How To Get Rid Of Brown Spots On Hands

"What really works for those of us 50+ who wear good sunscreen today but weren't so religious about that 20 years ago? How can I lighten the spots on my hands and face that are dark and stand out? Appreciate any insights you can share." — Thanks, Dianne

First thing Dr. Sandy Skotnicki said to me when I asked her your question, Dianne, was that this is one of the most common thing dermatologists get asked. And yet, I agree with you, I don't have any idea what to do about them either. "'Age spot' is not a medical term," says Skotnicki, who is my skin hero for her excellent and life-changing 2018 book "Beyond Soap," which taught us all to stop with the detergent overload, already. Bonus observation from the doc: "The pandemic has actually proven my point. We've all been showering less through lockdowns and, anecdotally at least, people are finding their skin is improving."

The other nickname for those dark spots that creep up on hands and face is "liver spots," which is because they are kind of liver-coloured (but have nothing to do with liver dysfunction, as went the old wives' tale). There are three different manifestations of extra pigmentation caused by an accumulation of exposure to the sun, according to Skotnicki (and yes, Dianne, you are right, these spots are preventable with sunscreen, but many of us didn't get that memo in the right decade of our lives).

We're going to pause here to remind ourselves (me included) that any new spots on our skin mean we must book a trip to the doctor to get things checked out. Also, while discoloration occurs in every skin type, sun/age spots tend to be most frequent in lighter skin types. Skotnicki explains the Fitzpatrick skin-type classification, where 1 is pale white skin that burns always, never tans; and 6 is dark brown or Black skin, never burns, always tans.

"When you get a tan" — if that is your skin type — "what's interesting is that that is your skin trying to protect itself from ultraviolet damage," she says. "Over time, that extra pigmentation starts to stay." This is not to be confused with freckles, which she says come and go over the course of our lives and are not related to the brown spots we are talking about here.

By far the most common brown spot is lentigo simplex, the aforementioned age or liver spots, which can occur anywhere but tend to congregate on hands and face. There is also melasma, which is larger patches of brown skin on upper cheeks, forehead, upper lip and sides of jaw, as well as lower arms. She says these tend to appear in our 50s and 60s, unless we have had exceptional exposure earlier. You may also have heard of chloasma, which are similar brown markings in similar areas except that they are associated with pregnancy.

"Both can be persistent. There seems to be a strong estrogen component," says Skotnicki, "Melanocytes (skin cells that form melanin, which determines the colour of pigmentation) have estrogen receptors." (I totally have this last, lower arms thing, as I shamelessly diagnose myself here: pale brown patches appeared on my forearms after an otherwise perfect trip to the baking sun of the south of France literally the summer I turned 50 a couple of years ago, and now they drive me bonkers.) The third kind of brown mark that appears with time is seborrheic keratosis, which are raised and flaky patches of brown.

There are treatments for each of these three issues, but here's the rub: there are no cheap or fast solutions. It is possible to get rid of these marks but, as Skotnicki says, "There is no 'Wow' with topical options. These are used for prevention or to continue to improve discoloration after treatments." But we'll get to those after we cover the big guns.

Lentigo can be "burned off" with liquid nitrogen, starting at $125 for one to three spots. But the gold standard treatment is Intense Pulsed Light (IPL): The wand targets colour (red or brown) and feels like the pinging of an elastic band on your skin. The advantage of IPL is that there is no downtime, and not the same scabbing and risk of white spots that liquid nitro treatments can leave behind. Numbing cream usually suffices to make the treatment bearable. This takes time, from three to six sessions, says Skotnicki. Packages at Skotnicki's offices, Bay Dermatology Centre, start at $475 per session; $1,275 for three.

Melasma is a different beast and responds best to fractional laser (Fraxel is the most common brand name), which pokes holes in the pigment. Says Skotnicki: "I explain this treatment is like aerating a lawn; after each treatment the skin comes in newer and smoother." Each treatment could remove about 20 per cent of skin and you need to remove at least 50 per cent to see an appreciable difference, so it's a process over time with multiple treatments. Fraxel also helps with very deep wrinkles and is the gold standard for acne scars. Fraxel is not comfortable and Bay Dermatology offers "laughing gas," which I've heard from anyone in the business is a great help in tolerating the treatment. The cost at Bay Dermatology is $900 for a single treatment; $2,500 for three. Another option for melasma is microneedling, which is a lesser form of the Fraxel laser, which is the same science of poking holes in skin; these treatments start at $425 each.

As for seborrheic keratosis, Skotnicki says liquid nitrogen, mentioned above, shave excision or cauterization are options to rid yourself of these outcroppings.

As for topicals, one that Skotnicki consulted on a study of — SkinCeuticals Discoloration Defense — is a good way to keep brown spots from coming back or getting worse, she says. Glycolic peels once a week can help. These generally come in a four to eight per cent concentration. She says go for the eight to 10 per cent higher-powered pads from companies such as Skinfix. These higher-impact topical investments, she says, can yield a 10 to 20 per cent decrease in pigmentation over time. And for maintenance, be sure to use the classics: retinol/Retin A and hydroxy acid exfoliants (PHA, LHA, AHA).

But mostly: make sunscreen your habit and your best friend. Skotnicki gets asked often for her favourite brands. As a dermatologist, she is both a skin doctor and a beauty pro. As such, she tries everything on the market. See below for her suggestions directly related to this article, plus a few relevant selections from her Shop My Shelf picks on her Instagram account (@drsandyskotnicki) for products that will address this issue.

Skotnicki's book has now also been published in Croatia, Ukraine, Czech Republic and Vietnam — skin is universal, after all. So, thank you, Dianne, for asking this question and prompting me to start saving so I can address all the signs of sun damage as they pop up unbidden, and reminding me to double down on prevention and maintenance in the meantime. Because regret is universal, too.

Send your pressing fashion and beauty questions to Leanne at ask@thekit.ca.

Shop the Advice

Dark spots may need more intensive (in-office) treatment to get the "wow" factor, says dermatologist Dr. Sandy Skotnicki. But here are a few of her top picks to prevent, maintain and even continue to reduce the visible effects of "age" spots with topical treatments.

SkinCeuticals Discoloration Defense serum, $137, skinceuticals.ca

Skotnicki says she reviewed the research on this product and thinks it has some value for treating dark spots, but it is especially useful for improving and maintaining gains and preventing development of further spots after in-office treatments are completed.

Skinfix Resurface + AHA BHA Exfoliating Pads, $67, sephora.com

Skotnicki says to go for the higher powered (10 % glycolic acid) action of these leave-on exfoliating treatments; use up to three times a week for brighter skin.

Neutrogena Rapid Wrinkle Repair Retinol Oil, $37, ulta.com

A good retinol formulation should be part of everyone's anti-aging plan.

SkinCeuticals Physical Fusion UV Defense SPF 50, $49, skinceuticals.ca

This sunscreen pairs well over the same brand's discoloration product; a barrier-style mineral SPF, its transparent titanium oxide and zinc oxide formula is water-resistant for safe sporting.

La Roche Posay Anthelios Stick Face XL SPF60, $21, shoppersdrugmart.ca

Skotnicki is a fan of stick sunscreens for their ease on the go and gives this one the thumbs up!

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How To Get Rid Of Brown Spots On Hands

Source: https://www.thestar.com/life/fashion_style/2021/07/09/how-can-i-lighten-my-age-spots.html

Posted by: jefferysionuirt.blogspot.com

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