Pigmentation, Mole Monitoring and Other Conditions

Vitiligo is a condition characterized by well-defined, milky-white patches caused by localized loss of the pigment (melanin) that gives skin its color. It develops when pigment-producing cells (melanocytes) lose their function and is often associated with autoimmune processes. It is not contagious and does not cause pain.

It can occur on any part of the body and often shows a symmetrical distribution. Hair in the affected area may also turn white. Because it is visible, it can be emotionally challenging, so a supportive approach is important.

Symptoms

• Well-defined areas of milky-white loss of skin color
• Common sites: hands, face (around the mouth and eyes), elbows, knees and genital area
• Usually symmetrical distribution
• Whitening of hair in the affected area and increased sensitivity of the skin to sunlight

Types

It is generally divided into a generalized (non-segmental) type that appears symmetrically on both sides of the body and a segmental type type.

Associated factors

Autoimmune predisposition (which may occur together with conditions such as thyroid disease) and genetic tendency play a role. Skin trauma, sunburn or intense stress may act as triggers in some people.

What to consider in daily life

Because areas with pigment loss are more easily affected by the sun, sun protection is especially important. Treating the skin gently and considering cosmetic camouflage options when needed may also be helpful.

When should you see a specialist?

For newly appearing or spreading white patches, dermatological evaluation is recommended for accurate diagnosis, follow-up and assessment of treatment options. Evaluation for associated thyroid problems may also be considered.

How is the diagnosis confirmed?

Vitiligo can often be recognized by its clinical appearance. In fair-skinned individuals, a Wood's lamp examination may be used to make differences in pigmentation more visible. Fungal infections, post-inflammatory hypopigmentation and certain congenital pigment differences can resemble vitiligo. In newly developing or rapidly spreading cases, associated autoimmune diseases may be assessed according to the clinical history.

How are treatment options determined?

The location and extent of the lesions, how long they have been present and whether they are actively expanding are important when choosing treatment. Topical medications, controlled light therapies and other dermatological methods may be used in suitable patients.

During breastfeeding

In general, there is no problem with dermatological evaluation of vitiligo and the use of appropriate treatments during breastfeeding. If medication, a product or a procedure is required, the appropriate option is selected by a specialist physician.

Moles (nevi) are usually benign pigmented lesions found in most people. The vast majority are harmless and remain stable over time. However, because changes in a mole may be significant, regular self-examination and periodic dermatological evaluation can help detect noteworthy changes early.

Monitoring is especially valuable for people with many moles, a family history of skin cancer, fair skin, or significant sun/tanning-bed exposure.

Changes to watch for (ABCDE)

• A – Asymmetry: If the two halves of a mole do not resemble each other
• B – Border: Irregular, notched or blurred borders
• C – Color: Multiple colors or uneven color distribution
• D – Diameter: Moles that are generally larger than 6 mm or continue to grow
• E – Evolving: Changes in size, shape or color; itching, bleeding or crusting

Monitoring and evaluation

In addition to regular self-examination, dermatological examination and dermoscopy (magnified examination) provide a more detailed assessment. In people with many moles, digital mole mapping can be used to monitor changes over time.

What to consider in daily life

Sun protection, monthly self-examination and noting any new or changing moles can help with early detection.

When should you see a specialist?

If any ABCDE feature changes, a new mole looks distinctly different from the others (the "ugly duckling" sign), or a lesion bleeds, itches or does not heal, prompt dermatological evaluation is recommended.

What does dermoscopy provide?

Dermoscopy helps magnify and examine pigment and vascular structures in moles that cannot be seen with the naked eye. The aim is not to remove every mole, but to distinguish lesions with suspicious features and monitor moles that appear safe. In people with many moles, digital dermoscopic imaging can make it easier to compare subtle changes over time.

How is the ABCDE rule used?

A stands for asymmetry, B for border irregularity, C for color variation, D for diameter and E for evolving. However, only large moles are not necessarily dangerous, and a small lesion can also be important.

During breastfeeding

In general, mole examination, dermoscopic follow-up and removal of moles considered necessary can be performed during breastfeeding. If medication, a product or a procedure is required, the appropriate option is selected by a specialist physician.

Skin cancer screening is the dermatological evaluation of the skin and moles to detect suspicious lesions at an early stage. Early diagnosis significantly improves treatment success. For this reason, periodic screening is particularly important for people at increased risk.

The main types of skin cancer are basal cell carcinoma, squamous cell carcinoma and, although less common, the potentially more aggressive melanoma.

Findings to watch for

• A sore that does not heal, crusts or repeatedly bleeds
• A newly appearing or rapidly changing mole or lesion
• A persistent scaly or hardened area
• Moles that meet ABCDE criteria

Who should be especially careful?

People with fair skin, numerous or atypical moles, a family history of skin cancer, significant sun/tanning-bed exposure or a history of severe sunburn, and immunosuppressed individuals should be especially vigilant.

