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Got Spots?! What To Do About Brown Spots and Patches

Are you noticing brown spots slowly appearing on your face or hands?  As you start to be out in this sunnier weather this spring, brown spots many start cropping up.  This is called hyperpigmentation, and is one of the most common skin conditions.  Hyperpigmentation is characterized by darkening areas of skin due to an increase in melanin (the natural substance that gives skin its color or pigment).

There are three main causes of hyperpigmentation.  The first is melasma, which is patchy brown discoloration that occurs on sun-exposed areas of the face and often occurs during pregnancy.  Women who are pregnant or women taking estrogen are prone to melasma.  The second is post-inflammatory hyperpigmentation.  This is caused from increased pigment production in areas of damage on the skin; such as acne that is healing, injury, or eczema.  Post-inflammatory hyperpigmentation is more common in people with darker skin tones.  The third is sun-damage which can cause brown spots, and commonly called age spots or liver spots.

Before I continue, I do want to emphasize to have a yearly skin and mole check with your doctor so they can determine if any of your spots might be cancerous.  If you notice unusual moles, ones that are darker, irregular around the edges, or ones that have changed, should be looked at by a professional.

Now back to hyperpigmentation…

The mainstay to keep hyperpigmentation under control is to use SUN PROTECTION.  Use a broad-spectrum SPF of 30 or greater daily to maximize the benefit of any skin-lightening product you decide to use.

There are a variety of topical skin lightening agents out there that will fade age spots and melasma.  With consistency and patience, these areas will fade over weeks to months.  Let me describe to you some of the common ingredients to look for.

Soy and Niacinimide are used in many cosmeceuticals for their skin lightening effects.  They work by preventing additional pigment from coming to the surface of the skin.  Ellagic Acid is a great antioxidant and works by inhibiting an enzyme needed for melanin production.  Lignin Peroxidase is a mild skin lightener found in over the counter products that is an enzyme that comes from a fungus that can break down melanin in the skin.  (This is actually how wood pulp is whitened for use in paper).  Kojic acid is another antioxidant derived from a fungus and works by breaking down melanin in the skin. Licorice extract is a mild skin lightener.

Hydroquinone is a prescription topical cream that slows down the pigment-making processes in the skin and is one of the strongest and most effective brightening agents we have.  At high concentrations, however, it can be irritating and toxic to the skin.  Doctors prescribe 4% but a 2% is also available.  It’s important to not use hydroquinone continuously and take a ‘holiday’ from it every 3 months to use other lightening agents.

Arbutin is a natural derivative of hydroquinone derived from plants.  This is typically found in combination with other skin-lightening agents and a nice alternative to hydroquinone.

There are a variety of products with their own unique combination of ingredients.  I suggest that you decide which you might the most effective and the least irritating.  If a product isn’t working or you feel its irritating your skin, look at the ingredients and switch it up!

There are some great medical procedures for hyperpigmentation as well.

IPL or Photofacial is a treatment with intense pulsed light and frequently recommended by doctors to treat hyperpigmentation.  Improperly administered IPL can make hyperpigmentation worse … so choose your doctor carefully.

IPL is my procedure of choice to treat hyperpigmentation, however there are other options.  Chemical peels such as a TCA, glycolic or phenol peel can also improve hyperpigmentation, as can CO2 laser.

After your melisma clears, you may want to stay on a mild form of maintenance therapy, continuing to use products that slow down the pigment making process.  And if nothing else, be sure to wear sunscreen daily.

Have a great week!


Dr. Jill

  • May 23, 2019
  • Category: blog
  • Comments: 0
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