

Optimal treatment of melasma requires a thorough dermatologic evaluation to rule out other causes of irregular pigmentation. Once confirming the diagnosis, Dr. Sadoff discusses her many options for successful treatment, including laser, microneedling, peels and customized topical bleaching products.