No matter how sure you are that laugh lines represent a well-lived life, it's hard to say the same about those not-so-subtle coffee-colored patches on your face, neck, and other sun-exposed areas. "This skin discoloration, called hyperpigmentation, is a result of sun exposure, hormones, and genetics; it affects most women by the time they turn 40," says Diane Madfes, M.D., assistant clinical professor of dermatology at Mount Sinai Medical Center in New York City. When the weather turns cool, these troublesome spots tend to become noticeable. "Summer color fades but the evidence of sun damage remains -- both from this year and marks that come to the surface from summers past," Madfes says. Sunscreen helps ward off the ultraviolet damage, but it's almost impossible to entirely shut out the sun. "Culturally, we're also much more aware of our skin and concerned about changes that wouldn't have troubled women 20 years ago," says Howard Sobel, M.D., a cosmetic dermatologist based in Manhattan. Bothered by what you're seeing? There's no need to cover up. With the right strategies and a few targeted products, you can eliminate spots -- for good.
The Pigment Predicament
Think of your skin as a factory that produces melanin, the pigment that gives your complexion its particular shade. Under normal circumstances, worker cells known as melanocytes manufacture a steady stream of color. When melanocytes are exposed to lots of sunshine, however, they can go a little haywire and start producing far more pigment than normal, which shows up on your skin as dark patches. The first step to a smooth complexion is identifying your spots.
It can take months or years for these dark spots or brown clusters to show up in sun-exposed places. Once visible, the color generally won't fade without help, but since they linger near the skin's surface, they're responsive to treatment.
These dusky, often symmetrical patches appear typically on the forehead, upper lip, and cheeks. They're triggered by hormone changes during pregnancy or from birth control pills, in combination with sun exposure. "This can be a persistent form of hyperpigmentation," Sobel warns. It tends to return easily."
Darker skin tones are most likely to suffer from these noticeable spots that linger after a pimple, burn, or abrasion has healed. Melanin is carried deep into the skin and it can take three to six months for color to fade.
There's no quick fix for hyperpigmentation, but with the right treatments you can make dramatic improvements to skin tone. Here's your game plan.
Step 1: Prevent
It (almost) goes without saying that the most effective method for treating hyperpigmentation is to stop it from happening in the first place. "Go for a broad-spectrum sunscreen, which shields against UVA rays (that lead to cancer) and UVB rays linked to wrinkling, aging, cancer, and discoloration," says Alex A. Khadavi, M.D., a Los Angeles dermatologist. Use it on exposed areas every day to keep cumulative damage at bay.
Step 2: Exfoliate
Using scrubs to manually remove dead skin cells or creams with acids (like the alpha-hydroxy acid found in fruit extracts) on affected areas can help fade spots and prepare the skin for deeper penetration of active ingredients.
Step 3: Treat
Many natural ingredients are found in over-the-counter skin care products that treat pigmentation, including kojic acid (derived from several species of fungi), arbutin (extracted from the bearberry plant), azelaic acid (found in wheat, rye, and barley), licorice extract, niacinamide, vitamin C, and grapeseed extract. "These all work by inhibiting the enzyme tyrosinase, which your cells need to produce melanin," Khadavi says. Kojic acid had been a popular treatment, but it can be irritating to sensitive skin. Niacinamide shows a lot of potential as a spot fighter: A recent review confirmed that in clinical trials, the B vitamin started to fade discoloration in as little as four weeks.
Step 4: See a Doc
If over-the-counter creams aren't helping, it may be time to visit a dermatologist for a prescription treatment. Hydroquinone is a powerful man-made compound that works in two ways to lighten the skin. "Not only does it reduce the total number of pigment-making cells, but it cuts off the production of tyrosinase," says Joel Schlessinger, a dermatologist in Omaha, Nebraska. With far less pigment being produced, spots quickly begin to vanish. Hydroquinone came under scrutiny years ago, when animal studies suggested that it could be linked to cancer. However, many dermatologists (including ones interviewed for this article) strongly agree that there's little to no validity to the claims. "Not only were the animals in the studies fed and injected with hydroquinone, rather than receiving topical applications, but after decades of use there are virtually no cases showing toxicity in humans," Schlessinger says. "The risks don't outweigh the rewards -- there isn't another ingredient on the market that works as effectively for hyperpigmentation." Most patients experience the first signs of skin lightening in a few days, with the bulk of the effects in about six weeks. After that, you can switch back to an OTC product for maintenance.
Step 5: Try Something Stronger
For stubborn spots, you may want to try laser or peels. Lasers (like Fraxel) tend to be most effective and have the longest-lasting results when the discoloration is fairly close to the surface of the skin. If your doctor determines the affected cells are located deeper, a glycolic or salicylic acid peel can help reach and suppress them. (Reality check: None of these treatments are permanent. Depending upon your genetic predisposition -- and how much sun exposure you get -- your spots could return within weeks or gradually over the years, so staying out of the sun and treating them early is key.) And Madfes cautions that when you're seeing spots, it's probably a good idea to start getting an annual skin exam, if you aren't already. "Changes in the skin can be early warning signs of potential skin cancers," Madfes says. "So it's smart to give your doctor a chance to check them out."
With potent natural extracts, over-the-counter skin remedies can help diminish brown spots. Use them daily to see changes.
Physicians Formula Dark Spot Corrector & Skin Brightener is a fragrance- and paraben-free concentrated serum that relies on soy isoflavones and other plant-based compounds to lighten spots. ($19, walmart.com)
Garnier Skin Renew Clinical Dark Spot Corrector utilizes the natural fading properties of vitamin C to decrease the enzyme production that triggers melanin production while breaking up pigment clusters. ($17, drugstore.com)
Clarins Vital Light Serum leverages the power of hexylresorcinol, a molecule that helps block tyrosinase and peroxidase, two enzymes responsible for telling your cells to produce darker-toned melanin pigment. ($85, clarins.com)
Specific Beauty Skin Brightening Serum contains a complex of licorice and the B-vitamin compound niacinamide (both of which help inhibit the production of melanin) and antioxidants. ($25, specificbeauty.com)
Jurlique Purely White Skin Brightening Cleanser is a combo cleanser-exfoliator free of potentially irritating ingredients. It reduces the appearance of discoloration with the help of kakadu plum extract, high in vitamin C. ($23, sephora.com)
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