The tanning salon was practically my dorm room throughout college. I cringe to admit that as a beauty editor, but it’s true; and it’s where the story of my unwanted dark spots began — with a tanning addiction. At the time, I believed that tan skin was attractive. My skin, however, was well beyond a sun-kissed glow. Thinking back, I can still smell the fresh burn I craved.
I continued indoor tanning until I landed my first job as a beauty editor at a major women’s magazine in my early twenties. The outlet preached safe sun. It became my responsibility to be an advocate for SPF, and to advocate for skin cancer awareness and prevention. That role — and the education that came along with it — caused me to stop tanning immediately. Before that, skin cancer had never been top of mind for me, and I consider myself very lucky that I haven’t faced any health scares to date.
Unfortunately, my newfound skin health kick had repercussions. Once I stopped tanning and started accepting my pale skin as beautiful, brown spots on my nose, cheeks, and forehead began to take center stage. That’s when my struggle with dark spots began. Now that I’m in my mid-thirties, I can say that I’ve won many battles with them throughout the years, but the spots keep winning the war. No matter how many times I embarrass my husband at the beach by covering myself from head to toe in hats and muumuus (and SPF 50, of course), I always end up pale with a face full of brown spots.
Throughout my decade of struggling, I’ve tried everything from topical treatments and chemical peels to lasers to help fade these unwanted marks. Sadly, I only saw minor success. So, I’ve recently been working on a new tactic with my dermatologist, and these days, I am optimistic that I’ve finally gotten my spots under control.
Dark spots are one of the most prevalent skin concerns, as they affect people of all genders, ethnicities, and ages. If you’re struggling with your own battle against them, keep reading: I’ve broken down everything you need to know, including what causes dark spots, different treatment methodologies to try, prevention tips, and more.
As always, talk to your doctor before starting any new treatment.
What causes dark spots?
Dark spots occur when areas of your skin are darker than normal — common sense, right? According to Adriana Lombardi, MD, my dermatologist and founder of the Skin Cancer and Cosmetic Surgery Center of NJ℠ in Edison, New Jersey, there are three main types and each has a different cause. The first are freckles, which are hereditary, and commonly appear around the nose and cheeks in a uniform pattern. Another type is melasma. This tends to consist of patchy brown spots along the center of the face, cheeks, or jawline. Because it can be caused by hormones, it is the most difficult to treat. The final category — and the brown spots I have — are lentigines, also known as sun spots (because they’re caused by the sun). Mine are irregularly shaped and haphazardly scattered all over my face.
“Lentigines have a malignant counterpart,” Dr. Lombardi warns, meaning that sun spots could be cancerous. For that reason, any brown spot that seems to be growing and changing, or has a darker brown spot within it, should be carefully looked at. “Prior to trying any lightening treatment, they should be examined by a dermatologist,” she adds. I’ve been fortunate that none of my spots have been dangerous. (For me, yearly skin checks always come before any cosmetic treatment.)
The frustrating thing about treating dark spots is that there isn’t a true solution. “There are no permanent fixes for [dark spots] and no matter how religious you are about your treatments, the sun will bring it right back,” clarifies Dr. Lombardi. There are, however, many different ways to lighten dark spots and help prevent them from returning.
Dark Spot Treatment Option #1: Over-the-Counter Serums and Creams
There are a variety of ingredients that help lighten lentigines, and I’ve tried them all. Do they work? Yes, when used with consistency, they do. However, in order to really achieve an even skin tone, I’ve found that using them in conjunction with medical treatments like peels and lasers is the way to go. (More on this later.)
One ingredient in particular to look for is vitamin C — which is non-negotiable in my skincare regimen. Specifically, I’ve been relying on two potent formulas: BeautyStatTM Cosmetics Universal C Skin Refiner ($80) and editor-favorite SkinCeuticals® C E Ferulic®. “Vitamin C is a great lightening agent, because it’s an antioxidant that helps prevent free radicals from forming and stimulates collagen,” explains Dr. Lombardi. “I recommend using it twice per day under moisturizer.” (Learn more about incorporating vitamin C into your skincare regimen here.)
Anti-aging powerhouse retinol is another must in my nighttime routine. “Since it helps turn over skin cells and get rid of the top layers of your skin, it helps to decrease the darkness of lentigines,” Dr. Lombardi explains. I like using a pea-sized amount of a retinol cream like PCA Skin® Intensive Clarity Treatment® .5% ($110) three times per week at night.
Retinol shouldn't be used by women who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.
Thanks to its retinol-like properties, the natural ingredient bakuchiol is showing up in serums and anti-aging creams with the same promises. According to a study in The British Journal of DermatologyTM, it helps smooth fine lines and even out your skin tone with less irritation than retinol. Dr. Lombardi recommends trying Isdin® Isdinceutics® Melatonik® Night Serum ($160), because it’s safe for all skin types and also contains vitamin C.
