Editor's note: Not all dark or discolored areas on the skin are benign. Some may be cancerous or precancerous.
Please consult your dermatologist or health care provider before beginning any depigmenting treatment and follow up as the provider directs.
Depigmenting treatments are not FDA approved and may have side effects, including allergic reactions and hyperpigmentation. They should not be used if pregnant, nursing or planning to become pregnant. Please consult your provider for specific medical advice.
What Are Dark Spots and Why Do They Appear?
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Hyperpigmentation, or "dark spots," are patches of skin that seem darker than the surrounding tissue. Although it can affect any region of the body, the face, arms, and hands are the most frequently affected areas. These spots form when cells known as melanocytes, which produce melanin, are overactive. The overproduction of melanin, the pigment responsible for skin color, leads to patches or spots that appear darker.
Several factors contribute to the development of dark spots. One of the main causes is sun exposure since UV rays hasten the formation of melanin. Hyperpigmentation can also be brought on by hormonal changes, such as those brought on by birth control drugs or pregnancy. Additionally, skin injuries, acne, and other forms of inflammation can result in post-inflammatory hyperpigmentation. Using a dark spot remover can help mitigate these spots, but understanding their root causes is crucial for effective prevention and treatment.
Image Source[/caption]
Hyperpigmentation, or "dark spots," are patches of skin that seem darker than the surrounding tissue. Although it can affect any region of the body, the face, arms, and hands are the most frequently affected areas. These spots form when cells known as melanocytes, which produce melanin, are overactive. The overproduction of melanin, the pigment responsible for skin color, leads to patches or spots that appear darker.
Several factors contribute to the development of dark spots. One of the main causes is sun exposure since UV rays hasten the formation of melanin. Hyperpigmentation can also be brought on by hormonal changes, such as those brought on by birth control drugs or pregnancy. Additionally, skin injuries, acne, and other forms of inflammation can result in post-inflammatory hyperpigmentation. Using a dark spot remover can help mitigate these spots, but understanding their root causes is crucial for effective prevention and treatment.
Dr. Alexis[/caption]
Andrew F. Alexis, MD, MPH
Vice-Chair for Diversity and Inclusion
Department of Dermatology
Dermatologist
Center for Diverse Skin Complexions
Weill Cornell Medicine – NY
MedicalResearch.com: What are the main types of skin cancer? Is the incidence changing?
Response: The 3 main types of skin cancer are melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Skin cancer is the most common cancer in the United States1 and 1 in 5 Americans will develop skin cancer in their lifetime. (2)
The overall incidence has changed as follows:
• Melanoma: Rates doubled over past 30 years from 1982 to 2011.3 It differs by age group.
o Adolescents and adults age 30 and younger: incidence rate is declining
o Older age groups (e.g. 80 and older): incidence rate is increasing
• Squamous Cell Cancer:
o Incidence increased 263% between 1976-1984 and 2000-20104
• Basal Cell Cancer:
o Incidence increased 145% between 1976-1984 and 2000-20104
According to the 
Dr. Minneci[/caption]
Peter C. Minneci, MD
Chair of Surgery at Nemours Children’s Health
Delaware Valley
MedicalResearch.com: What is the background for this study? Would you briefly explain the symptoms/course of pilonidal disease?
Response: Pilonidal disease is relatively common and affects up to 1% of the population starting in adolescence and up until young adulthood. Pilonidal disease occurs when cysts or sinuses form between the buttocks. It is believed to be an inflammatory reaction to hair or debris that gets caught in the crease of the buttocks. Risk factors for the condition include a sedentary lifestyle, hygiene and obesity.
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Pilonidal Cyst
Dr. Zirwas[/caption]
Matthew Zirwas, MD
Founder, Bexley Dermatology Research Clinic
Bexley, OH 43209
MedicalResearch.com: What is the background for this study? How does Roflumilast differ from other treatments for seb derm?
Response: Seborrheic dermatitis affects up to 5% of the population globally and can have major impacts on quality of life. Treatment regimens are often complicated given the association of seborrheic dermatitis to hair bearing areas of the body, requiring multiple treatments for different parts of the body. Our phase 2 study aimed to understand the efficacy and safety of once-daily roflumilast foam 0.3% in adults with seborrheic dermatitis on their scalp, face and trunk. Roflumilast foam is a selective and highly potent phosphodiesterase (PDE) 4 inhibition that is being studied for a range of inflammatory skin conditions.
