Introduction
Café-au-lait spots are benign pigmented macules of an even light-brown colour, which may be present from birth or appear during childhood or adulthood. They result from a localised increase in melanin without any abnormal growth of pigment cells. In most cases they are isolated and harmless.
Symptoms
- Even, light-brown “milky coffee”-coloured patches
- Sharp, regular borders
- Flat surface, not raised
- Variable size, stable over time
- Can occur anywhere on the body
- No pain, itching or inflammation
Causes
- Localised pigmentation abnormality
- Genetic factors
- Present from birth or appearing gradually
- Rarely associated with genetic syndromes when they are numerous
Diagnosis
- Clinical skin examination
- Assessment of the number, size and location of the spots
- A search for associated signs if there are multiple spots
Treatments
- Results vary depending on the depth of the pigment
- Specific medical pigment lasers
- Repeated treatments, sometimes with only partial results
- Strict sun protection to limit recurrence
Management
Clear information about their benign nature
A personalised dermatological assessment
A realistic discussion of the benefits and limits of treatment
Dermatological monitoring if there are multiple lesions