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White spots on legs or arms? Think of Beer spots!

  1. Beer spots are white spots that mainly occur on the arms and legs of young adults. However, they can only be seen when the limbs are held down! As soon as an arm or leg is lifted high enough, they more or less disappear. Therefore, they should not be confused with pigment disorders such as vitiligo or idiopathic guttate hypomelanosis. These beer spots are caused by local differences in the blood circulation in the skin.

How to identify?

  1. Beer spots were first officially described by August Bier in 1898. Other common names for this condition are hail skin, multiple anemic macules and constitutive speckled vascular mottling. Beer spots are easy to spot. They are small white spots distributed in a regular pattern on the arms and legs (and very occasionally on the trunk). You can only see them when the limbs are held down. Once you lift the limbs, they largely disappear as blood flow improves. If you press the Bier spots for a few seconds, the skin around it also becomes completely white, but then the skin darkens again so that you can see the Bier spots again. They usually develop spontaneously and mainly occur in young adults, but sometimes pregnant women can get them too. Beer spots may get worse over time or spread, but in most cases it will eventually disappear completely. With some you can see them much more clearly than with others. Quite a few people have this condition.

What is the cause?

  1. It is not certain how and why these Bier spots were created. In any case, they have to do with differences in the blood circulation in the skin. At the location of the white Bier spots, the blood vessels may be more narrowed, so that less blood flows through and / or in the darker skin around them they are more dilated. There are also sources that claim that the blood in the skin around the spots may contain less oxygen, so that the blood there is more purple and the skin there is also more purple. A combination of these factors is also possible.

Do they indicate an underlying disease?

  1. Because beer spots have to do with the blood flow, you would think that it might indicate an underlying cardiovascular disease. Yet only a few cases are known where people who had beer spots also suffered from this. Most people with Bier spots have nothing else at all! There is even a good chance that your doctor has never heard of Bier spots at all, because people with Bier spots often do not suffer from it and therefore do not go to the doctor! For people with an increased risk of cardiovascular disease, it is useful to check with your doctor whether your beer spots are an indication of an underlying disease. In addition, you often hear that people who suffer from liver disease have beer spots. Yet they often suffer from several things that belong to liver diseases (fatigue, swollen stomach) and not just the Bier spots.

What can you do about it?

  1. Although it is being experimented with, so far no treatments or drugs have been found that help against Bier spots. For example, it has been tested with the drug Nifedipine, which is often prescribed in people with high blood pressure, but it was not effective.

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