A Guide to Your Spotty Skin

“Most women in their 40s or 50s didn’t slather on SPF back in the day,” says Tina Alster, M.D., a dermatologist in Washington, D.C. “We baked ourselves to get a perfect tan, and now the sins of our past are coming back to haunt us in the form of spots and splotches. But it’s never too late to protect your skin, and to reverse some of that damage,” she says. Step one: If you haven’t yet, start getting annual skin checks from your dermatologist to help catch pre-cancerous lesions. Once you’ve received your clean bill of health, here’s a rundown on the different types of markings on your skin and what you can do about them.

These round-ish little brown splotches are caused by sun damage. The hyperpigmentation is an overproduction of melanin in response to UV exposure. It’s your body’s way of protecting itself from the sun. You can prevent future sun spots on your skin by wearing a broad-spectrum sunscreen with SPF 30 or higher whenever your skin is exposed—at the beach, walking outside, sitting near a window, or just all the damn time! As for erasing them: “A series of two to four fractionated laser treatments or chemical peels can help wipe the slate clean of spots,” says Alster. (FYI, peels are a much more cost-effective option.) At home, try using an exfoliating body lotion that contains AHA or BHA acids (CeraVe Renewing SA Lotion), or a brightening product with vitamin C or retinol. “Topical skincare products like these can’t eliminate pigment like a professional treatment can, but they will definitely improve skin texture and tone,” says Alster. 

These confetti-like sprinkles are another sign of sun damage. They appear where UV rays have basically fried the melanocytes in a particular area so they can no longer produce pigment. Prevention = sunscreen. 

This rough, flaky bump can appear out of nowhere, and is extremely common. “An SK can be gray, tan, or dark brown, and it often becomes itchy,” says Laurel Naversen Geraghty, M.D., an Oregon-based board-certified dermatologist. Seborrheic keratoses are created when too many dead keratinocytes get rolled up into a scaly little barnacle. While it’s benign, an SK is annoying, and has dogged staying power. That little blob won’t budge, no matter how much scrubbing you do, but a dermatologist can freeze it off with liquid nitrogen or use electrocautery to burn it off.   

These tiny red flecks may be flat or slightly raised and can literally appear overnight. “They are actually tiny clusters of very fine blood vessels that collect underneath the surface of the skin like a little flower,” says Geraghty. Like so many spots, these red bumps usually don’t show up on people under the age of 30. Sometimes they go away on their own, but more often they don’t. Typically, a cherry angioma is harmless, but if it bothers you, a dermatologist can use a pulsed dye laser to remove it in one treatment.

If a purplish brown, oddly shaped little blotch shows up out of nowhere, it’s probably a purpura—a form of a bruise that will fade away in a few days. “These are often seen on hands and arms, and can easily occur from the slightest trauma, even resting your handbag in the crook of your arm,” explains Geraghty. “As we get older, the skin becomes thinner, drier, and more prone to injury or irritation, so you need to be aggressive with moisturizing in order to keep that protective barrier strong.” Using a rich cream treatment (try Cetaphil PRO Gentle Body Moisturizer) will help keep these blotches at bay.