Question:
After the summer, I have suddenly become aware of a lot of disfiguring brown spots on only hands, legs and body. Is there a cream I could use to make them less noticeable or get rid of them please?
Answer:
The first thing to say is that if you are worried about your brown spots, you should, of course, consult your doctor or dermatologist immediately, because of the risk of skin cancer (especially if you have been in the sun a lot, without sun protection). Without actually looking at your 'brown spots', it's hard to diagnose but here are some possibilities.
Freckles
These are more common in people with fair skin, particularly with red hair, and are the result of a localized production of melanin, the pigment that gives your skin its colour. Small brown spots appear on areas of skin frequently exposed to sun.
Solar lentigos
Flat paler brown patches that appear anywhere on the skin and affect most people as they get older. These are also referred to as age or liver spots, and usually affect people over 40. Unlike freckles, they appear on covered areas of the body, too, and don't fade in winter. Lentigos are usually harmless but need watching as, over time, they can develop into malignant melanomas, i.e., skin cancer.
Moles
These flat or raised growths, which can run in families, may be rough or smooth and vary in colour from light to dark brown; they are caused by an overproduction of pigmented skin cells, called melanocpes, and can form anywhere on the body. They appear from birth onwards and most people have ten to 20 moles by the age of 30. There are several different types and they are usually non-cancerous but, again, should be regularly assessed by your doctor if you notice any changes.
Seborrhoeic keratose
Also known as seborrhoeic warts, these are irregularly round or oval, flat-topped plaques that seem 'stuck' on to the skin; they usually occur more on the torso than on the hands or legs. In a fair-skinned person, they are light brown at first but become darker with time. They tend to grow often several millimeters across, and new ones may appear continually. Their margins are very distinct; the surface becomes warty, and may have small projections visible to the naked eye. Rubbing can cause them to 'peel off' and there could be some bleeding. People who have them often think they are malignant, but they are, in fact, harmless.
It is interesting to know something about the biology of the skin so you can understand more about why these different lesions appear. The skin is composed of three main layers. The outermost is the epidermis, consisting of two main cell types, called keratinocytes and melanocpes. The middle layer is the dermis, which has connective tissue, nerve endings, blood vessels, lymphatic vessels and many other cells like fibroblasts (which form scar tissue) and mast cells (which contain histamine and produce the allergic reactions on skin, eg, swelling rash, itching). The third layer is subcutaneous tissue and contains fat, which acts as a cushion between the outer layers and the muscles and bones. This layer gives the contour to your body shape. Unless there is a problem with these lesions, most physicians tend to leave them alone, but we have had several letters from concerned readers, so here are some tips that might help to contain them.
Start following the instructions as soon as you notice them on your skin.
Diet
Avoid foodstuffs that inflame the skin, such as citrus fruits, yeast products, cheese and mushrooms, and only drink alcohol in moderation.
Remedies
* Take three twigs kadu and one third teaspoonful kariatu powder; soak in a cup of hot water overnight, strain and drink first thing in the morning. Do this for two months.
* Buy an aloe vera plant and every evening slice a small part off the leaf, squeeze the pulp onto a saucer and with a fingertip apply gently on the spots until it's absorbed bythe skin. Do this twice a week for two months. Alternatively, use pure aloe gel.
* A patient of mine, who is over 80 years old, used to go to a naturopath who told her to rub castor oil on her brown spots every, night, and she no longer has them on her face and arms. Since I have been recommending this to my patients some have said that the spots become less raised.
Sun protection
Some of these brown spots occur, or get worse, because of a sensitivity to sunlight, so always use appropriate suncare and apply it lavishly and regularly. (I prefer products that uses a physical barrier - rather than chemical - such as zinc oxide.)
