Brown Sun Spots

Many people have mottled brown spots, freckles and patches on their skin due to excess pigmentation. 

These are easily treated with Elos, Fraxel Dual laser or IPL. There are a range of different causes of pigmentation. Treatments differ depending on what type of pigmentation is affecting your skin. The brown pigmentation is called melanin and is made by special cells in the skin called melanocytes. The main categories of pigmentation problem are freckles, age spots, (also called liver spots or sun spots) melasma and postinflammatory hyperpigmentation. A doctor at Palm Clinic can tell you what type of pigmentation you have. You may have a combination of pigment problems.

Freckles

Freckles are small flat brown marks on sun exposed areas. The medical term is ‘ephilide’ and they are an accumulation of melanin in the surface skin cells (keratinocytes). The tendency to form freckles is inherited and is often seen in red heads and younger people. Freckles usually fade in winter and reappear in summer. They need no treatment except sun protection. They can also be faded by Photoderm IPL laser or Elos Aurora, but will reappear with sun exposure. No treatment can transform a skin which freckles, into one which tans evenly.  Of course, further sun exposure can bring the freckles out again so it is very important to wear a good sunscreen following treatment to maximise results.

Age spots are larger flat skin spots on the face and hands that appear in middle age after years of sun exposure. The medical term is ‘solar lentigo’ (plural: lentigines). They are caused by an accumulation of the cells that make pigment and fade but don’t disappear in winter.

 

Before and after elos aurora

If the brown marks are scaly, they may be solar keratoses (pre-cancerous sun damage) or seborrheic keratoses (senile warts). It is also important to distinguish them from early malignant melanoma (lentigo maligna). If the spot has appeared recently, has an irregular border, has more than one colour or you have any doubts see your dermatologist for a check.

Sun spots should always be protected from the sun. They can be faded with creams containing hydroquinone, alpha-hydroxy acids, retinoids and vitamin C. Stronger, quicker options to fade or remove spots are liquid nitrogen, chemical peels and many lasers.

Freckles on the decolletage area of the chest are easily removed with Elos Aurora IPL.

Palm Clinic’s best option for treating age spots or freckles is Photoderm IPL and Elos lasers which reduce the top layers of pigment, fading the brown spot without reducing the number of melanocytes. Good sun protection is essential after treatment to prevent brown spots darkening again. These lasers also reduce red veins and promote natural collagen formation.

Alternatively the revolutionary new Fraxel Dual laser which partially resurfaces the skin can also be used to remove brown spots. The melanocyte population is reduced making the brown spots less likely to recur. Fine lines and skin texture are significantly smoothed at the same time improving the overall appearance of the skin.

Melasma

Melasma, also known as chloasma, is blotchy areas of skin pigmentation on the face, especially forehead, cheek and upper lip. It is more common on darker skin types. It is especially common in women aged 20-40 and is associated with pregnancy or taking the contraceptive pill or injection. It also happens in healthy, non pregnant woman taking no medications and men using aftershave.

Sun exposure following some cosmetics can cause a phototoxic reaction where the chemical substance absorbs UV light. The resulting pigmentation extends where sun and cosmetic use have coincided, for example down the neck, often more on the right side in countries that drive on the left.

Melasma is more stubborn to treat than freckles or age spots because the melanocytes have become sensitized and continue to produce extra pigment with even the slightest hint of sun.

Sun protection is an essential part of treatment. Consider stopping hormonal medications although it may be many months before any benefit from this becomes apparent. Fading creams containing hydroquinone, alpha-hydroxy acids, retinoids or Vitamin C inhibit new pigment formation. Lasers and chemical peels can reduce existing pigmentation but should be used carefully as skin with melasma is more prone to postinflammatory hyperpigmentation. Cosmetic camouflage using special make up is another approach.

Palm Clinic has the best available laser for treating melasma, the Fraxel Dual laser. This is a revolutionary new laser which improves melasma by fractional resurfacing of the skin. This decreases the melanocyte population so less melanin is produced. Fraxel is the first laser to be approved by the American FDA for melasma and can be used on Asian and European skin.

The Photoderm IPL and Aurora lasers can temporarily fade melasma. Ongoing treatment with fading cream is essential to preserve improvement.

Melasma before and after Fraxel laser

Postinflammatory hyperpigmentation (PIH)

Inflammation can cause melanocytes in the skin to make excess melanin, particularly in darker or easily tanning skin types. Many skin conditions cause inflammation and can lead to hyperpigmentation, including cuts or burns, acne, dermatitis, medication reactions, allergic reactions or trauma such as rubbing or waxing.

The extra pigment forms where the original inflammation was, and will go darker in the sun. Pigment can be trapped deep in the skin if the inflammation disrupts the lower layers. Most hyperpigmentation fades once the inflammation is gone, but it can take 6-12 months. Deeper (dermal) pigmentation can persist for years.

Treatment of this sort of pigmentation is more difficult, as the melanin cells have become over stimulated. The mainstay of treatment is time and sun protection. All other treatments need to be gently and cautiously used to avoid creating more inflammation which aggravates the problem. Creams containing hydroquinone, retinoids, Vitamin C and steroids may be used to prevent formation of new melanin and reduce inflammation. Gentle glycolic peels can be helpful for surface pigment.