Brown spots come with age…yes…but most are due to sun damage. Not just direct sun damage – incidental sun damage too – like walking your dog in the morning, picking up food at lunch time, driving to and from anywhere (near and far) etc etc. You are NEVER truly out of UV rays from the sun – no matter how hard you wish to believe that you are. The proof is in the sun damage you develop – and then must deal with.
Pigmentation can also come from hormonal issues in women (melasma), acne (post-inflammatory pigmentation), genetic disorders, photo-sensitivity due to medications….
And then there is pigmentation from your skin not breaking down cell material properly when cells die off (or are killed off by safety mechanisms in the body). This issue has no real solution as yet. The big brown spot on my left cheek is proof of this.
According to the March/April 2010 edition of MedEsthetics, doctors invariably attack pigmentation issues with strong ingredients like Hydroquinone and retinoids (Retin-A and all similar products). Both of these product ingredients are irritating to the skin and often can not be tolerated by patients – who wants red/irritated/flaky skin?
As stated in the article “many individuals with uneven pigmentation also have sensitive skin, so it is important to ease into any treatment regimen”. Strengthening and balancing the skin is my #1 goal, so let’s do that before you embark on any expensive medical treatments.
Medical treatments for fair skin tones with light to moderate sun damage includes IPL and other stronger laser resurfacing treatments. Unfortunately doctors usually prescribe strong detergent cleansers and hydroquinone products post laser treatments so your skin will definitely be red/irritated/uncomfortable for quite some time.
Medical treatments for dark skin tones include the same harsh detergent cleansers and other barrier damaging ingredients in moisturizers, coupled with retinoids. I like glycolic acid serums and retinaldehydes in treating darker skin – it takes longer but will not create potential hypopigmentation issues (light spots). I agree with some of the doctors that a Jessner peel is a good solution of light skin tones as well as some darker skin tones. Come in for a consultation and we can decide if you are a good candidate for a strong peel. Specialized peels are an option at Blue Turtle Spa. I prefer to consult with you on a peel first, and if your skin is suitable we can set up an appointment. You will need to review the post-peel home care regimen because a peel is a commitment that you must plan for…
The essential aspect of any pigment lightening treatment is the repair and rejuvenation that occurs after the initial procedure. Help the skin get stronger with antioxidants (like the antioxidant vitaserum ), hydration gels (like the Hale Dermist HA ), and repair stimulating beta glucans and glycoproteins (as in the aloCell Gel ). Ongoing lightening in the home care regimen will include a nightly application of glycolic acid serums (like Glyco-A-Gel or Age Limit ) as well as a retinaldehyde (Vit A) serum (like Renew or Calm ). ALWAYS wear a mineral sunscreen (>10% minerals) EVERYDAY – otherwise your quest to lighten dark spots will all be wasted as the sun (UVA and UVB – whether direct or incidental) will always cause pigmentation issues to reappear.
Hydroquinone is approved by the FDA as a skin lightener. It does works. I can get you a high % Glycolic acid and 2% Hydroquinone mix for strong skin, and a high % Lactic acid and 2% Hydroquinone mix for less strong skin. Both have a distinctive ‘sting’ when applied to the skin. Some people may be able to use it nightly – others only 3 x per week. You have to scale back on it’s use if you are getting irritated skin (always a possibility with frequent use of products like this). Often the pigmented area will turn quite dark within a week or 2 but this will peel off and leave the area lighter – or even without the pigmentation if it is not too deep… I never recommend strong acids and hydroquinone for rosacea or weak/unbalanced skin.
Alternatives to hydroquinone are available – though they tend to work a little slower – so these are fine as long as you are not impatient about getting results. Arbutin from Bearberry extract is a natural form of Hydoquinone, Azelaic acid from almonds, Kojic acid – another natural form of Hudroquinone, Licorice and mulberry extracts also show lightening effects. Vitamin C also has skin lightening abilities (as well as being a great antioxidant) but there are many forms of Vit C, the one that penetrates the skin barrier the best is tetrahexyldecyl ascorbate – found in the Triple C E formula . Peptides are also a growing area of skin lightening ingredients.
The most important aspect of using any skin lightening ingredients is how well they can absorb into the skin. Many poorly formulated products will just sit on the skin and do not penetrate to where they will be effective. The quantity of the ingredient in the product is also critical to the level of success you can expect. Using an exfoliator like glycolic acid (in Glyco-A-Gel or Age Limit) together with any skin lightening ingredients will be the most effective.