Hydroquinone is another lightening topical that’s efficient, but its use can be controversial. In the early days of my career, a publicist at a skincare brand I worked sent me a hydroquinone product that was supposed to be for dermatologist use only, knowing I was desperate to get rid of my brown spots for cosmetic reasons. Without proper knowledge of how to use it, I accidentally bleached my whole face and ended up with irritated skin. It is imperative that you don’t use powerful products without the supervision of your dermatologist — it’s just not worth the risk!
Hydroquinone has not been FDA-approved. Talk to your doctor before starting any treatment with it.
“Up to two percent hydroquinone can be found in over-the-counter products like Ambi® Fade Cream ($5),” Dr. Lombardi states. “However, if you’re using more than that, it’s important to do so under the direction and care of a dermatologist.” As a general rule, consult with your doctor to see which, if any, of the above ingredients is right for your skin.
Dark Spot Treatment Option #2: Chemical Peels
If you’ve never gotten a chemical peel before and aren’t familiar with them, here’s a quick primer: Chemical peels use acids and other ingredients to help exfoliate and remove the top layers of skin, revealing the fresh new skin underneath. For years, I went for bi-weekly 10 percent glycolic acid peels with Neal Schultz, MD, and his team at The Peel Bar® in NYC. I’ve also done deeper Skinceuticals and DermaCeuticTM chemical peels at dermatologist offices every chance I could get.
“Chemical peels are a great solution when it comes to evening out your skin tone, but you’ll need to do a series of them,” Dr. Lombardi remarks. “They’re typically superficial, so depending on where your pigment is, you may need to do deeper ones with significant downtime.” (There are multiple depths of chemical peels — learn more about that here.) I found that the deeper my peels went, the happier I was with the results. The five or so days of redness and peeling weren’t that bad as long as I had SkinMedica® TNS® Ceramide Treatment Cream ($69). It really helped to soothe my skin each time.
I will mention that I had one very bad experience with a peel that truly burned different areas of my face. It was extremely painful, and I’m still not sure if I should blame it on the peel itself or the provider who applied it. That being said, make sure to find a provider you trust and read reviews on the peel before committing to it. Furthermore, if you have skin of color, you should ensure that the peel you’re considering is safe for your complexion.
Dark Spot Treatment Option #3: Lasers and Light Therapy
Depending on where I am in my battle with dark spots and how much downtime I can afford, I love to experiment with all different types of lasers. (As you can probably tell, I’m a bit aggressive when it comes to this battle!) Fraxel® gave me the best results, but also had the most downtime. Ultimately, though, I decided it wasn’t worth it. Though the treatment gave me fresh, even skin, my dark spots came back the first time I went out in the sun.
After speaking to Dr. Lombardi about my long-time battle with dark spots, she helped me come up with a more strategic plan that includes the aforementioned vitamin C and retinol, SPF, and a series of intense pulsed light (IPL), followed up by a few maintenance sessions per year. For the first time, I felt like I had a long-term plan to help keep them at bay.
IPL is a broad wavelength light source that penetrates your skin and targets pigmented lesions, broken blood vessels, and hair (yes, it’s used for hair removal, too). Its many uses make it a popular pick among providers. The light heats up to the point where it causes cellular damage to the brown spot, but spares the surrounding skin. Over time, this targeted treatment also stimulates collagen and reduces the appearance of pores.
To date, I’ve done two of the recommended three to five sessions and have already seen significant results in the lightening of my brown spots. Dr. Lombardi uses an optional numbing cream, and then applies a cooling gel to minimize the damage from the heat. The total treatment takes about eight minutes, and feels like little rubber bands are snapping against my face. It’s completely tolerable, though I admit I’m not sure how it would feel without the numbing cream.
Dr. Lombardi recommends skipping retinol a week before and a week after treatment, because it can be drying and potentially cause reactions. Besides that, there’s no prep, and — even better — minimal downtime, which is why it’s often called a “lunchtime laser.” I can attest to this claim! After the treatment, the brown spots simply turn a bit darker before they fade or disappear.
Above all, though, I’ve found that throughout my 13-year career as a beauty editor, the number one piece of anti-aging advice I ever received is that it’s easier to prevent than to correct. That definitely would have been the case with my dark spots. “Wearing a physical-based SPF 50 with UVA and UVB protection daily and reapplying it is the single best thing you can do to prevent brown spots from forming,” advises Dr. Lombardi. She recommends physical sunscreens like Neutrogena® Sheer Zinc Mineral Sunscreen ($11) or ISDIN Eryfotona Actinica® ($55). From my experience, I can tell you that wearing a hat and staying out of the sun is the icing on the cake.
Some complimentary products and treatments were provided to the author for the purpose of writing this article.
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