Treatment for Sunspots: How to Lighten Pigmentation

For people who get small or medium-sized flat, dark markings on the skin, they might be sun spots (solar lentigines)1. These are basically collections of pigment that often start to appear after a person has been exposed to ultraviolet light. Because the hands and face are often the parts of the body that get the most sun, patients may see them there first, but they get more noticeable with age. Before a patient does anything else, though, check with a dermatologist to make sure the sunspots are benign.

At-Home Remedies for Sunspots

Consider trading regular facial cleanser for an exfoliating cleanser. These often have salicylic or glycolic acids to remove dead skin cells with excess pigment. Add a brightening serum or vitamin C to the skincare routine, which will help smooth the skin so that it reflects light more evenly. A serum might also contain melanin inhibitors, antioxidants to prevent discoloration, and exfoliating ingredients. Look for products with kojic acid2, alpha-arbutin, licorice extract, and vitamin C – a combination can be more potent3. Also, use retinol to target hyperpigmentation and speed skin cell turnover.

Prescription Medication for Sunspots

A doctor can prescribe skin solutions that are stronger than anything a patient can get over the counter. These may include hydroquinone, which halts the production of melanin and inhibits tyrosinase, the enzyme that controls melanin production4. This is a powerful product, and must be used under the direction of a doctor.

Remember that hydroquinone suppresses the melanin, and when a patient stops use the melanin can surface again. Some can experience a rebound effect after stopping the use of hydroquinone, where they may notice pigment return. When discontinuing the use of hydroquinone it is recommended to use products with Kojic acid, alpha-arbutin, licorice extract, and vitamin C in order to maintain the reduction in pigment.

We compound our own WIFH Reluminate Pads with 4%, 6%, and 8% hydroquinone (60-day supply). The liquid mixture is poured over dry pads making application simple and easy. The liquid is also absorbed faster than other prescribed hydroquinone creams.

Microdermabrasion and Chemical Peels

If sun spots resist other at-home methods, patients may wish to look at professional procedures. Microdermabrasions help exfoliate and remove the superficial layer of dry and dead skin cells5. With a series of treatments it can help remove some of the pigment lesions, but it also allows lightening products and treatments to penetrate deeper and better.

Chemical peels are a popular skin rejuvenation procedure that range in strength from no sloughing to quite powerful, so there is a chemical peel for every skin condition and skin type. Basically, a peel consists of a chemical solution being applied to the skin to destroy the buildup of dead skin cells on the surface, revealing the new skin underneath, and stimulating collagen production6. By removing the skin, pigmented areas are lifted as well. Again, by removing dead skin it will allow at-home brightening products to work better, too. The VI Peel with Precision Plus is a great peel that effectively addresses sun damage and pigmentation.

IPL

IPL, or intense pulsed light (also called PhotoFacial), utilizes pulses of light to gently deliver energy into the skin to target sun spots, age spots, facial veins, and redness (rosacea). The pigmented areas absorb the light and the destruction process begins. These brown spots will turn darker in color and flake off over the next few days or weeks. You will need a series of treatments to get rid of all of the sun damage and pigmentation.

Laser Skin Resurfacing

Using a laser to resurface the skin can improve skin tone and texture, and is quite effective in reversing sun spot damage7. Micro-fractional carbon dioxide laser, or micro-fractional CO2 works by destroying the upper layers of skin to reveal dramatic results.

Laser Treatment for Sunspots

It also stimulates collagen and elastin production, which are the building blocks of skin tissue to further the rejuvenative process. While micro-fractional CO2 does have several days of downtime associated with it, many patients will only require one treatment to achieve their desired results. This procedure is also only safe for lighter skin types.

Don’t forget – patients always need to protect their skin from the sun. If sun exposure has resulted in sun spots, invest in a stronger sunblock to make sure the pigmentation on the skin does not become larger and darker over time. A hat is also recommended when patients are going to be outside.

Citations
1. Praetorius, C (2014). Sun-induced freckling: ephelides and solar lentigines. Pigment Cell & Melanoma Research. 2014; 27(3): Pages 339-350. https://www.ncbi.nlm.nih.gov/pubmed/24517859
2. Monteiro, RC (2013). A Comparative Study of the Efficacy of 4% Hydroquinone vs 0.75% Kojic Acid Cream in the Treatment of Facial Melasma. Indian Journal of Dermatology. 2013; 58(2): Page 157. https://www.ncbi.nlm.nih.gov/pubmed/23716817
3. Situm, M (2011). Melasma—updated treatments. Collegium Antropologicum. 2011; 35: Pages 315-318. https://www.ncbi.nlm.nih.gov/pubmed/22220462
4. Lajevardi, V (2017). Comparison of the therapeutic efficacy and safety of combined oral tranexamic acid and topical hydroquinone 4% treatment vs. topical hydroquinone 4% alone in melasma: a parallel-group, assessor- and analyst-blinded, randomized controlled trial with a short-term follow-up. Journal of Cosmetic Dermatology. 2017; 16(2): Pages 235-242. https://www.ncbi.nlm.nih.gov/pubmed/27762489
5. El-Domyati, M (2016). Microdermabrasion: a clinical, histometric, and histopathologic study. Journal of Cosmetic Dermatology. 2016; 15(4): Pages 503-513. https://www.ncbi.nlm.nih.gov/pubmed/27357600
6. O’Connor, AA (2018). Chemical peels: A review of current practice. Australasian Journal of Dermatology. 2018; 59 (3): Pages 171-181. https://www.ncbi.nlm.nih.gov/pubmed/29064096
7. Omi, T (2014). The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology. Laser Therapy. 2014; 23(1): Pages 49-60. https://www.ncbi.nlm.nih.gov/pubmed/24771971
About the Author

Sarah Richardson, LME

Sarah Richardson is a Licensed Medical Esthetician with over 8 years of skin care experience. Sarah is WIFH’s Lead Medical Esthetician and an Assistant Cosmetic Laser Practitioner licensed by the Georgia Medical Composite Board. Sarah also manages the skin care side of our practice. She is certified to perform Microneedling, VI Peels, SkinCeuticals & Skin Medical Peels, HydraFacial, SilkPeel, Dermaplaning, DermaSweep Microdermabrasion, IPL PhotoFacials, SculpSure.