Due to their resemblance to coffee with milk, cafe au lait spots are named after the French term for flat, pigmented patches of skin that are usually light brown in color. Although they are common and harmless, cafe au lait spots may sometimes indicate an underlying genetic disorder.
A cafe au lait spot is a result of an increase in the production of melanin, the pigment that gives skin, hair, and eyes color. Melanocytes are specialized cells in the epidermis that produce melanin. It is unclear exactly why some melanocytes produce more melanin than others, but genetic mutations, hormonal changes, or environmental factors may play a role.
Some of the genetic disorders that are associated with cafe au lait spots are:
In neurofibromatosis type 1, tumors grow on nerves as a result of the condition. Before puberty, people with NF1 typically have six or more cafe au lait spots larger than 5 mm in diameter, as well as freckles on the armpits and groin, skin folds, and eye iris.
A condition affecting the bones, skin, and endocrine system is McCune-Albright syndrome (MAS). In addition to cafe au lait spots covering a significant portion of the body, people with MAS may also exhibit bone deformities, early puberty, and overactive thyroids.
A person with Legius syndrome usually has multiple cafe au lait spots that are similar to those seen in NF1, but has no other characteristics of NF1.
A person with tuberous sclerosis (TS) may have cafe au lait spots, but they are usually smaller and fewer than those with NF1. This condition affects the brain, skin, kidneys, heart, and other organs. Seizures, white patches on the skin, and facial angiofibromas (red bumps) may also occur.
Usually cafe au lait spots do not cause pain, itching, or discomfort. However, if they are large or numerous, they may affect some people's appearance and self-esteem. As mentioned above, cafe au lait spots can also be a sign of a genetic disorder, which may also manifest as other symptoms and complications.
It is usually possible to diagnose cafe au lait spots through a physical examination of the skin. A Wood's lamp emits ultraviolet light to make the spots more noticeable. To rule out or confirm any genetic disorders associated with cafe au lait spots, the doctor may also ask about the person's family and medical history and perform some tests. Tests may include blood tests, urine tests, genetic tests, or imaging tests, such as X-rays, MRIs, and CT scans.
Unless the spots are a cosmetic concern or a genetic marker, they are not treated. If a person wishes to remove or reduce the appearance of the spots, the following options are available:
In laser therapy, melanin-producing cells in the skin are targeted and destroyed with a beam of light. In addition to lightening or eliminating spots, laser therapy can also cause side effects, including blistering, scarring, and infection. Additionally, laser therapy may not be effective for all types of spots, and may require multiple sessions to achieve desired results.
As a result of dermabrasion, a rotating device removes the top layer of the skin. It may reduce the visibility of spots, but it can also cause side effects, such as bleeding, infection, scarring, and skin color changes. Additionally, dermabrasion may not be suitable for all types of spots, and it may take more than one session to achieve the desired results.
In a chemical peel, the top layer of the skin is removed using a chemical solution. It has been shown that chemical peels can improve skin texture and tone, but they may also cause side effects, such as burning, stinging, redness, swelling, or infection. Furthermore, chemical peels may not be effective for all types of spots, and multiple sessions may be required to achieve the desired results.
It may be necessary to undergo regular monitoring and treatment for other symptoms and complications if the person has a genetic disorder associated with cafe au lait spots. Depending on the severity and type of the disorder, this may involve medication, surgery, or other therapies.
There is no known way to prevent cafe au lait spots, as they are mostly determined by genetic factors. However, some general tips to protect the skin and prevent further pigmentation are:
The sun can increase the production of melanin and darken spots, so it is important to limit exposure to the sun, especially during the peak hours of 10 a.m. to 4 p.m. A sunscreen with a sun protection factor (SPF) of at least 30 is also recommended, as well as clothing, hats, and sunglasses.
It is important to avoid skin irritation by not scratching, rubbing, or picking at the spots. Therefore, it is advisable to avoid any actions that may irritate the skin, and to use gentle skin care products that do not contain harsh chemicals or fragrances.
It is important to consult a doctor as soon as possible if the spots change in size, shape, color, or number, or if the person develops any other symptoms that may indicate a genetic disorder. By diagnosing and treating the disorder early, complications can be prevented or managed.
In most cases, cafe au lait spots are harmless and are caused by an excess of melanin, the pigment that colors the skin. NF1, MAS, Legius syndrome, or TS can sometimes be associated with cafe au lait spots, which can have other symptoms and complications as well. Unless they are a cosmetic concern or a sign of a genetic disorder, cafe au lait spots do not require treatment. Laser therapy, dermabrasion, and chemical peels are some of the options available to someone seeking to remove or reduce the appearance of spots. It is important to keep in mind, however, that these procedures may have side effects and may not be effective on all types of spots. Sun exposure, skin irritation, and consulting a doctor if you notice any changes or concerns are important for protecting the skin and preventing further pigmentation.
