I have a spot in my face which is spreading. What could it be?

Hi,

Welcome to icliniq.com.

I am sure your problem is distressing and is affecting you severely. Let us understand your case.

Since you are a very fair skin type patient, you are naturally more exposed to sun radiation which is UV-A and UV-B (ultraviolet A and B) rays. In effect what it does is, it disrupts the self-healing power of your skin and makes you more vulnerable to sun damage. The damage surmounts over time and the net result is skin changes along with the symptoms you described in your questionnaire. Microscopically, the cells in the deepest layers undergo irreversible changes and the cellular environment becomes a very rampant scenario where the speed to clear the damaged cells falls short of the rate at which the cells are damaged. So it results in pigmentation, slow or non-healing, and damage at the molecular level. In my professional opinion, gauging from the picture (attachment removed to protect patient identity) alone my diagnosis goes in favor of discoid lupus erythematosus or DLE. It is a chronic or longstanding skin response to sun damage.

It is a reversible benign condition if we institute the treatment right away. However, if we leave it to change letting time be the healer, it can transform itself into a more severe form of skin condition. It would include wearing good sunscreen like SPF 50+ (sun protection factor) or SPF 70 with PA+++ on a daily basis. It should be applied liberally on all the sun-exposed sites of the body like arms, face, neck, etc. You must apply it 15-20 minutes before going outdoors. It should be reapplied again after 2-3 hours. If the face becomes oily, it is a good idea to cleanse the face with a face wash and then reapply the sunblock.

My advice is to visit your dermatologist and take a skin biopsy to analyze the edges and the cell changes to clinch the perfect diagnosis. Biopsy is the definitive diagnosis. The treatment option is adequate sun protection. You can use mid-potent steroid cream like Mometasone on the affected part every night for 12-14 days and you can see a dramatic improvement. Avoid sun at all costs. Use a cloth to cover the area when you go outside. Strict sun protection is the cornerstone of the treatment. Try eating more beta-carotene in your diet from sources like carrots which act as natural sunscreens.