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The face is our most present part of the body. It is therefore no wonder that changes in the form of spots are immediately visible and correspondingly disturbing for those affected. Stains on the face can have a wide variety of shapes and colors and have a wide variety of physiological and disease-related causes.
Like every skin area of our body, the facial skin is determined by the individual pigmentation and the general skin appearance of a person. When it comes to spots on the face, these two aspects play an important role. Added to this is the flatness factor. In terms of appearance and the type of facial spots, a distinction is made between raised spots and level spots similar to skin level. In addition, the extent of the stains is taken into account in the definition and a distinction is made between small, locally limited and large-area stains.
There is hardly any limit to the palette when it comes to the coloring of the facial spots. The spots can be lighter than the skin tone up to whitish, but also darker and therefore either brownish or reddish to violet. A distinction is made between the spots in the itchy and non-itchy, and dry to scaly. With a view to possible causes, it is also possible to differentiate between physiological and disease-related facial spots.
Face spots caused by physiology
Face spots do not always have to indicate an illness, in many cases they can simply be an expression of physiological processes in the body. The best-known example here are the fleeting spots that affect many people in stressful or very emotional situations. These spots are not a cause for concern, but an expression of an increased alertness of the vegetative nervous system. They are caused by a sudden expansion of the capillaries of the skin, which means that more blood flows through them and glows red. Usually they disappear as quickly as they came. But this does not mean that those affected experience little suffering because they often appear in the most inappropriate situations.
Starting with nervousness about an upcoming job interview or a presentation in front of a large crowd up to the first kiss with the new acquaintance, there are numerous situations in which an expansion of the capillaries can lead to spots on the face. Even drinking alcohol or staying in overheated rooms can be considered for this form of facial spots. Although the spots are annoying to unpleasant for those affected, they can usually be seen as a harmless expression of increased sensitivity and therefore do not pose a serious health risk.
Another, rather harmless variant of the facial spots are age spots. They develop increasingly with increasing age and manifest in addition to the face, especially on the hands. The medical term describes these abnormalities, which is due to an increased deposition of melanin in the skin areas, as hyperpigmentation. Their occurrence increases steadily beyond the age of 40 and is caused by a changed activity of the melanocytes in old age, which leads to an increased enrichment of the skin with the skin pigment melanin. The color pigments were originally intended to protect the skin from strong sun exposure, whereby people with a light main type in particular tend to develop an uneven distribution of the melanin, which is otherwise only slightly developed in some parts of the body.
Liver spots and moles are created in the same way. Here, too, an increased melanin concentration can be found in the dark brown colored speckles or spots on the skin. Where birthmarks are already present at birth and liver spots only appear in the course of life.
In the case of age spots as well as birthmarks and liver spots, science has assumed a certain genetic disposition as the cause. However, there is still disagreement about other influencing factors. Only the theory of very strong sun exposure as a driving force in the formation of pigment spots appears to be undisputed so far. Freckles in particular, which owe their name to the fact that they are increasingly caused by exposure to the sun's rays, support the assumption that an uneven, sun-induced distribution of melanin is responsible for the majority of all physiologically caused facial spots.
Important: If the spots caused by melanin enrichment behave inconspicuously and do not change in size or shape, they are no cause for concern. It looks different when pigment spots change in their appearance. There is a risk of carcinoma here, which is why changing skin spots should always be examined by a doctor in order to detect and treat imminent skin cancer at an early stage.
Face spots due to illness
Facial spots can be more serious if they are an expression of an existing clinical picture. In this case, the spots are indicative of a health problem that requires attention. On the one hand, these diseases can be limited to the organ of the skin, on the other hand, they can also affect other organ systems and metabolism.
Skin diseases as the cause
Skin diseases that can provoke facial spots include:
- Floret lichen,
- Skin cancer,
- Lupus erythematosus and
The causes of these diseases are often inflammatory in nature and can occur once or repeatedly. Acne is the best example of this. The disease results from inflammatory skin impurities, which people with a very oily skin often have to struggle with. It can sometimes be observed that discoloration persists in the skin area of the inflammation even after it has subsided. This is due to an impaired melanocyte activity due to the inflammation. Such a skin change is typical for acne, neurodermatitis and forms of psoriasis.
You should be particularly careful when existing stains change in size, extent and nature. Face spots of this type could hide a malignant degeneration of the skin cells, namely white or black skin cancer. Liver spots and birthmarks also carry an increased risk of degenerating over the course of life, even though they are originally of a more physiological nature.
A special form of facial spots caused by skin diseases is the so-called light dermatosis. These are local inflammatory processes in skin areas that are exposed to a lot of sunlight and become particularly irritable due to this strong sun exposure. The irritation reactions are comparable to those with existing allergy disease in the dermal area. For this reason, light dermatosis is also known colloquially as sun allergy. Doctors suspect that exposure to the sun with this skin sensitivity creates an allergen in the body, to which the body reacts excessively. In most cases, red, sometimes itchy spots appear.
In the case of light dermatosis, the skin reaction can also be intensified by certain substances such as preservatives and perfumes in cosmetic products. Some medications, including certain diuretics, antibiotics, heart medications and St. John's wort preparations, are also known to increase the sensitivity of the skin to light and thus favor light eruption.