Dr. Ruiz[/caption]
John M. Ruiz, Ph.D
Associate Professor of Clinical Psychology
Department of Psychology
University of Arizona
Dr. Ruiz is the incoming editor-in-chief of the American Psychological Association (APA) journal, Health Psychology
Dr. Ruiz joined the U.S. Preventive Services Task Force in January 2022
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Skin cancer is the most common type of cancer in the United States, but it often does not cause serious complications or death. The Task Force’s recommendation on screening for skin cancer focuses on the effectiveness of visual skin exams for children and adults who do not have any symptoms. When reviewing the latest research, we found that there is currently not enough evidence to tell us whether or not screening people without signs or symptoms is beneficial. This is an I statement.
Dr. Guttman-Yassky[/caption]
Dr. Emma Guttman-Yassky, MD, PhD
Waldman Professor and System Chair
The Kimberly and Eric J. Waldman Department of Dermatology
Director, Center of Excellence in Eczema
Director, Laboratory of Inflammatory Skin Diseases
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background for this study are studies that show that OX40 is a pathway that is upregulated in patients with atopic dermatitis (or eczema). OX40 is involved in activation of immune molecules associated with allergy and atopy, and also with formation of memory immune cells that are required for disease recurrence. The hypothesis to the study was that giving an OX40 antagonist will not only ameliorate the disease but perhaps have a remittive effect in that the disease will not come back.
Indeed all drug doses were significantly effective at week 16, the primary endpoint compared to placebo and continued to improve towards week 36, the secondary endpoint. In addition, the responders to treatment maintained their responses for an additional 20 weeks, which is unusual, suggesting a potential for disease modification.
Dr. Curhan[/caption]
Sharon G. Curhan, MD, ScM|
Director, CHEARS: The Conservation of Hearing Study
Channing Division of Network Medicine
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02114
MedicalResearch.com: What is the background for this study?
Response: Herpes zoster, commonly known as “shingles,” is a viral infection that often causes a painful rash. Shingles can occur anywhere on the head or body. Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person has chickenpox, the virus stays in their body for the rest of their life. Years and even decades later, the virus may reactivate as shingles. Almost all individuals age 50 years and older in the US have been infected with the varicella zoster virus and therefore they are at risk for shingles.
About 1 in 3 people will develop shingles during their lifetime, and since age is a risk factor for shingles, this number may increase as the population ages. The risk is also higher among individuals of any age who are immunocompromised due to disease or treatment. A number of serious complications can occur when a person develops shingles, such as post-herpetic neuralgia (long-lasting pain), but there was limited information on whether there are other adverse long-term health implications of developing shingles.
There is a growing body of evidence that links VZV, the virus that causes shingles, to vascular disease. VZV vasculopathy may cause damage to blood vessels and increase the risk of stroke or coronary heart disease. Although some previous studies showed a higher risk of stroke or heart attack around the time of the shingles infection, it was not known whether this higher risk persisted in the long term. Therefore, the question we aimed to address in this study was to investigate whether shingles is associated with higher long-term risk of stroke or coronary heart disease.
To address this question, we conducted a prospective longitudinal study in 3 large US cohorts of >200,000 women and men, the Nurses’ Health Study (>79,000 women), the Nurses’ Health Study II (almost 94,000 women) and the Health Professionals Follow-Up Study (>31,000 men), without a prior history of stroke or coronary heart disease. We collected information on shingles, stroke and coronary heart disease on biennial questionnaires and confirmed the diagnoses with medical record review. We followed the participants for up to 16 years and evaluated whether those who had developed shingles were at higher risk for stroke or coronary heart disease years after the shingles episode. The outcomes we measured were incident stroke, incident coronary heart disease [defined as having a non-fatal or fatal myocardial infarction (heart attack) or a coronary revascularization procedure (CABG, coronary artery bypass graft or percutaneous transluminal coronary angioplasty)]. We also evaluated a combined outcome of cardiovascular disease, which included either stroke or coronary heart disease, whichever came first.
Dr. White[/caption]
Alexandra J. White, PhD, MSPH
Stadtman Investigator
Epidemiology Branch
National Institute of Environmental Health Sciences
National Institutes of Health
Research Triangle Park, NC
MedicalResearch.com: What is the background for this study? What is the chemical primarily used in hair straighteners?
Response: Hair products such as dye and chemical straighteners contain several different chemicals that may act as carcinogens or endocrine disruptors and thus may be important for cancer risk. Straighteners in particular have been found to include chemicals such as phthalates, parabens, cyclosiloxanes and metals and may release formaldehyde when heated. Previous research has suggested that hair dye and chemical straighteners are related to other hormone-sensitive cancers such as breast and ovarian cancer, but no previous study has considered how they are related to uterine cancer risk.
