There is hope in the form of prescription medicines, medical procedures and a host of affordable, over-the-counter options, according to Fort Worth dermatologist Dr. Betty Rajan of Rajan and Morris Dermatology.
Causes Uneven skin tones and brown spots, called hyperpigmentation, are the result of the overproduction of melanin, the substance that gives color to our skin, hair and eyes.
An excess of hormones like estrogen, which occurs during pregnancy or when a woman is taking birth control pills, can often cause a kind of hyperpigmentation known as melasma, which manifests as light brown to dark brown spots primarily on a woman's face and neck, Rajan explained. But, she added, by far the most common cause of hyperpigmentation is overexposure to the sun. Sun damage, in fact, can even worsen the melasma resulting from hormones.
Treatments Because so many cases of hyperpigmentation are caused by overexposure to the sun, Rajan said the best treatment is prevention. "Always wear sunscreen," she said.
Some forms of hyperpigmentation, such as the "liver spots" often associated with aging, respond best to laser treatments, in which lasers are used to precisely strip away the layers of hyperpigmented skin. Other treatments like chemical peels and microdermabrasion, performed by a dermatologist, work on the same basic principle of stripping away damaged skin layers.
But many cases, Rajan said, can be treated by less invasive, over-the-counter options like a retinol product, bleaching cream or an exfoliating cleanser.
Rajan suggested that Neutrogena and Clinique both offer effective skin-lightening creams. "The key is hydroquinone," she added. "Products with hydroquinone are usually the most effective."
Rajan also noted that a lot of new over-the-counter options have hit the market that rely on Vitamin C complexes.
This includes Vitamin C Serum, offered by emerginC. The company describes the product as one of the most stable, high concentration vitamin C serums available for use on all skin types. Another product is DNA Eye Renewal by DNAEGF Renewal, a combination of enzymes engineered from marine and botanical sources that, according to the manufacturer's Web site, "intensify skin's ability to repair and defend cellular DNA by stimulating the recognition and elimination of damaged DNA."
Ask the Experts A number of factors - skin type, skin tone, ethnicity and more - can come into play when choosing the best treatment, Rajan said. And of course, dark spots on the skin can sometimes indicate a more serious problem.
A doctor should check a spot that bleeds easily, that will not heal, that appears to be changing or growing or that is asymmetrical. "Those with a family history of skin cancer should definitely see a dermatologist; and remember, there is no specific age recommended for skin cancer screenings," she said.
But even those who simply want treatment for hyperpigmentation and nothing more serious should seek expert advice. "It is always best to be screened by a dermatologist in deciding on a treatment for hyperpigmentation," Rajan said. "A specialist can help you choose the best treatment for you." a
