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Ever notice brown spots on your skin after a rash or an injury? Brown spots on your skin are often blamed on the sun, but any damage to your skin can result in skin spots.
Skin color is caused by pigment-producing cells called melanocytes. Anything that excites these cells will cause them to release brown pigment into your skin. Sun causes them to release pigment, but so can an infection, a rash, and even acne.
When you have an infection, injury or a rash, inflammation develops to protect your skin from harm and to repair damage. This inflammation is apparent as redness, scaling, swelling, pus, pain, or even itching. Inflammation triggers the melanocytes to make brown pigment which is dispersed and sinks into the deep layers of your skin.
Long after the inflammation is gone, the pigment remains and the brown spots stay visible. People with darker skin tones release more pigment when their skin is inflamed, which leads to more noticeable brown skin spots.
Brown spots such as these are called post-inflammatory hyperpigmentation because they appear after inflammation resolves. Unfortunately, once that pigment is deposited in the skin, it is very slow to fade. Over-the-counter bleaching creams such as hydroquinone 2% can lighten brown skin when used for weeks to months. More potent prescription creams such as Tri-Luma® can remove brown spots, but are expensive and generally are not covered by health insurance.
It is much easier to prevent than to remove brown skin spots:
Photo: Pat Hensen
Dear Dr. Benabio,
OMG, my face is a disaster! My acne is worse than ever. PLZ help me!
Desperately,
Your Patient
Many of my patients email me; this is the most common email I am getting this week. Why is everyone’s acne flaring up all of a sudden? It’s because of this simple formula: [High School Stress + Hormones = Acne].
Acne results when your pores clog, trapping sebaceous oils and bacteria deep in the skin. When you’re under stress, your body releases cortisol, a hormone that helps you stay alive in life or death situations. High school, however stressful, is not usually life or death, but your body doesn’t know that, and it reacts as if it were.
Two side effects of increased cortisol are increased sebaceous oil production and increased inflammation in your skin. The result: big, red pimples in the middle of your face that make you now wish you were dead.
If you have painful, cystic acne bumps, then your dermatologist can inject the worst ones with steroids to reduce the inflammation and to flatten them out quickly — “Nurse! Give me a syringe with Kenalog. Stat!” (Who said I don’t do emergencies?) Steroid injections can, however, cause atrophy or dimpling in your skin, which can last for months — much longer than the original pimple.
Remember that school is stressful, so eat well, sleep well (preferably not in calculus class), and exercise regularly. These will decrease your stress hormones and help keep you acne free.
Disclaimer: I did not receive any free products or reimbursement from any products mentioned in this post; these are my unbiased suggestions.
Photo: John Steven Fernandez
