A well defined, flat area that is darker in color than the rest of the skin (hyperpigmented) is called a café au lait macule (CALM). This refers to the characteristic even (homogeneous) color of “coffee with milk,” which may be light to dark brown. Although they may be present at birth, café au lait macules usually appear first in early childhood and can be indicators of more extensive (multisystem) disease like neurofibromatosis.

Café au lait macules needs no therapy. For cosmetic concerns, lasers may be used although the color often comes back after the treatment.

The signs and symptoms of café au lait macule include light-to-dark-brown, well-defined, even-colored, and often oval, flat lesions anywhere on the skin except for linings (mucous membranes) of body cavities such as the nose, mouth or genital areas.