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Looking Great Out, Damn Spots! By Leslie Baumann, M.D., July & August 2008 Tips for making dark, patchy "age" spots disappear

On television, in magazines, even over lunch with friends, wrinkles get plenty of attention. But hyperpigmentation—patchy darkening of the skin, also known as age spots or sun spots—can contribute to an aged appearance even more than lines and wrinkles do.

Hyperpigmentation occurs when melanin, the brown pigment that gives skin its color, forms deposits under the skin. While hormonal changes, genetic conditions, and skin diseases such as acne can cause pronounced hyperpigmentation, the most common cause is sun exposure.

Fortunately, age spots and dark patches are treatable, no matter the cause.

First, spot-treat affected areas with skin-lightening ingredients. Hydroquinone (in prescription products such as Tri-Luma, or in over-the-counter products including Skin Effects by Dr. Jeffrey Dover Advanced Brightening Complex) is particularly effective, but some companies have begun removing it from their products because of concerns it might be carcinogenic. (The FDA has not made any formal recommendations.) Kojic acid (in DDF Intensive Holistic Lightener, for example) and arbutin (in products like Philosophy’s A Pigment of Your Imagination) are also effective.

Then, try professional treatments. For stubborn cases of hyperpigmentation, your dermatologist or aesthetician may suggest microdermabrasion or laser treatments. Lasers such as the Nd:YAG and the Alexandrite produce energy that destroys the melanin in sun spots. While those lasers must be used with caution in darker skin, the Fraxel laser is considered a safe treatment for any skin type, since it eliminates pigmented cells only in the top layer of skin.

Healing the Sun’s Damage

Dr. Baumann Recommends
Olay Definity Correcting Protective Lotion with SPF 15 has glycerin to nourish delicate skin and niacinamide to lighten spots.

Once dark patches clear up, prevent new ones with this four-step maintenance regimen

1. Use a facial cleanser with alpha-hydroxy acids (such as glycolic or lactic acid) to help subsequent products penetrate the skin.

2. Target hyperpigmentation with products containing niacin or niacinamide (in the NIA24 line and Olay Total Effects, Regenerist, and Definity products, for instance) and soy (in Aveeno Positively Radiant products).

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3. Apply broad-spectrum sunscreen (Lancôme’s Absolue Sôleil Premium Bx with SPF 30, for instance). Exposure to ultraviolet rays increases production of melanin, thus aggravating hyperpigmentation.

4. Start using retinoids if you’re not already doing so. Not only do they speed cell turnover to help fade dark spots; they also get rid of wrinkles.

Leslie Baumann, M.D., is a dermatologist at the University of Miami School of Medicine. You can read her blog at www.skinguru.com or www.skintypesolutions.com.Be sure to check with your doctor before beginning any new skin-care regimen.

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