A new dark or brown spot on the skin may seem like a harmless sign of aging, especially when it appears on areas that receive a lot of sunlight, such as the face, temples, hands, shoulders, or scalp. Many people simply assume that every new brown mark is an age spot and never think about it again.
In many cases, that assumption is correct. Sun exposure over many years can cause areas of increased pigmentation commonly known as age spots or sun spots. They are usually flat, brownish areas that can become more noticeable with age.
But not every new or changing skin spot is an ordinary age spot.
The most important thing is to pay attention to changes in a spot rather than simply its presence. A mark that changes in size, shape, color, or texture deserves closer attention, particularly if the change happens over a relatively short period.
A useful way to remember warning signs is the ABCDE approach. “A” stands for asymmetry, meaning one half of the spot looks different from the other. “B” refers to an irregular or poorly defined border. “C” refers to color variation, especially when a spot contains several different shades of brown, black, red, blue, or white. “D” refers to diameter, particularly a spot that is larger than about 6 millimeters, although concerning skin cancers can sometimes be smaller. “E” stands for evolving, meaning the spot is changing over time.
The last point is particularly important. A mole or dark spot that has remained unchanged for years may be less concerning than a new mark that is rapidly changing.
Other warning signs can include a spot that repeatedly bleeds, forms a crust, becomes painful, develops persistent itching, or does not heal. A sore that repeatedly opens and heals or simply refuses to heal should also be evaluated rather than treated indefinitely with home remedies.
The image accompanying this article shows pigmentation around the temple and hairline. This type of pigmentation can have many possible causes, including sun exposure and ordinary changes associated with aging. An image alone cannot determine whether a particular spot is harmless or requires medical attention.
Sun exposure is one of the most important factors affecting long-term skin health. Ultraviolet radiation can contribute to premature skin aging, wrinkles, uneven pigmentation, and skin cancers. This is why protecting the skin from excessive sun exposure remains important throughout life.
Using broad-spectrum sunscreen, wearing a hat, seeking shade, and limiting prolonged exposure during periods of strong sunlight can help protect the skin. Sunscreen is especially important on areas that are frequently exposed, including the face, ears, neck, hands, and scalp in people with thinning hair.
Another mistake people make is trying to remove suspicious spots at home. Lemon juice, baking soda, vinegar, strong acids, bleaching products, or abrasive scrubs may irritate the skin and potentially make pigmentation worse. More importantly, attempting to destroy a suspicious lesion yourself can delay proper diagnosis.
If a dermatologist needs to examine a spot, they may use a specialized instrument called a dermatoscope to look at structures that are not easily visible to the naked eye. If necessary, a biopsy can determine what the lesion actually is.
Not every brown spot is cancer, and most common age spots are harmless. Other benign conditions can also produce pigmentation, including freckles, seborrheic keratoses, post-inflammatory hyperpigmentation, and other types of moles.
The important point is not to panic when you discover a new mark. Instead, examine it carefully and pay attention to whether it changes.
Taking a clear photograph can be useful for monitoring a spot over time. Try to take the photograph in good lighting and include something that provides a sense of scale. If you notice significant changes, show the area to a healthcare professional.
You should be particularly cautious if a new or changing spot appears after years of having relatively stable skin, if it looks noticeably different from your other moles, or if it develops bleeding, crusting, pain, or persistent itching.
People with extensive sun exposure, a history of skin cancer, numerous moles, or a family history of certain skin cancers may need to be especially attentive to new or changing lesions.
The good news is that paying attention to your skin doesn’t have to be complicated. Once a month, take a few minutes to look at your skin, including areas that are easy to overlook. Check your face, scalp, neck, arms, hands, chest, back, legs, and feet.
If someone can help you examine areas that are difficult to see, such as your back or scalp, that can make the process easier.
Most importantly, don’t assume that every dark spot is simply an age spot. A new or changing mark deserves attention, but a skin spot cannot be diagnosed accurately from a photograph or from its color alone.
If you notice a spot that is changing, bleeding, growing, becoming irregular, or failing to heal, arrange an evaluation with a dermatologist or other qualified healthcare professional.
Early evaluation doesn’t mean that something is necessarily serious. It simply means that you are giving yourself the best opportunity to identify a problem early while also getting reassurance when the spot turns out to be harmless.
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