How is screening performed?

A full-skin examination and dermoscopic assessment are fundamental. In people with many moles, periodic follow-up can be performed with digital mole mapping.

When should you see a specialist?

Prompt evaluation is recommended for any suspicious, new, changing or non-healing lesion. If you are in a high-risk group, regular screening can be beneficial even without symptoms.

Who should be monitored more closely?

People with numerous or atypical moles, a family history of melanoma, fair skin that burns easily, or a history of intense sun exposure or repeated sunburn since childhood may benefit from more regular dermatological follow-up. The risk of certain skin cancers may also be higher in people taking immunosuppressive medications.

What is done during screening?

The dermatologist evaluates not only a single mole noticed by the patient, but the entire skin when clinically indicated.

During breastfeeding

In general, skin cancer screening, dermoscopy, necessary biopsies and local surgical procedures can be planned during breastfeeding. If medication, a product or a procedure is required, the appropriate option is selected by a specialist physician.

Sunburn is skin damage caused by excessive ultraviolet (UV) exposure and may cause redness, pain and sometimes blistering. Beyond short-term discomfort, repeated sunburns can increase the long-term risk of premature skin aging and skin cancer. Prevention is therefore the priority.

The effects usually become noticeable a few hours after exposure and may peak within one to two days.

Symptoms

• Redness, a feeling of heat and pain on touch
• Swelling and sometimes blisters
• Peeling over the following days
• In severe cases, fever, chills, dizziness or nausea

Prevention (most important)

• Use broad-spectrum sunscreen with SPF 30 or higher and reapply regularly
• Avoid the hours when the sun is strongest (approximately 10:00–16:00)
• Use a hat, sunglasses and lightweight covering clothing; seek shade
• Take extra care around reflective surfaces such as water, sand and snow, especially with babies and children

When sunburn occurs

Keeping the area cool, drinking plenty of water, using gentle moisturizers and avoiding further sun exposure may provide relief. Blisters should not be popped.

When should you see a specialist?

For widespread blistering, severe pain; symptoms such as fever, chills, dizziness or nausea; signs of dehydration; or burns in babies and young children, medical attention should be sought promptly .

How is the severity of sunburn assessed?

Mild sunburn causes redness, increased warmth and tenderness, while blistering, widespread swelling and marked pain may indicate deeper damage. If there is a very extensive burn, high fever, dizziness, intense thirst or altered consciousness, medical evaluation is required not only for the skin burn but also for possible systemic effects related to heat.

Care during the first days

Cooling the skin, using a gentle moisturizer and maintaining adequate fluid intake may be soothing. Applying ice directly to the skin, popping blisters and using irritating peeling products are not recommended.

During breastfeeding

In general, sunburn can be dermatologically evaluated and appropriate care can be provided during breastfeeding. If medication, a product or a procedure is required, the appropriate option is selected by a specialist physician.

Hyperhidrosis is sweating far more than is necessary for the body to regulate temperature. It most commonly affects the palms, soles, underarms and face. Because it can negatively affect daily life, social comfort and work, it should not be regarded as merely a "cosmetic" problem.

It is divided into a primary (focal) type that affects a specific area and usually begins at a young age, and a more widespread secondary type type.

Symptoms

• Visible, excessive and often symmetrical sweating in specific areas
• Daily-life problems such as soaked clothing or hands that are slippery and difficult to grip with
• Skin softening (maceration), odor or increased susceptibility to secondary infections

Possible causes and triggers

In primary hyperhidrosis, there is no clear underlying cause and genetic predisposition may play a role. In secondary hyperhidrosis, an underlying condition or certain medications may be involved. Stress, spicy foods and caffeine may increase sweating.

What to consider in daily life

Choosing breathable fabrics, using antiperspirant products, managing triggers and maintaining appropriate local hygiene may be helpful.

When should you see a specialist?

Dermatological evaluation is recommended if sweating affects daily life; if it starts suddenly, is one-sided or occurs at night, suggesting a possible secondary cause; or to assess suitable treatment options such as medical antiperspirants and local procedures.

How are primary and secondary sweating distinguished?

Primary hyperhidrosis usually begins in childhood or young adulthood and causes symmetrical excessive sweating of the underarms, palms, soles or face. The absence of marked sweating during sleep is typical. If sweating begins later in life, affects the entire body or occurs at night, secondary causes such as thyroid disease, infections, certain medications and metabolic conditions may be investigated.

What are the treatment options?

Treatment is stepped according to the location and severity of sweating. Medical antiperspirants, iontophoresis, botulinum toxin injections and systemic treatments may be considered in suitable patients.

During breastfeeding

In general, hyperhidrosis can be dermatologically evaluated and appropriate treatment options can be used during breastfeeding. If medication, a product or a procedure is required, the appropriate option is selected by a specialist physician.