Why Do Skin Spots Occur?
Skin health, beyond aesthetic appearance, is a biological indicator reflecting the overall condition of our body and its reactions to environmental factors. “Skin spots” (hyperpigmentation), which are among the top reasons for visits to dermatology clinics, are a common condition resulting from the irregular and excessive accumulation of pigments that give the skin its natural color in certain areas. Having smooth, even-toned, and vibrant skin is the desire of almost everyone; however, our genetic inheritance, hormonal fluctuations, and most importantly, the environmental factors we are exposed to, can put a stop to this dream. Spot formation is actually a complex biochemical process that the skin initiates as a “defense mechanism,” but which gets out of control over time.
Especially in a region like Izmir, where approximately 300 days of the year are sunny and the UV (Ultraviolet) index is high, understanding the mechanism of spot formation becomes even more critical. The skin of individuals living in Izmir is constantly exposed to the triggering effects of the sun, which causes melanocyte cells to work more actively. Not only the sun, but also the use of incorrect cosmetics, acne scars, pregnancy, and the aging process play a leading role in spot formation.
The Biology of Spots: Melanin and Melanocytes
To answer the question, “Why do skin spots form?”, it is first necessary to understand the “melanocyte” cells, which are the skin’s color factory.
Located in the lowest layer of the epidermis, the upper layer of our skin, melanocytes produce a pigment called “melanin”. Melanin is the substance that gives our skin its color; however, its main function is not to provide an aesthetic color, but to protect the DNA in the skin’s core from the sun’s harmful rays (UV). When we go out in the sun, our skin tans, which is actually the skin opening an “umbrella” by sending melanin, which it produces to protect itself, to the surface.
Normally, melanin pigment is evenly distributed in the skin. However, when certain triggering factors (sun, hormones, trauma) come into play, melanocytes “panic” and begin to produce excessive amounts of melanin. These excess pigment packets (melanosomes) clump and accumulate in certain areas of the skin. These accumulations form the dark spots we see on the skin’s surface.
Main Trigger: Sunlight (Ultraviolet Radiation)
The undisputed number one cause of spot formation is the sun.
As those living in Izmir know very well, sunlight reaches the skin in both UVA and UVB forms. UVB rays burn the upper layer of the skin, causing tanning and sunburns; UVA rays are more insidious and penetrate the deeper layers of the skin (dermis), causing long-term damage. Sunlight directly stimulates melanocyte cells, activating an enzyme called “Tyrosinase.” This enzyme is key in initiating the melanin production process. Unprotected sun exposure causes this enzyme to work continuously, leading to chronic spot production. This damage, accumulated over the years, manifests as “Solar Lentigo” (Age/Sun Spot) in later years.
Hormonal Changes and Melasma
Hormones are the most important internal factor in spot formation, particularly affecting women.
Pregnancy (Chloasma): Increased estrogen and progesterone hormones during pregnancy make melanocyte cells hypersensitive to the sun. During this period, the map-like spots that form on the forehead, cheeks, and upper lip are called “Pregnancy Mask” or “Melasma.”
Birth Control Pills: Hormonal medications can also trigger spot formation through a similar mechanism.
Thyroid Diseases: Hormonal imbalances can lead to disruptions in skin pigmentation.
Post-Inflammatory Hyperpigmentation (PIH)
Trauma to the skin is also a common cause of spot formation.
Acne, insect bites, burns, cuts, or improperly performed cosmetic procedures (aggressive peels, laser burns) create inflammation in the skin. As the skin heals, melanocytes in this area overreact and produce excess pigment. The brown or reddish spots that remain at the site of the healed wound are called “Post-Inflammatory Hyperpigmentation” (PIH). Especially in people with darker skin tones and those living in sunny regions like Izmir, the risk of scarring during wound healing is much higher.
Common Skin Spots and Their Characteristic Features
Understanding the cause of the spot is important for choosing the right treatment. The following table summarizes the most common types of spots:
| Spot Type | Main Cause | Appearance Characteristics | Location |
|---|---|---|---|
| Solar Lentigo | Chronic Sun Damage, Aging. | Clearly defined, round/oval, brown spots. | Face, back of hands, shoulders,décolleté. |
| Melasma | Hormones + Sun + Genetics. | Irregular borders, large patches, symmetrical. | Forehead, cheek, upper lip, chin. |
| PIH (Acne Scar) | Trauma, Acne, Injury. | Dark marks left at the site of acne or wounds. | Face, back, or area of trauma. |
| Freckles (Ephelides) | Genetics + Sun. | Small, numerous, darkening in summer dots. | Bridge of the nose, cheeks. |
Spot Management and Prevention in Izmir
Living in Izmir requires developing an extra defense strategy against spot formation. The first and most important step in spot treatment is “Prevention”.
- Sunscreen: Regardless of summer or winter, even if you are indoors (due to UVA and blue light coming from the window), a broad-spectrum (UVA+UVB) sunscreen with at least SPF 30 (preferably SPF 50+) should be used. If you are outdoors in Izmir, it is essential to reapply your sunscreen every 2-3 hours.
- Physical Protection: Wearing a hat and sunglasses are important barriers in preventing the formation of spots.
- Antioxidant Use: Topical antioxidants such as Vitamin C neutralize free radicals created by the sun, suppressing the formation of spots and increasing the effectiveness of sunscreen.
Treatment Approaches: Scientific Solutions
In the treatment of existing spots, medical aesthetics and dermatology adopt a multifaceted approach. The treatment plan varies according to the depth (epidermal or dermal) and type of the spot.
Today, methods such as **Thulium Laser (Lavieen)**, **Q-Switch Lasers**, **Spot Mesotherapy**, **Enzyme Peels (Cosmelan/Dermamelan)** and **Chemical Peels** are successfully used in the treatment of spots. The main goal of these treatments is to break down accumulated pigment, suppress melanin production (with tyrosinase inhibitors), and allow the skin to regenerate and shed the stained layer. However, it should be remembered that treating blemishes is a process that requires patience, and there is always a risk of the blemish returning (recurrence) if protective measures are discontinued.
Conclusion: Understanding the Language of Your Skin
In short, the answer to the question “Why do skin blemishes occur?” is a result of the skin’s self-protective instinct. The skin reacts to the sun, hormones, and trauma by producing melanin. Although this reaction may not be aesthetically pleasing, it is a biological process.
In Izmir, the key to having blemish-free and healthy skin is to understand this biological process well, to establish a harmonious but distanced relationship with the sun, and to always keep the skin’s defense barrier strong. When fighting your blemishes, instead of relying on hearsay, the best approach is to seek support from expert dermatologists or medical aesthetic physicians who can analyze your skin’s structure.
