Dark spots are the new wrinkles. Whether you call them age spots, sunspots, liver spots or brown spots, we want them gone. You have two options for dealing with them: Either make it a DIY project (less expensive, painless, no downtime but requires patience), or let a dermatologist take over with in-office procedures (costly, more immediate results, requires downtime and there's a definite ouch factor). Here's expert advice from three board-certified dermatologists — Christine Choi Kim, M.D., of Los Angeles; Corey L. Hartman, M.D., of Birmingham, Alabama; and Joshua Zeichner, M.D., of New York City — plus a few beauty-editor tips from me.
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1. Make mineral-based sunscreen a daily habit
Prevention is an essential part of the solution, and here's why. Continued sun exposure revs up pigment production, activates new spots and darkens older ones — sabotaging any dermatological treatments or topical products you're applying. Think of this as part of your wellness strategy, like eating healthy or exercise. It will pay off in the long run. “Brown spots have a tendency to recur, regardless of how they are treated — by laser, IPL, chemical peels or liquid nitrogen,” says Kim. “Therefore, sun protection year round is an absolute must in preventing new brown spots and protecting skin that has been treated. I recommend sunscreens containing titanium dioxide and zinc oxide because they offer superior broad-spectrum protection for UVA and UVB rays, are less allergenic than chemical sunscreens and are not harmful to marine life. The American Academy of Dermatology recommends using a sunscreen with an SPF of at least 30, which blocks 97 percent of UVB rays.” So, to recap: Even spots you've treated at home can come back unless you make mineral-based sunscreen part of the plan. Also apply mineral “face” sunscreen to hands, neck and chest — any place that's vulnerable and visible to the sun.
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2. Check your spots with a dermatologist before DIY dabbling
If you're opting for at-home treatment and have not had your yearly skin cancer check, schedule one. “Many brown spots are harmless benign moles and growths, but it takes a trained eye to discover whether a brown spot is normal or should be examined more closely,” explains Kim. “If your dermatologist thinks a spot looks suspicious, she may recommend a biopsy.” Hold off on taking those discolorations into your own hands until you get the green light from your doctor.
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3. Cover them with makeup
Discolorations after age 50 are annoying but normal. “Women of every skin color see changes in the color of their skin as they get older: Some get dark spots, but others get light spots and some develop broken blood vessels or red spots,” says Hartman. “And many get a combination of all three, which are called poikiloderma.” Discolorations that are not a health risk can easily be camouflaged with foundation. Try one of the new high-pigment, lightweight formulas — like It Cosmetics Your Skin But Better Foundation + Skincare ($40, sephora.com) with 40 shades, Maybelline Dream Urban Cover Full Coverage Foundation SPF 50 ($11, target.com) with 12 shades, or Dermablend Flawless Creator Liquid Foundation Drops ($40, ulta.com) with 20 shades — instead of fiddling around with a bunch of concealers. These next-level face makeups really do cover and look skin-like — not dry, cakey or fake. A small amount goes a long way.
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4. Add a “next generation” retinol to your routine
Retinol is a form of vitamin A known for increasing cell turnover, which, in turn, smooths out lines and wrinkles. It has been around for years, but did you know retinol also helps minimize brown spots? “Retinol products that combine this power ingredient with other spot banishers like niacinamide, hyaluronic acid, vitamin C, glycolic or lactic acid are the current news,” says Zeichner. Try multitaskers like Melé Even Dark Spot Control Facial Serum for Melanin Rich Skin ($28, target.com), Neutrogena Rapid Tone Repair Retinol + Vitamin C Correcting Cream ($31, target.com), or Pond's Rejuveness Advanced Hydrating Night Cream ($10, walgreens.com). But stay the course since results don't happen overnight. Consistent use of retinol and sunscreen helps skin that has been treated for spots with dermatological procedures remain fresh and glowing.
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PHOTO BY: Target (2); Ulta Beauty
5. Count on vitamin C to lighten and brighten
Vitamin C (also known as L-ascorbic acid) is another big-deal ingredient we love for its ability to block free radicals — renegade molecules that cause skin damage and wrinkles. But vitamin C is also an efficient spot fader with the ability to specifically target problem areas — without affecting healthy ones — and even out skin tone. This makes it useful for the face as well as the backs of hands and the chest/neck area. But beware: Vitamin C can sometimes irritate sensitive skin. Do a patch test on your inside forearm and wait 24 hours before applying it for the first time to your face. If you have dry skin, look for moisturizing formulas like CeraVe Skin Renewing Vitamin C Face Serum with Hyaluronic Acid ($22, target.com) with hydrating hyaluronic acid, Olay Tone Perfection Serum with Vitamin B3 + Vitamin C ($30, target.com) with soothing protective niacinamide, or Peach & Lily Transparen-C Pro Spot Treatment ($43, ulta.com) with nourishing vitamin E. Apply it under your morning sunscreen or moisturizer with SPF, since vitamin C is known as an ideal partner to counteract UV rays.
