A brown spot on your face is often a sun spot: a flat, evenly colored patch on skin that gets a lot of sun. But melasma, dark marks left after acne or irritation, seborrheic keratoses and, less often, skin cancer can look similar. If a spot is new, changing, uneven in color or shape, or bleeding, or if you plan to treat it, have a dermatologist look at it first.
Here's how dermatologists tell common brown spots apart, and which changes are worth a visit.
Sun spots (solar lentigines): flat, even and on sun-exposed skin
Sun spots go by several names: age spots, liver spots and, in medical terms, solar lentigines. They come from years of ultraviolet (UV) exposure.
Typical features:
- Flat, not raised
- Tan to dark brown, and the same color throughout
- On skin that gets sun: the face, backs of the hands, shoulders, arms and upper back
- More common after age 50, though younger people who spend a lot of time in the sun get them too
Sun spots are harmless and don't need treatment, though many people choose to lighten them. Freckles are different: they are smaller, usually appear in childhood, and tend to darken in summer and fade in winter.
Melasma and post-inflammatory marks: why they're treated differently
Melasma usually shows up as larger patches, often on both sides of the face in a matching pattern. Common areas are the cheeks, forehead, bridge of the nose, above the upper lip and the chin. The color can be tan, brown or grayish brown. It is most common in women, especially those with medium to dark skin tones. Hormones play a role: pregnancy and birth control pills can bring it on, and sun exposure makes it darker. It may fade after pregnancy, but it can last for years and tends to come back. If you think a medicine is involved, talk with the doctor who prescribed it before you change anything.
Post-inflammatory hyperpigmentation is the dark mark left behind where skin was inflamed or hurt: a pimple, an eczema patch, a bug bite, a burn, or a product that irritated your skin. It is more common, and often lasts longer, in darker skin. According to the American Academy of Dermatology (AAD), a mark a few shades darker than your skin usually fades within 6 to 12 months once the cause stops, while deeper marks can take years.
Why the difference matters: melasma and post-inflammatory marks react easily to irritation. Some treatments used for sun spots can make them darker, especially in darker skin. Melasma care usually starts with daily sun protection and creams. Post-inflammatory marks start with controlling the cause, such as acne or eczema.
Other common brown spots, such as seborrheic keratoses
- Seborrheic keratoses: raised, waxy growths that look "stuck on" the skin. They range from tan to black, are very common with age, and are harmless.
- Dermatosis papulosa nigra: small, dark, harmless bumps on the cheeks and around the eyes, common in people with darker skin.
- Moles: usually a darker brown, and can be flat or raised.
- Actinic keratoses: rough, scaly patches on sun-damaged skin. They can be pink, red or brown. Some can turn into skin cancer, so they are worth having checked.
Less often, a skin cancer can look like a sun spot. One example is lentigo maligna, an early form of melanoma that tends to appear on sun-damaged facial skin in older adults. It usually begins as a flat brown patch that slowly grows and becomes uneven in color. This is one reason the AAD recommends having a dermatologist examine spots before you treat them.
How a dermatologist tells them apart
A dermatologist looks at a spot's color, shape, edges and texture, and where it sits on your face. They'll ask when it appeared, whether it has changed, and about pregnancy, medicines, acne, skin products and sun habits. Many dermatologists use a lighted magnifier for a closer look. If a spot can't be identified with confidence, a biopsy can settle the question.
Treatment depends on what the spot is
There's no single best treatment for sun spots on the face. The right choice depends on what the spot is, your skin tone, and how much time and downtime you're willing to accept. For confirmed sun spots, a dermatologist may discuss:
- Fading creams, over the counter or by prescription, which take weeks to months of regular use
- Chemical peels
- Cryotherapy (freezing the spot)
- Laser and light treatments
Whatever you choose, daily sun protection helps keep spots from coming back. Individual results vary. Melasma and post-inflammatory marks need their own plans, built around gentler care.
At Bay Ridge Dermatology: exams, biopsies and pigment care
Bay Ridge Dermatology treats pigment disorders as part of medical dermatology and offers full-body skin exams. When a spot needs a closer look, a shave biopsy can be done in the office (see surgical services). The practice does not offer laser treatment for pigmentation, including laser for sun spots and melasma, and its IPL (intense pulsed light) service is for hair reduction, not brown spots. Knowing what a spot is still comes first, and it helps you choose a treatment that fits.
Dr. Evangeline Perez is a board-certified dermatologist with more than 20 years of experience.
When to book a skin check
See a dermatologist if a brown spot on your face:
- Is new and looks different from your other spots
- Is growing or changing in shape or color
- Has several colors, or an uneven or blurry edge
- Bleeds, itches, crusts or doesn't heal
- Is a rough patch that keeps coming back
It's also worth a visit before you start any at-home or cosmetic treatment on a spot that hasn't been diagnosed. Having many sun spots is a sign of a lot of past sun exposure, so a full-body skin exam can be worthwhile. Our skin cancer screening guide explains what a screening covers.
If a spot on your face has you wondering, you can book online or call (347) 497-4984. A visit can help you learn what it is and what, if anything, to do next.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.