Atopic dermatitis and psoriasis are skin diseases with an autoimmune background. And lupus erythematosus and mastocytosis are serious autoimmune diseases, some of which are manifested in the formation of facial spots. In the case of lupus disease, the typical butterfly erythema develops as extensive reddening of the cheeks and the bridge of the nose. Mastocytosis, on the other hand, usually develops smaller brown spots, which turn reddish when heated, rubbed or otherwise irritated and deformed pimply. Regardless of the different types of facial spots, both autoimmune processes require detailed diagnostics. Because the symptoms are often not limited to the skin.
Some metabolic disorders are reflected in more or less typical skin changes. In most cases, the cause of this is an excessive accumulation of metabolic products in the skin. Corresponding body processes also play a special role in acne. The skin disease is particularly common in adolescents, with doctors suspecting this age-related increase in inconsistencies in the metabolism, which can be attributed to hormonal changes in the body during puberty. Metabolic skin discoloration on the face can also indicate a disorder of the liver, kidney or adrenal gland.
Brownish spots around the area of the lips and inside the mouth can indicate the very rare but serious hereditary disease Peutz-Jeghers syndrome. This genetic defect is associated with an increasing number of gastrointestinal polyps that can also degenerate and lead to cancerous growths.
Recklinghausen's disease, known as neurofibromatosis, also describes a serious cause of facial spots. Here, tumors develop on all conceivable organ systems, but particularly often in the nervous system and on the bones. This disease is often associated with the appearance of so-called cafe au lait spots. These light brown spots can also appear on the face on other parts of the body. They are usually present at birth or develop in the first months of life. It should be noted that cafe-au-lait spots do not necessarily have to appear as a symptom of this malignant disease and can also be quite harmless in nature. Nevertheless, they always require detailed control and medical clarification by a doctor.
Facial blemishes can be determined by simply diagnosing the eyes. With regard to finding the cause, however, more extensive investigation measures could be necessary. In the case of suspicious birthmarks and liver spots, for example, biopsies are often carried out here to check skin samples for questionable cell degeneration. A biopsy is also common for skin diseases such as neurodermatitis or psoriasis. Other autoimmune diseases, on the other hand, are often examined on the basis of laboratory tests using blood samples to find possible autoantibodies and signs of inflammation. If necessary, genetic tests can also be carried out.
The treatment of facial spots is based on the underlying causes and can include everything from medicine, from an easy-to-use ointment therapy to an operation or even comprehensive system therapies. And even if it sounds paradoxical, in some cases specialized light therapy can help.
Home remedies and homeopathy
If the facial spots are caused by hyperpigmentation, you can certainly use various home remedies to achieve an equalization of the skin tone. The effect is based on a slight bleaching of the dyes in the skin, which can be achieved with the following natural substances:
- fresh lemon,
- raw potato,
- Apple Cider Vinegar,
- Aloe vera and
- Olive oil.
Appropriate treatments can be applied either as a pad or in conjunction with a lubricating healing ointment several times a day. Before treatment, however, the tolerance of the natural substances should always be tested on a small, inconspicuous area of the skin (e.g. behind the ear). It is also advisable to leave out the area around the eyes to avoid the risk of irritation.
From the repertoire of homeopathy and Schüßler salts, the following preparations have also shown good success in treatment and, above all, in preventing the tendency to face spots:
- Schüßler Salt No. 6 - Kalium sulfuricum,
- Schüßler Salt No.19 - Cuprum arsenicosum,
- Sempervivum tect. C30 and
- Berberis D6.
When used as a pad or applied internally, the preparations should support the skin flora positively and sustainably reduce the risk of skin imperfections and skin spots.
Inflammatory and autoimmune facial spots respond very well to local treatment with antibiotic and cortisone-containing ointments. In particularly severe cases, systemic therapy with cortisone and antibiotics in the form of tablets or even infusion solutions can be considered. People with chronic skin diseases are also recommended to use Dead Sea salt, silica and ointment regularly to improve their complexion.
It can happen that face spots have no real disease value, but nevertheless cause enormous suffering in those affected. This is mostly due to a very prominent expression and positioning of a pigment mark. Sufferers suffer a lot from this and they can be increasingly restricted in their day-to-day design, surgical or laser-assisted removal can be considered. Of course, the benefits and risks have to be weighed up very carefully here and the possible remaining scars should also be included in the decision-making process.
Surgical treatment is of course also out of the question if degenerate tissue or very suspicious tissue must be removed immediately to avoid spreading the cancer cells. Massively inflamed acne may need to be surgically removed as there is a risk of germs spreading to the brain.
Face spot diseases
Atopic dermatitis, psoriasis, floret lichen, acne, skin cancer, lupus erythematosus, mastocytosis, light dermatosis, white skin cancer, black skin cancer, metabolic disorders, Peutz-Jeghers syndrome, neurofibromatosis. (ma)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Shinjita Das: Hyperpigmentation, MSD Manual, (accessed August 21, 2019), MSD
- Martin Röcken, Martin Schaller, Elke Sattler, Walter Burgdorf: Taschenatlas Dermatologie, Thieme Verlag, 1st edition, 2010
- Alana M. Nevares: Systemic Lupus Erythematosus (SLE), MSD Manual, (accessed August 21, 2019), MSD
- Dorothea Terhorst-Molawi: Dermatologie Basics, Elsevier / Urban Fischer Verlag, 4th edition, 2015
- William J. Cunliffe; Harald P. M. Gollnick: Acne Diagnosis and Therapy, Taylor & Francis Ltd, 2004