Most spots that appear on your skin are completely harmless. Age spots, small red dots, dry pale patches, and waxy raised bumps account for the vast majority of marks people notice, and they rarely need treatment. But because a small percentage of skin spots can signal something more serious, knowing what to look for makes a real difference. Here’s a guide to the most common types, what causes them, and which features deserve a closer look.
Flat Brown Spots From Sun Exposure
The most common skin spots people notice are solar lentigines, better known as age spots or sun spots. These are flat, brown or tan marks that show up on areas that get the most sunlight: the backs of your hands, your face, neck, and forearms. They typically measure 3 to 6 millimeters or larger and have clearly defined edges. They’re not raised, they don’t itch, and they don’t change texture over time.
Sun spots are caused by years of UV exposure triggering pigment-producing cells to cluster together. They become more common after age 40 but can appear earlier in people who spend a lot of time outdoors or use tanning beds. They’re purely cosmetic and don’t become cancerous, though they can sometimes be confused with other pigmented spots that do need attention.
Freckles are a related but distinct type of flat brown spot. They tend to be smaller, appear earlier in life, and fade noticeably during winter months. Sun spots, by contrast, stay put year-round once they develop.
Waxy, Raised, “Stuck-On” Growths
If you’ve noticed a raised, rough-textured bump that looks like it was glued onto your skin, you’re likely looking at a seborrheic keratosis. These are among the most common benign growths in adults over 50. They range in color from light tan to dark brown or even black, and they have a characteristically waxy, greasy surface with well-defined borders. They can appear almost anywhere on the body except the palms and soles.
Seborrheic keratoses are harmless and don’t require treatment unless they catch on clothing or bother you cosmetically. Their “stuck-on” appearance and sharp edges are the key features that set them apart from precancerous spots, which tend to be rough, scaly, and blend into the surrounding skin without a clear border.
Rough, Scaly Patches on Sun-Exposed Skin
Actinic keratoses look and feel quite different from the waxy growths described above. These are rough, sandpaper-textured patches that typically appear on the face, scalp, ears, and forearms. They’re often pink or reddish, with poorly defined edges that fade into the surrounding skin. You might feel them before you see them.
These spots are considered precancerous. A small percentage can progress to a type of skin cancer called squamous cell carcinoma if left untreated. If you have rough, scaly patches that don’t heal or keep coming back in sun-exposed areas, getting them evaluated is worthwhile. Treatment is straightforward and usually handled in a single office visit.
Small Red or Purple Dots
Bright red, pinpoint-sized bumps that appear on your torso, arms, or legs are most likely cherry angiomas. These are tiny clusters of blood vessels just under the skin’s surface. They’re round, smooth, and usually 1 to 5 millimeters across. Almost everyone develops a few by middle age, and they become more numerous over time. They’re entirely benign.
One quick way to check: press on the spot. Cherry angiomas typically blanch (turn white) when you apply pressure, then return to red when you release. Petechiae, which are tiny dots caused by broken blood vessels beneath the skin, do not blanch with pressure. Petechiae look like flat pinprick-sized dots, often appearing in clusters, and they can indicate a bleeding issue or an infection. If you notice a sudden crop of non-blanching red or purple dots, that warrants prompt medical attention.
Light or White Patches
White spots on the skin fall into a few categories depending on how they look and where they appear.
Pityriasis alba is extremely common in children and young adults. It shows up as pale, slightly dry, round or oval patches, most often on the face and upper arms. The borders are indistinct, blending gradually into the surrounding skin, and the surface may feel slightly rough due to fine scaling. It’s associated with dry skin and often becomes more noticeable after sun exposure, since the affected patches don’t tan as well. It resolves on its own, sometimes over months.
Vitiligo looks different. It produces patches of completely depigmented (milk-white) skin with sharper borders. Rather than being slightly lighter than surrounding skin, vitiligo patches have lost their pigment entirely. It’s an autoimmune condition in which the body’s immune system attacks pigment-producing cells, and it can appear at any age. It’s not dangerous, but it tends to be progressive without treatment.
Patches That Change Color With the Seasons
If you have oval or round spots on your chest, back, neck, or upper arms that seem to shift between lighter and darker than your surrounding skin, you may be dealing with tinea versicolor. This is a fungal skin condition caused by a type of yeast that naturally lives on everyone’s skin but occasionally overgrows.
The name “versicolor” refers to the variable colors these spots can take. On darker skin tones, the patches tend to appear lighter than the surrounding skin. On lighter skin tones, they tend to appear tan, pink, or light brown. The spots are covered in a fine scale that can be hard to see at first glance but becomes obvious if you gently stretch or scrape the skin. The condition is particularly common in warm, humid climates and in teenagers and young adults.
Tinea versicolor is not contagious and isn’t a sign of poor hygiene. Over-the-counter antifungal washes often clear it up, though the color difference in the skin can linger for weeks or months after the fungus itself is gone.
Dark Patches on the Face
Symmetrical brown or grayish-brown patches across the cheeks, forehead, upper lip, and nose point toward melasma. In one study of melasma patients, the cheeks were involved in about 90% of cases, the forehead in 73%, the upper lip area in 67%, and the nose in about 65%.
Melasma is driven primarily by hormonal changes and UV exposure. It’s especially common during pregnancy, while taking hormonal birth control, or during hormone therapy. The pigment-producing cells in people with melasma appear to have heightened sensitivity to hormonal stimulation. Sun exposure darkens the patches further, which is why melasma often worsens in summer and improves in winter. It’s a cosmetic concern, not a health risk, but it can be stubborn to treat.
Spots That Could Signal Skin Cancer
Most skin spots are benign, but a few warning features should prompt you to get a spot evaluated. The well-known ABCDE framework remains the most practical tool for checking moles and pigmented spots:
- Asymmetry: one half of the spot doesn’t match the other.
- Border: the edges are irregular, ragged, or blurred.
- Color: the spot contains uneven shades of brown, black, tan, white, gray, red, pink, or blue rather than a single uniform color.
- Diameter: the spot is larger than about 6 millimeters (roughly the size of a pencil eraser), though melanomas can be smaller.
- Evolving: the spot is changing in size, shape, or color over weeks or months.
Basal cell carcinoma, the most common type of skin cancer, often doesn’t look like a mole at all. It frequently appears as a small, shiny, slightly translucent bump with a pearly or pinkish surface. It may develop tiny visible blood vessels and can bleed, scab over, and then bleed again without fully healing.
How Skin Checks Work
If you have a spot that concerns you, a dermatologist can usually assess it visually using a dermatoscope, a handheld magnifying device with its own light source. If a spot looks suspicious, the next step is a biopsy, which takes just a few minutes in the office.
The three common biopsy types are a shave biopsy (removing a thin layer from the surface, usually no stitches needed), a punch biopsy (taking a small cylindrical sample including deeper layers, often requiring a stitch or two), and an excisional biopsy (removing the entire spot along with a margin of normal skin, which does require stitches). Healing generally takes several weeks, with leg and foot wounds taking the longest. You’ll typically need to avoid soaking the area in water for about seven days.
For people at average risk, periodic self-exams are the most practical approach. If you have a family history of melanoma, fair skin, light eyes, red hair, or a large number of moles, guidelines from multiple countries recommend professional skin checks every 6 to 12 months along with monthly self-exams at home. Germany offers routine screening every two years for all adults 35 and older through its public health system.