Age spots on African American skin

These flat marks reflect localized extra pigment and may appear medium brown, deep brown or grey-brown. Sun exposure contributes, but marks left by acne, eczema, irritation or injury can look similar and may require a different plan.

A sun spot, also called a solar lentigo, is usually flat with a distinct edge and develops on exposed skin. Post-inflammatory hyperpigmentation more closely follows a rash, spot, scratch or irritating product. The colour contrast may be subtle on richly pigmented skin, so texture, distribution and the way a mark has changed provide useful clues.

A clinician experienced in examining darker skin tones can distinguish a cosmetic pigment concern from a lesion that should be sampled. Skin colour alone cannot establish the diagnosis.

Apply broad-spectrum sunscreen to exposed areas and use shade or protective clothing during strong sun. Tinted sunscreen containing iron oxides may also help limit visible-light-related darkening. Avoid picking and stop products that cause ongoing burning or inflammation, because irritation can leave a more noticeable mark.

Once the diagnosis is clear, treatment may involve a topical pigment regulator or a carefully chosen procedure. Peels, freezing, intense pulsed light and lasers can all inflame skin; settings, cooling and aftercare must be selected with the risk of post-inflammatory darkening or lightening in mind. A test area may be considered before treating a larger field.

Book an examination for a spot that is enlarging, changing shape or colour, becoming raised, bleeding, crusting, persistently itching or failing to heal. Also seek care if many marks appeared after a new medicine or alongside a widespread rash.

Photographing the mark in consistent lighting can help show change, but an image does not replace examination when warning features are present.

You may want to ask whether the mark is a solar lentigo or post-inflammatory pigmentation, how the treatment was chosen for your skin tone, whether a test spot is appropriate, and what aftercare reduces irritation.