What causes them. How to avoid them. What to do about them.
How dark spots develop
Have you noticed your skin developing dark spots (two of our least favorite words). Dark spots (hyperpigmentation) don't happen overnight -- it's the result of many factors over time. So why exactly is this happening?
Even as we take precautionary measures to protect our skin from sun damage, natural environmental factors and age can lead to dark spots (sometimes called age spots, melasma or liver spots) on the skin.
Your skin contains melanin, which gives your skin its color. Dark spots appear when melanin is produced in concentrations. These spots occur when the skin produces too much melanin and can range in color from light to dark tan, brown or black. They vary in size and usually appear on the areas most exposed to the sun such as the face, hands, shoulders and arms. However, dark spots can also develop as a result of aging, or hormonal changes such as during pregnancy or menopause.
Another way dark spots occur is by a condition called post-inflammatory hyperpigmentation (PIH). You can develop PIH due to acne, bites, cuts, and burns, excessive or incorrect hair removal techniques, ingrown hairs, harsh skin care products and scarring from psoriasis or other skin conditions.
Dark spots are common in adults older than age 50, but younger people can get them too, especially if they spend a lot of time in the sun or use tanning beds.
What can I do about these spots?
If you’re unhappy with the appearance of dark spots (and who isn’t), not to worry, there are a variety of ways you can have them lightened or removed. The dark pigment is at the base of the epidermis — the topmost layer of skin — so any treatments must penetrate this layer of skin. The correct diagnosis as well as, skin type and severity are important considerations for a successful outcome.
The latest corrective procedures for dark spots
IPL Lasers
Lasers have a unique ability to specifically target pigment in the skin. This property allows for safe, effective and rapid treatment of brown spots. Laser therapies target melanin granules and melanin-producing cells (melanocytes) without damaging the skin’s surface.
Intense Pulsed Light (IPL) technology is one of the most effective treatments for dark spots.
IPL is a treatment that works to rejuvenate the skin by encouraging skin cell turnover and new collagen production. On dark spots, this treatment reduces the unnecessary melanin that produces excess pigment. Because IPL treats only pigment, rather than surrounding skin, you’ll experience a fast, effective treatment with minimal downtime. IPL is an FDA-approved treatment for correcting dark spots, and most you’ll see results within just a few treatments.
A major benefit of IPL treatments is that they are completely customizable and can reduce the appearance of dark spots on the face, chest, back, neck, hands and other locations on the body.
Unlike a traditional laser, which utilizes a single color of light, our IPL lasers flash a whole spectrum of colors at one time.
The IPL laser’s broader spectrum of colors and wavelengths can target skin irregularities more effectively and efficiently minimize the pigmentation in dark spots. The light energy, also called photo-thermal energy, is directed at the skin in short blasts of high-intensity light, which focuses heat on those areas of skin. While it works to heat the skin, IPL does not burn, and patients report minimal discomfort during and after the procedure.
A great benefit of IPL is that it is a minimally invasive treatment with limited downtime.
Depending on the area of skin that is receiving treatment, sessions typically last between five and 30 minutes. You should expect to feel some moderate heat sensation in the treated area for one to two hours after treatment. There will be some redness in the skin immediately after treatment and your dark spots will appear darker. Over the course of one week after treatment, these spots will naturally exfoliate and turnover revealing rejuvenated skin underneath. You will be able to resume normal daily activity following your treatments and can even apply sunscreen or makeup immediately following treatment and return to your normal daily life.
Based on the extent of your treatment we may recommend avoiding strenuous activity and long showers or baths for 48-72 hours following treatment, as these can trigger the body’s natural inclination to flush. By avoiding these activities, the skin vessels are able to remain closed, which improves the efficacy of your IPL treatment.
Topical Lightening
You can enhance the effectiveness of laser treatments by using over-the-counter topical treatments that target hyperpigmentation in different ways.
Lightening creams can improve the appearance of brown spots.
The exfoliants in these treatments are acids that dissolve the top layer of skin cells. They include alpha hydroxy acids (AHAS), such as lactic acid, and beta hydroxy acids (BHAs), such as salicylic acid. The best varieties also contain proven brightening agents such as azelaic acid and glycolic acid. These chemical exfoliants speed up skin cell turnover to gradually lighten hyperpigmented spots and brighten and smooth skin. Regular and consistent use over the course of several weeks or months is usually necessary to produce results.
Some of the following “at-home” daily treatments we’re most impressed with are:
SkinMedica
Even & Correct Advanced Brightening Treatment
Even & Correct Advanced Brightening Treatment is a powerful daily serum to help target and prevent visible hyperpigmentation. Hydroquinone-free and Retinol-free.
Even & Correct Dark Spot Cream
Even & Correct Dark Spot Cream is a fast-acting spot treatment booster that addresses even the most stubborn dark spots left by skin damage from acne or sun exposure.
Even & Correct Brightening Treatment Pads
Alcohol-free brightening pads exfoliate for visibly bright skin. These pads can be used day and night as part of a daily skincare regimen.
Know your lightening ingredients!
There are many active ingredients in products that can help fade dark spots. We’ve provided a list of some of the pros and cons of these ingredients in more detail.
Hydroquinone
Hydroquinone cream works by reducing the production of melanin. Hydroquinone can cause skin irritation, especially when people use higher concentrations of it. It may also lighten the skin surrounding the dark spots if a person does not apply it carefully.
