ASK THE EXPERTS: BROWN SPOTS?
Q: Over the past few years, I’ve developed more brown spots on my face. What are they and how can I get rid of them?
A: Blotchy brown discoloration (hyperpigmentation), involves pesky pigment collections in the skin. Exposure to sun, skin injury, or the effects of hormones contribute to those unwanted little spots over time. Although there may not be a “cure,” there are treatments to temporarily remove, reduce or suppress the discoloration and even out skin color. Mild improvements can be seen with some over-the-counter creams; however, most brown discoloration lies within the deeper layers of the skin and requires prescription-strength creams, chemical peels, or laser- or energy-based technologies to get significant results.
Hydroquinone (four percent) cream has been shown to be extremely effective, allowing for simplified, “at-home” treatment on a day-to-day basis. Hydroquinone works by suppressing pigment production and works well for sun damage and skin injury based hyperpigmentation (such as acne scars).
Chemical peels use various agents to remove dead skin and brown discoloration, with the added benefit of collagen stimulation. Peels can reach some of the deeper pigment related to hormonal changes (called “melasma”). The deeper the peel the more effective the treatment; however, the deeper peels have more down time and potential risks.
Energy basted treatments such as intense pulsed light (IPL) and fractional laser treatments are the most intense procedures and are used for very deep or excessive pigment problems. Be aware that these treatments also carry the greatest risks, but have the secondary benefit of improving wrinkles.
When considering discoloration of the face skin cancer should always be evaluated. All treatments have their risks and benefits, so it is important to have a consultation with a physician who has specialty training in laser, cosmetic or aesthetic medicine.