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6. Spot treat with a cocktail of proven ingredients
Attacking stubborn discolorations is not a one-solution-fits-all deal. In fact, another answer is to try a potent but safe mix of a few ingredients that even out the skin in what amounts to a group effort. “The most effective OTC brightening products are those like Rodan + Fields Reverse Tone Correcting Treatment ($110, rodanandfields.com), which combine scientifically proven brightening agents like kojic acid with antioxidants like a vitamin C and a retinol for synergistic results,” says Kim. Look for other mixes that include two tried-and-true ingredients — hydroquinone and kojic acid. You'll find hydroquinone in Ambi Skincare Fade Cream ($7, target.com) along with alpha hydroxy acid and vitamin E. Or try a kojic acid blend like Urban Skin Rx Even Tone Super Glow Serum ($23, ulta.com) with niacinamide, vitamin C and ferulic acid; or La Roche-Posay Glycolic B5 Dark Spot Corrector ($40, target.com) with kojic acid and glycolic acid.
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7. Have your dermatologist treat spots with liquid nitrogen
Dark spots are afraid of the cold. One in-office treatment for a few random brown spots is cryotherapy — where your dermatologist sprays or applies with a Q-tip freezing liquid nitrogen to individual spots, which destroys the excess pigment. “It's a good way to target specific well-defined brown spots like seborrheic keratoses and lentigines. It's old-fashioned, but it still works!” says Kim. I'll add that it hurts for a moment (but it's quick), and you may get a slight redness or small scab afterward. But it is great for treating one or two spots at a time.
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8. Ask your doctor about in-office microdermabrasion
This is a souped-up version of gentle exfoliation where your dermatologist uses a wand or brush attachment to spray tiny particles of aluminum oxide or sodium chloride crystals over your face. “Microdermabrasion is a great way to exfoliate your stratum corneum and gently stimulate collagen growth without significant downtime,” says Kim. “It also promotes better penetration of topical ingredients. In combination with an at-home brightening skin-care regimen, regular dermatologist-office microdermabrasion treatments can help to reduce brown spots.” Keep a good thing going with at-home use of retinol and/or vitamin C.
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9. Schedule an IPL treatment
Intense pulsed light (IPL) treatments (also known as a photofacial) and broadband light (BBL) treatments are a next-level doctor solution. “IPL/BBL acts as a magic eraser for red and brown sun damage,” says Hartman. “Downtime is minimal, and no anesthesia is necessary. This treatment has best results when applied in a series and continued as a preventive one.” These treatments use scattered light in a less focused way than lasers. They are better for lighter rather than darker skin tones. Expect initial redness, darkening of the skin and peeling as the treated skin flakes off a week later. You'll need to take a few days downtime and avoid the sun. Also, your doctor will advise whether to treat hands and chest to IPL when the face is done. “Facial skin reacts differently to brown spot treatments than body skin,” explains Hartman. “Start conservatively with one area — say the face — before moving on. I also factor in the patient's lifestyle, tolerance to pain, the amount of topical anesthetic that can be safely applied and differences in sun exposure in the various areas to be treated.”
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10. Opt for a laser procedure
This dermatologist solution is the priciest one. “Lasers are ideal for more immediate pigmentation improvement on mature skin that's saggy and wrinkled,” says Hartman. “They have the ability to penetrate deeply to affect the pigment on the surface, but also the collagen found deeper in the skin.” Using the right laser is key since some are more focused in treating discolorations. For example, pigment-specific lasers work selectively to destroy excess pigment spots in a particular area, while fractional-resurfacing lasers nab precancerous sun damage and build collagen for firmer skin allover. Don't kid yourself: No matter what anyone says expect at least a few days to a week or even 10 days of downtime. “Some patients want only one or two spots treated, while others want large numbers treated or the whole face,” says Kim. “If you're doing a procedure for purely cosmetic reasons, it's wise to make sure your skin's healing response is satisfactory before embarking on treating a large number of spots. Only a board-certified dermatologist can choose the right laser and settings for you, and not all skin tones can be treated with the same approach — whether lasers or IPL.” Lasers have replaced other more extreme procedures like dermabrasion and chemical peels. “Very few dermatologists perform dermabrasion anymore; it's been supplanted by lasers,” says Kim.
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My final word
You're probably wondering (because I am, too!) whether blue light from your computer and cellphone are contributing to dark-spot formation. Hartman says, “The verdict is still out. We know that inordinate amounts of blue light may contribute to aging skin. We know that we are all being exposed to more devices and screens which emit blue light. The actual effect on the aging process of the skin is still in need of more research.” Kim agrees: “There is evidence that visible light — specifically blue light — can contribute to dark-spot formation, especially in darker skin tones. This is an area of active research, and hopefully we will learn ways to protect our skin better from blue light radiation, because technology is certainly not going away!” Stay tuned.
Lois Joy Johnson is a beauty and style editor who focuses on women 50 and older. She was the beauty and style editor at Ladies’ Home Journal and a founding editor of More magazine. She has written three books: The Makeup Wakeup, The Wardrobe Wakeup and The Woman's Wakeup.
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