At high concentrations, hydroquinone can be toxic to the skin. (Some countries have banned it). Doctors usually prescribe a 4% hydroquinone cream, but patients should use it with great care. Hydroquinone can be irritating and can actually increase pigmentation if used for too long.
Kojic acid
Kojic acid is another popular treatment for hyperpigmentation. It is a very effective pigment reducer that you can use continuously without the risk of the side effects that can come with hydroquinone.
Niacinamide
Niacinamide is another ideal choice, as it not only inhibits melanin production to allow for gradual lightening of discolored skin but it has oxidative effects to help repair and protect skin from environmental damage, including sun damage.
Vitamin C
Vitamin C is another popular treatment. Studies show C can help brighten skin and fade hyperpigmentation much like hydroquinone, but without as much irritation. "Look for high levels of magnesium ascorbyl phosphate in the ingredients of a brightening treatment. This form of vitamin C stays stable, so it's more effective.
Retinoids
Retinoids are derivatives of vitamin A. They increase the turnover of new skin cells, which can fade dark spots over time. Doctors may prescribe a professional-strength retinoid, such as tretinoin for severe hyperpigmentation. These products can take 3-6 months to work. The stronger the retinoid, the more likely it is to cause irritation. Retinoids also increase the skin’s sensitivity to UV light, so it is important to use SPF on the face every day while using retinoids.
Professional Chemical Peels
Professional chemical peels are stronger versions of over the counter acid exfoliants. Stronger peels work on deeper layers of the skin, but they also have longer recovery times. As with retinoids, these acids increase the skin’s sensitivity to the sun. Based on your prognosis, Medically Yours has a variety of professional-grade chemical peels.
How to prevent sun-induced dark spots
Sometimes the best place to start is before you develop sun-induced dark spots. Here's what we suggest doing to prevent them from occurring in the first place, or to prevent them from reoccurring.
Avoid the sun
Whenever possible, stand in a spot out of direct sunlight -- even little things, like crossing to a shadier side of the street matter. And, if you drive a lot, consider getting an ultraviolet protective coating on the side windows of your car.
Wear protective clothing
A wide-brimmed hat will shield your face, the area most prone to hyperpigmentation. You need that physical protection from the sun. And a hat is a key accessory if you're undergoing treatment for hyperpigmentation. But don’t forget about sun protective clothing and sunglasses too.
Never skip SPF
You have to wear an SPF 30 with SPF 50 or higher as the ideal amount of protection every day. Every UV ray that hits your skin causes damage. And the damaging rays can pierce through clouds and glass, so you always need SPF protection.
Here’s a list of what we believe are some of the most effective sunscreens on the market:
SkinMedica
Total Defense + Repair Broad Spectrum Sunscreen SPF 34
Revolutionary superscreen goes beyond UV protection to defend against harmful infrared rays while supporting the skin’s ability to restore itself.
Essential Defense Mineral Shield Broad Spectrum
This sheer, lightweight, mineral sunscreen gives you the highest level of UVA protection available, along with UVB coverage to protect you from damaging rays.
Essential Defense Everyday Clear Broad Spectrum SPF 47
This lightweight, sheer sunscreen is ideal for oily and/or combination skin, giving you the highest level of UVA protection available, along with UVB coverage in a formulation that won't clog pores.
colorescience
Even Up Clinical Pigment Perfector SPF 50
Brighten, correct and protect your skin with Colorescience Even Up Clinical Pigment Perfector Sunscreen SPF 50. Lightly tinted and clinically tested to diminish the appearance of discoloration and immediately blur stubborn brown spots, while protecting against blue light and future sun damage with powerful minerals.
Sunforgettable Total Protection Face Shield Flex SPF 50
A lightweight mineral sunscreen with tinted color coverage immediately evens skin tone for a flawless look. This hydrating, antioxidant-rich all-mineral formula is powered by patented EnviroScreen Technology - which means comprehensive defense against UVA/UVB, Blue Light, Pollution, and Infrared radiation, combined with advanced antioxidants and nourishing, hydrating ingredients for long-term skin health. FLEX features innovative, iron oxide pigments that bloom in your fingertips to deliver tone-adapting buildable color coverage with a demi-matte finish. Available in four uniquely flexible shades, each ideal for a broad range of skin tones and under tones.
Medically Yours Skin Care
Tinted SPF 44 Protect
Tinted SPF 44 Protect is a water resistant, physical sunscreen that features a moisturizing base with a sheer, universal tint beneficial for most skin types. Formulated as a chemical-free alternative to sun protection, Tinted SPF 44 Protect is a great option for even the most sensitive skin types, including post-procedure. Zinc Oxide 10% and Titanium Dioxide 5.5% provide protection against UVA-aging and UVB-burning rays. In addition to the mineral based sun protection, this gentle sunscreen also contains Hyaluronic Acid which effectively
hydrates the skin to restore a youthful appearance. This product is light enough to wear alone or under makeup for everyday protection.
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Clear SPF 40 Protect
This hydrating broad-spectrum sunscreen is packed with skin-loving ingredients to protect and nourish your skin. The mineral sunscreen actives provide broad-spectrum protection from harmful UVA and UVB rays, while bioflavonoids and glycoproteins help to soothe and revitalize the skin. Humectants and shea butter provide long-lasting hydration, leaving skin feeling soft and moisturized. The addition of dimethicone creates a silky, smooth finish, making this sunscreen perfect for daily use.
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We have a solution for your dark spots
If you are interested in a free consultation to discuss your dark spot options just call or book and appointment with us at Medically Yours, we would be happy to help you on your journey to more “spot free”, rejuvenated skin.