7 reasons you may have dots, spots or blotches on your skin

Skin bumps and irregularities of all shapes and sizes appear from time to time. Experts break down the common causes and treatments.

Skin bumps, dots, spots and blotches can be caused by numerous conditions.

While many skin issues resolve on their own, others require intervention.

Two experts outline some common skin problems and ways to treat them – but always speak to a doctor or skin specialist if you have particular concerns.

1. Sun/liver spots

Specialist dermatologist and mohs surgeon Dr Adam Sheridan explains sun spots/liver spots are clinically known as “solar lentigines” and appear as fixed shaded freckles that develop in areas subject to excessive UV damage.

“Sun exposure is the primary cause of sun spots, but other oxidative stresses including other forms of radiation, smoking, alcohol and stress may also play a role,” he says.

What can you do about sun or liver spots?

Prevention is always better than cure, so Dr Sheridan stresses vigilant sun-safe practices including applying a daily broad spectrum SPF 50+ sunscreen.

For existing sun spots, Dr Sheridan says options include ingested and applied antioxidants such as vitamin A and C; or vitamin B3, which encourages skin DNA repair in the face of UV damage.

“There are also fading creams, photodynamic therapy, IPL and laser treatment,” he says.

2. Milia

Milia appear as white small round balls sitting just under the skin surface, says The Dermal Diary skin therapist Isabella Loneragan.

They often appear in clusters when keratin becomes trapped, causing white or yellow cysts.

Milia affects a broad range of age groups, and Isabella says while the exact trigger is unknown, it’s sometimes linked to the use of “heavy oil-based face products”.

What can you do about milia?

Milia will often resolve itself, disappearing quickly for young people, or within weeks or months for adults.

For ongoing milia, it’s beneficial to assess whether overly greasy skin care products may be to blame.

To speed up their disappearance, Isabella suggests encouraging skin cell turnover.

“(Try) exfoliating products like enzymes, lactic acids and vitamin A (Retinol),” Isabella says.

Dr Sheridan adds: “Skin treatments ranging from skin peels, prick and release, retinoids and laser may be helpful.”

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3. Acne

Acne is an inflammatory skin condition, and a broad categorisation for concerns including whiteheads, blackheads, pimples, cysts and nodules.

“It appears on the skin through pustules, redness, lumpy skin, inflammation and excessive oiliness,” says Isabella.

“Acne is generally triggered by hormonal changes; both natural and due to disease states and medications,” says Dr Sheridan.

Improper skin care products or methods may also contribute to breakouts.

What can you do about acne?

There are numerous acne treatment options, depending on the type and severity.

An acne-targeted skin routine is often the treatment entry point.

Dr Sheridan recommends gentle non-abrasive and non-occlusive skin care products.

“Avoid harsh physical treatments such as scrubs and peels because while they may yield a short-term cosmetic improvement, they tend to inflame the skin and may encourage further acne and potentially leave scars,” he says.

A doctor or skin professional will be able to diagnose your specific acne type and provide a tailored response – including investigating any underlying hormonal issues.

“If your acne is significant, seek medical attention early as effective treatment exists for acne and its aftermath,” Dr Sheridan says.

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4. Eczema

Eczema is an itchy, scaly and at times weeping rash, says Dr Sheridan.

He says there are two kinds; one usually a result of genetic pre-disposition, the other caused by external or environmental factors that trigger irritation or incite an allergic response.

Products containing soap and fragrance are among the most common eczema triggers.

“Diet and gut health are also eczema triggers,” says Isabella, who recommends investigating your digestive health if you’re struggling to determine your potential eczema trigger source.

What can you do about eczema?

As with all skin irritations, it’s important to determine the trigger and avoid it when possible.

Dr Sheridan adds you should also adopt skin protective measures when you’re not experiencing a flare-up.

“Work to repair and build the resilience of your skin through regular moisturising, adequate water intake and a healthy balanced diet and lifestyle,” he says.

In severe cases, Dr Sheridan says a practitioner will likely prescribe topical and/or ingested corticosteroids and antihistamines.

“Your doctor may also initiate investigation to discover avoidable triggers and guide progression to further prescribed treatments including steroid alternatives and narrow band light therapy,” he says.

5. Psoriasis

Psoriasis looks like salmon pink, scaly plaques on the skin, explains Dr Sheridan. It’s most commonly found on the knees and elbows and may involve the scalp and nails.

There are some similarities between psoriasis and eczema, in that sufferers tend to be genetically pre-disposed to the condition and they’re often triggered by exposure to an external or environmental factor.

But unlike eczema, Dr Sheridan says psoriasis is usually less irritated or itchy.

“Common triggers that ‘draw out’ psoriasis include streptococcal throat infections, lack of natural sunshine, low Vitamin D levels and stress,” says Dr Sheridan.

What can you do about psoriasis?

Dr Sheridan says the first step is to rule out any underlying health issues potentially sparking psoriasis, and recommends a health check to determine if low vitamin D or a throat infection are at play.

He recommends safeguarding your skin’s hydration and overall health with moisturiser, sun protection, plenty of water, a balanced diet and healthy lifestyle.

For an active flare-up, treatment options range from topical creams and ointments to light therapy or oral or injected medications.

• Scaly skin: How to deal with psoriasis

6. Rosacea

Appearing on the face as small red, pus-filled bumps, rosacea is a common skin condition that causes redness and visible blood vessels, often lasting for weeks or even months at a time.

“There are three main triggers for rosacea: environmental damage, and in particular sunshine; hormones; and irritation of the gastrointestinal system,” says Dr Sheridan.

What can you do about rosacea?

The best way to manage rosacea is to familiarise yourself with your individual triggers – and avoid them.

“Consult your doctor regarding your hormones and to determine any triggers,” Dr Sheridan says. “Your doctor may also suggest remedies including creams, tablets and laser.”

For active rosacea, Isabella recommends seeing a specialist to implement a skin treatment plan.

“Niacinamide, vitamin C and vitamin A are all examples of ingredients that are known to have had a positive impact,” says Isabella. “And suitable sun protection is also a must.”

• Rosy cheeks: How to treat rosacea

7. Hives

“Hives is the common term for urticaria, a histamine release-induced inflammatory change within the skin,” says Dr Sheridan.

“Urticaria presents as raised lumps and bumps within the skin that are often itchy or irritated.”

An allergic reaction is usually to blame for their emergence and occurs in people who have a genetic pre-disposition to hives.

Dr Sheridan says all it takes to start an outbreak is the perfect storm of external triggers like extremes of temperature and vibration; or ingested drugs (like non-steroidal anti-inflammatory drugs or alcohol). 

What can you do about hives?

It’s important to discover your hives triggers – and avoid them as much as possible.

Dr Sheridan advises avoiding vigorous scratching as this can exacerbate the spread.

Instead, he suggests applying a cold pack to soothe the itchy area.

Over subsequent days it’s important to keep your skin care routine as gentle and hydrating as possible.

“Over-the-counter antihistamines and prescription topical corticosteroids may also be recommended by your doctor or pharmacist,” says Dr Sheridan.

“But seek medical care if you suffer a severe episode; and treat it as a medical emergency if you also experience shortness of breath, palpitations or a swollen tongue or lips.”

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Written by Sharon Hunt.