Age spots and melasma are usually treated with a lightening cream. Our skin specialists offer a variety of prescription and over-the-counter topical solutions, including hydroquinone, kojic acid and alpha hydroxy acids that reduce dark pigment and inhibit melanin production for brighter skin.
Diffuse hyperpigmentation is often associated with certain medications and may improve upon discontinuation or substitution of the medication. We also use light-based and laser treatments to improve this type of discoloration.
Skin Lightening Creams
Skin lightening creams can help fade acne scars and other dark spots on the skin. They work by inhibiting the enzyme tyrosinase, which is responsible for creating skin-darkening melanin. These creams are typically applied to the dark areas of the skin, usually twice a day, although some products also come in pill form.
Hydroquinone is an active ingredient in many skin-lightening creams. It works by blocking the process that leads to discoloration and is available by prescription. However, it can be irritating and should not be used on broken or irritated skin. In addition, it can increase photosensitivity, so patients should limit sun exposure to the treatment area.
Other active ingredients in some skin lightening creams include vitamin C, licorice root extract and kojic acid. These ingredients also inhibit tyrosinase, but are less cytotoxic to melanocytes and may be safer in the long run. These creams are not effective on deep melasma, but can help lighten and fade dark patches caused by injury or pregnancy.
Retinoids
Retinoids are powerful skincare ingredients that can treat a variety of skin issues, including hyperpigmentation. These compounds help speed up cell turnover, which reduces dark spots and helps the skin look brighter.
They also target the pigment cells that produce melanin. The retinoid stimulates the proliferation of these cells and encourages the dispersion of the melanin to the top layer of the skin, resulting in a lighter tone.
While retinoids can help lighten dark spots, they cannot address deep-seated pigmentation or certain types of hyperpigmentation, such as melasma (the “Mask of Pregnancy” or the hormonal changes associated with oral contraceptives). For these conditions, you may need a deeper chemical peel to treat your dark spots.
Retinoids are a good option for all skin types and tones, though darker complexions might see more benefits. If you are sensitive to dryness or irritation, however, it is best not to use a retinoid. Instead, a dermatologist can recommend other treatments that focus on fighting inflammation such as tranexamic acid or cysteamine.
Chemical Peels
Chemical peels can be used to treat mild to moderate hyperpigmentation, sunspots and post-inflammatory pigmentation (PIH). Light chemical peels, which don’t penetrate as deep as medium or deep peels, exfoliate the skin and remove dead cells. They also improve skin tone and texture, making it brighter and more even.
In addition to light chemical peels, there are a number of other treatments that can help fade dark spots and hyperpigmentation. Fade Bright melanin inhibitor, for example, works by inhibiting the production of melanin in the skin and fading existing dark patches.
Medium and deep chemical peels penetrate the outer layers of the skin for intense cell renewal treatment. A trichloroacetic acid, or TCA peel, targets the middle layer of the skin and is one of the strongest treatments available for treating severe hyperpigmentation. This treatment requires a longer recovery time, but it can produce dramatic results. It is important to avoid sun exposure after a TCA peel.
Laser Skin Resurfacing
Laser skin resurfacing can improve skin tone, reduce fine lines and wrinkles, treat sun damage, correct skin texture irregularities, and remove unwanted pigmentation. Both ablative and non-ablative laser treatments can be used to target specific areas of the face and body.
Laser treatment can trigger a form of hyperpigmentation known as post-inflammatory hypopigmentation (PIH) in some patients. This is because laser treatment is a form of inflammation that causes the skin to heal, and inflammation triggers melanin production.
For these reasons, limiting sun exposure after laser treatments is one of the best ways to prevent PIH. Wearing a broad-spectrum sunscreen and wearing a wide-brimmed hat will protect the skin from UV damage.
Several laser treatment sessions are usually needed to see dramatic, long-lasting results. Some forms of discoloration, such as severe sun spots or melasma, may not respond to laser therapy. These patients will need to consider alternative hyperpigmentation treatments like retinoids, chemical peels, or Cosmelan.