Age Spots and Sun Damage
Brown spots on skin are called chloasma or melasma and can happen for several reasons. One side effect of sun damage is the skin discoloration known as solar lentigenes, also known as liver, sun or age spots. They are definitely not associated with the liver, but they can have everything to do with unprotected sun exposure. On lighter skin types, solar lentigenes emerge as small brown patches of freckling that grow over time. On women with darker skin tones, they appear as small patches of ashen-gray skin.
Brown or ashen patches of skin can also occur due to birth control pills, pregnancy, or estrogen replacement therapy. In those instances the discoloration is referred to as pregnancy or hormone masking.
Regardless of the source, the issue is the same: site-specific, increased melanin production, or hyperpigmentation. Melanin is the pigment or coloring agent of skin. It is created by melanin synthesis, a complex process partially controlled by an enzyme called tyrosinase.
Diligent use of a sunscreen alone allows some repair as well as protection from further photodamage. No other aspect of controlling or reducing skin discolorations is as important as the use of sunscreen, SPF 15 or greater with the UVA-protecting ingredients of titanium dioxide, zinc oxide, or avobenzone. Using skin-lightening products or laser treatments without a sunscreen is a waste of time. Sun exposure is one of the primary causes of hypermelanin production. Before you look at any other treatment for discolorations this is the first and most practical step. When it comes to selecting treatment for these areas, one factor to consider is the depth of the discolored pigment. Most of the time discoloration is superficial. In a few cases, the discoloration lies deep in the dermis. If the pigment is in the epidermis, it can be helped with skin-lightening products. If the pigment is deeper, laser treatments are a consideration. For topical treatments, hydroquinone 2 to 4% alone or in combination with tretinoin 0.05 to 0.1% is proven and effective. Topical azelaic acid 15 to 20% can be as efficacious as hydroquinone. Tretinoin is especially useful in treating hyperpigmentation of photoaged skin. Kojic acid, alone or in combination with glycolic acid or hydroquinone, has shown good results, due to its inhibitory action on tyrosinase. Chemical peels are also useful to treat melasma."
Pigment deep in the dermis does not respond well to topical agents. Resurfacing procedures such as chemical peels and laser treatments may help some of these problems, but the results are not consistent, problems can occur, and without the strict use of a sunscreen with UVA-protecting ingredients the discolorations almost always come back. Moreover, laser treatments of this kind are often a problem for those with darker skin tones. However, when laser treatments do work they can make a marked difference in the appearance of the skin. The results can be startling, and completely eliminate any appearance of the problem.
Diligent use of a sunscreen with the UVA-protecting ingredients of titanium dioxide, zinc oxide, or avobenzone is the first line of defense when tackling skin discolorations. 2% to 4% hydroquinone lotions can be more effective when combined with Retin-A or Renova and AHAs. Higher strengths of hydroquinone (over 2%) can possibly help deeper sources of pigment discoloration, although they can be a problem for darker skin tones. It is also extremely helpful to consider chemical peels or laser treatments to remove or lighten skin discolorations and then use topicals to maintain the improvement During the consultation session, our specialist at laser cosmetics clinic will determine the most appropriate treatment option for your specific condition