Becker's Naevus

Authored by | Last edited

This article is for Medical Professionals

Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.

This page has been archived. It has not been updated since 23/05/2011. External links and references may no longer work.

Synonyms: Becker melanosis, pigmented hairy naevus of Becker

Becker's naevus is a form of epidermal naevus (birthmark). It usually appears around puberty as a hyperpigmented patch, most often found on the upper trunk or shoulders.[1, 2, 3]


There is overgrowth of the epidermis (upper layers of the skin), pigment cells (melanocytes) and hair follicles. It may be due to a gene defect (as yet unidentified), perhaps triggered by circulating androgens, which would explain its onset during adolescence.

  • It is more common in men.
  • One study reported a prevalence of 0.52% in men aged 17-26 years.[4]
  • A large brown area, sometimes covering half the upper back or chest. Most lesions become hairy (hypertrichosis).
  • After puberty it often becomes darker and expands, usually over a period of 1-2 years.
  • Occasionally acne may develop in the naevus.
  • Some fading (reduced pigmentation) may occur in adulthood.
  • One case of bilateral, symmetrical pigmentation is reported - this is unusual.[3]

The age of onset, site and the fixed nature of the lesion are usually enough to make the diagnosis.

  • McCune-Albright syndrome (with café-au-lait patches on the skin).
  • Pityriasis versicolor is usually symmetrical and slightly scaly.
  • Epidermis: acanthosis and hyperpigmentation of the basal layer, with elongation and fusion of adjacent rete ridges and variable hyperkeratosis.
  • Dermis: hyperplasia of the dermal smooth muscle and melanophages.
  • No treatment is necessary except for cosmetic reasons; usually reassurance and a diagnosis are enough.
  • For cosmetic treatment of the lesion:
    • Electrolysis or laser treatment may help with hair removal.
    • Laser treatment can sometimes reduce the pigmentation, but may be ineffective or may worsen the lesion.
    • Fractional resurfacing has also been used to lighten the lesions.[3]
  • For acne in the lesion, use standard acne treatments.
  • If there is doubt about the diagnosis (eg possible melanoma), urgent referral is appropriate.

The naevus remains indefinitely.[2]

This is a Becker's naevus with additional abnormalities of underlying tissues derived from ectoderm. It is a type of epidermal naevus syndrome. There may be underdevelopment or overdevelopment of underlying structures, including:

It is named after S. William Becker who first described the lesion in 1949. Becker naevus syndrome was described in 1995 by Happle.

Flu vaccination.
Protect yourself this autumn.
Find out if you are eligible for a free NHS flu vaccination.
Check eligibility

Further reading and references

  1. Becker Naevus, DermNet NZ, September 2010

  2. Becker's Naevus, DermIS (Dermatology Information System)

  3. Grim KD, Wasko CA; Symmetrical bilateral Becker melanosis: A rare presentation. Dermatol Online J. 2009 Dec 1515(12):1.

  4. Tymen R, Forestier JF, Boutet B, et al; (Late Becker's nevus. One hundred cases (author's transl)). Ann Dermatol Venereol. 1981108(1):41-6.

  5. Rivers JK et al; Becker Melanosis, Medscape, Apr 2010

  6. Cosendey FE, Martinez NS, Bernhard GA, et al; Becker nevus syndrome. An Bras Dermatol. 2010 Jun85(3):379-84.

  7. Steiner D, Silva FA, Pessanha AC, et al; Do you know this syndrome? An Bras Dermatol. 2011 Feb86(1):165-166.

hey new to this form so please let me know if I'm doing this wrong, over the past few months iv noticed a small rash form on my right palm and left middle finger that have thee tiniest black specs...

Health Tools

Feeling unwell?

Assess your symptoms online with our free symptom checker.

Start symptom checker