What causes dark spots on the face of a 40-year-old man, and what should be done about it?

Dark spots on the face of a 40-year-old man may result from ultraviolet (UV) exposure, aging, melasma, post-inflammatory hyperpigmentation, or seborrheic keratosis. These can be improved through sun protection, lifestyle adjustments, and medical treatments. If the dark spots grow rapidly, have irregular shapes, or are accompanied by itching or pain, prompt medical attention is necessary.

1. UV Exposure: Prolonged sun exposure stimulates melanocytes in the skin due to UV radiation, leading to excessive melanin deposition and formation of dark spots, commonly seen on sun-exposed areas such as the cheeks and forehead. It is recommended to practice daily sun protection by applying sunscreen, wearing wide-brimmed hats and masks, and minimizing direct UV exposure.

2. Aging: As one ages, skin metabolism slows down, impairing the clearance of melanin, which gradually accumulates on the face forming scattered dark spots with varying shades. It is advisable to maintain regular sleep patterns, consume more fruits and vegetables rich in vitamin C, and use skincare products containing whitening ingredients to promote melanin metabolism.

3. Melasma: Hormonal fluctuations or genetic factors can cause symmetrical light brown to dark brown patches on the face, which darken after sun exposure but typically do not cause discomfort. Under medical guidance, topical treatments such as hydroquinone cream, azelaic acid cream, or vitamin C injections may be used to improve symptoms.

4. Post-inflammatory Hyperpigmentation: After inflammatory skin conditions like acne or eczema resolve, localized melanin deposition may occur, resulting in dark spots that match the previous inflammation area with relatively clear borders. Under a doctor's supervision, medications such as tretinoin cream, centella asiatica glycoside ointment, or tranexamic acid tablets may help alleviate symptoms.

5. Seborrheic Keratosis: Caused by skin aging or genetic predisposition, this condition involves benign proliferation of keratinocytes, leading to flat, wart-like lesions ranging from light brown to black on the face, which may have a rough surface but usually cause no pain or itching. Under medical advice, topical treatments such as tretinoin cream, tazarotene gel, or salicylic acid ointment can help manage symptoms.

Maintain facial hygiene using gentle cleansers, consistently apply sun protection to prevent worsening of pigmentation, eat a balanced diet rich in antioxidant foods, maintain regular sleep habits and avoid staying up late, support healthy skin metabolism, and regularly monitor any changes in the appearance of dark spots.