We all know that sun
exposure can cause brown freckles to appear on our skin, but did you know too
much sun can also cause white spots
to develop?
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| IHG spots (before and after) treated with a chemical peel |
The white spots are known
medically as idiopathic guttate hypomelanosis (IGH) and
most commonly affect the legs, arms, upper back/shoulders and face.
What’s the difference between white and
brown freckles?
The white freckles of IGH are due to a decrease
in melanin (pigment) in the skin. This localised loss of pigment occurs
following damage to the skin cell’s DNA, caused by cumulative exposure to
ultraviolet light.
Brown freckles, on the other hand, are due to an increase
in melanin. This excess of pigment leads to hyperpigmentation (darkening of the
skin) – this is also caused by damage to the DNA of the skin cells.
Both types of freckles are benign and harmless and do not
indicate an increased risk of skin cancer. IGH is not related to vitiligo in
which melanin producing cells (melanocytes) die or are unable to function
properly and no longer form melanin.
Who is affected by IHG?
IHG is most commonly seen in fair-skinned people,
but can also be seen in older dark-skinned individuals.
It is a condition which tends to manifest in a
person’s 30s or 40s (in those with pale skin) and worsen with age. This is
thought to be because of the cumulative effect of sun exposure over the years,
rather than just as a result of aging.
However, there is evidence of a genetic component
as IHG has been known to run in families.
The
small white spots of IHG are usually seen
first along the anterior portion of the legs. The condition often affects women
earlier than men, possibly because their legs are more exposed.
How can IHG be treated?
IHG is harmless and does not require treating,
however you may find the white spots unsightly, especially if you have darker
skin. Sometimes the white freckles form in clusters making them more noticeable
and they will also be more visible when you have a suntan.
In the past, IHG has been treated with creams
such as retinoids and steroids (and also with natural remedies such as ginger
and figs), but these have limited efficacy.
In 2014 a clinical trial was
run to test the effectiveness of a phenol-based chemical solution – the
same as is used for facial peels. The results were very encouraging, with
repigmentation noted in 64% of IGH macules (white spots).
Spot peeling was carried out on 20 patients with
a total of 139 IGH macules. 88% phenol was applied with an ear bud once a month
and patients were assessed both subjectively and objectively after every
session and at the end of three months of therapy.
The researchers concluded that chemical peeling
is a “safe, simple, cost-effective, outpatient procedure for IGH”.
Chemical peel at Ocean Clinic Marbella
A chemical peel strips away layers of old skin to
stimulate the production of new cells, in a process known as ‘therapeutic
wounding’.
Peeling is usually carried out on the face,
because it is also effective for reducing the appearance of lines and wrinkles.
However, we are able to treat other parts of the body, such as the hands, or
apply spot peels to localised areas (i.e. to individual marks or blemishes).
Chemical peeling not only improves the appearance
of IHG spots, but also brown age/liver spots, scars and other discolouration.
And by ensuring use of an adequate SPF at all times and avoiding tanning beds,
patients can prevent further sun damage occurring to their skin.
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