The formation of spots needs to be explained from several angles:
**Classification of Spots**
1. **Active Spots**: Caused by active tyrosinase, these are unstable in nature and affected by external factors such as sunlight and hormonal changes. The color may vary in depth and can be removed. Common types include melasma, sunspots, pregnancy spots, and black spots.
2. **Fixed Spots**: These are stable in nature and do not change due to external factors. Once removed, they do not reappear in the original area. Common types include genetic spots, freckles, age spots, and pigmented moles.
**Characteristics of Spots:**
1. **Freckles**: Related to genetics, 3% are associated with autosomes and blood. Sun exposure can deepen their color. They appear as isolated dots, each no larger than 0.5 cm in diameter, commonly distributed on cheeks, hands, and shoulders. They usually start appearing between the ages of 5-7 and cannot be completely eradicated, only lightened.
2. **Melasma**: Also known as butterfly spots or liver spots, they appear as light brown patches of varying sizes, with clear boundaries and irregular shapes. They do not protrude above the skin and are commonly found symmetrically on the cheeks. The main causes are related to endocrine issues and hormonal imbalances in women.
3. **Pregnancy and Sunspots**: These are caused by ultraviolet rays and are considered acquired conditions. They form in irregular sizes.
4. **Black Spots**: Includes metallic spots and rebound spots, which are acquired and related to cosmetics. Long-term use of makeup or heavy metal-containing cosmetics, such as those with lead or mercury, can cause these spots, but they can be eradicated.
5. **Age Spots**: Caused by natural aging, physiological decline, and slow metabolism. They often protrude above the skin and are generally found on the face and hands.
**Five Major Causes of Spots:**
1. **External Factors**: UV radiation, use of poor-quality cosmetics, and external abrasions.
2. **Internal Factors**: Endocrine disorders:
- A. Pregnancy-induced activation of tyrosinase leading to melanin deposition.
- B. Acid-base imbalance with a tendency towards acidity can slow down metabolism and cause pigmentation.
- C. Poor nutrition, vitamin deficiency, slowed metabolism leading to spots.
3. **Stress**: High stress, excessive fatigue, nervous system dysfunction, and decreased adrenal cortex function can activate tyrosinase, leading to pigmentation.