Macule

What is it?

A macule is a flat spot on the skin that looks different in color from the surrounding skin but feels completely smooth when you touch it. Think of it like a stain on fabric - you can see it but can't feel it with your eyes closed. Macules are typically smaller than a pencil eraser (less than 1 centimeter) and can be various colors including brown, white, red, or purple.

What does it look like?

Macules appear as:

• Flat spots that are level with the skin surface
• Size of a pinpoint up to a pencil eraser (less than 1 cm)
• Various colors: brown (freckles), white (vitiligo), red (flat birthmarks), tan (café-au-lait spots)
• Smooth texture - no roughness, scaling, or elevation
• Clear or fuzzy borders depending on the cause
• Single spots or multiple spots that may cluster together

Where does it appear?

Macules can appear anywhere on the body:

• Face: Freckles, age spots, melasma
• Trunk and back: Café-au-lait spots, drug reactions
• Arms and legs: Vitiligo, post-inflammatory color changes
• Sun-exposed areas: Solar lentigines (age spots)
• Anywhere: Flat moles, medication reactions

Associated features

Macules may occur with:

• No symptoms at all (most common)
• Multiple similar spots in the same area
• Gradual color changes over time
• Darkening with sun exposure (brown macules)
• Family members with similar spots
• Other types of skin lesions if part of a rash

When to see a doctor

Seek medical evaluation for:

• New dark spots that appear suddenly
• Macules that change color, size, or shape
• Multiple café-au-lait spots (could indicate genetic condition)
• White patches that are spreading
• Red or purple spots that don't fade with pressure
• Any concerning changes in existing spots
• Macules accompanied by other symptoms like fever