Dr. Vashi[/caption]
Dr. Neelam Vashi MD
Director of the Boston University Center for Ethnic Skin
Dermatologist at Boston Medical Center, and
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Dr. De La Garza[/caption]
Dr. Henriette De La Garza MD
Research fellow
Boston University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: The COVID-19 pandemic abruptly shifted many of our daily activities to an online world, dramatically increasing the use of electronic devices. Although visible light exposure from screens is small compared with the amount of exposure from the sun, there is concern about the long-term effects of excessive screen time. Recent studies have demonstrated that exposure to light emitted from electronic devices, even for as little as 1 hour, may cause reactive oxygen species generation, apoptosis, collagen degradation, and necrosis of skin cells. Visible light increases tyrosinase activity and induces immediate erythema in light-skinned individuals and long-lasting pigmentation in dark-skinned individuals. In recent years, tinted sunscreens have been rising in popularity because they are an effective and convenient way to protect against high-energy visible light while providing cosmetic benefits. The purpose of this analysis was to study current available options and product factors that may influence consumer preference when choosing a tinted sunscreen so dermatologists can improve their familiarity with available products and tailor their recommendations to patients with all skin tones.
Dr. Klimis-Zacas[/caption]
Dorothy Klimis-Zacas, MS, PhD, FACN
Professor of Clinical Nutrition
School of Food and Agriculture
Graduate Faculty
School of Biomedical Sciences
Associate Faculty, Institute of Medicine
Fulbright Fellow
University of Maine Orono, Maine 04469
MedicalResearch.com: What is the background for this study?
Response: Bioactive compounds such as polyphenols have been documented to have wound healing properties . In the Klimis-Zacas laboratory, phenolic extracts (PE) from wild blueberries (WB) were reported to promote angiogenesis in HUVEC cells via cell migration, angiogenesis, through VEGF/P13K/AKT pathway documented that the PE, primarily composed of chlorogenic acid significantly promoted cell migration and closure speed of wound by 38% above the control as well as angiogenesis and gene expression for proteins critical for cell movement while the anthocyanin fraction inhibited the above processes (5,6). 
Dr. Chen[/caption]
Chih-Shan Jason Chen, MD, PhD
Director, Dermatologic and Mohs Micrographic Surgery Unit
Memorial Sloan Kettering Skin Cancer Center at Hauppauge
Attending Mohs Surgeon, Dermatology Service
Memorial Sloan Kettering Cancer Center
Chief, Dermatologic Surgery Northport VA Medical Center
Associate Professor of Clinical Dermatology
Renaissance School of Medicine at Stony Brook University
MedicalResearch.com: What is the background for this study?
Response: Managing a surgical wound on the lower leg can be a challenge. Often, higher wound tension, atrophic skin, edema, and compromised circulation result in higher risks of wound dehiscence and infection, and significantly limit the capacity of wound closure post-surgically. Therefore, healing by secondary intention is a practical option for many lower leg Mohs defects. However, a secondary intention wound on the lower leg is expected to take a longer time to heal. Certain factors such as older age and health conditions of the host may adversely affect healing time.
Timolol is a nonselective beta-adrenergic receptor antagonist that has FDA approval for the treatment of glaucoma. In addition to this FDA-approved indication, topical timolol has several off-label uses in dermatology, such as for the treatment of infantile hemangiomas, venous stasis ulcers, and refractory wounds. Although timolol solution has been used in chronic wounds, knowledges of the efficacy and utility of timolol in an acute post-surgical wound setting is lacking.
Lara van der Schoot[/caption]
Lara van der Schoot
MD, PhD candidate
Department of Dermatology
Radboud University Medical Center
Nijmegen, The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Psoriasis is a chronic, immune mediated skin disease for which effective targeted biological agents have become available the past years. Inherent to their immunomodulatory mechanism of action, biologics might increase infections risk. We know from clinical trial data that respiratory tract infections are among the most common adverse events during biologic treatment, but real-world data is sparse. Regarding the risk of serious infections among biologic users, mostly defined as infections requiring hospitalization, previous studies provided different results and there is limited comparative data for the newer biologics available.
The COVID-19 pandemic turned attention to the risk of infections among biologic users, especially for respiratory tract infections, as they might relate to susceptibility for viral respiratory tract infections such as COVID-19.
In our study, the primary aim was to determine the risk of respiratory tract infections among real-world psoriasis patients treated with biologics, including the newer IL-17 and IL-23 inhibitors. The secondary aim was to assess risk of serious infections in this cohort. Additionally, rates of SARS-CoV-2 infections were assessed.