Brown Spots and How to Get Rid of Them

Are you wondering what to do with those dark blotches that continue to appear on your skin, especially on the face?

Visiting your dermatologist is the first step in making sure that these spots are not pre-cancerous or even cancerous, and to initiate the proper medical treatment, if needed.

Most facial brown spots however, are harmless. There are several benign causes of this unwanted discoloration of the skin. They may be solar lentigos (literally meaning sun-induced spots occurring in mature, sun-damaged skin), ephelides (common freckles seen in children and young adults due to excessive sun exposure), post inflammatory hyperpigmentation (seen in people of color due to skin irritation after pimples, insect bites, rashes and other causes of skin inflammation) and melasma (skin darkening due to the influence of UV light exposure in combination with estrogen. Melasma, which is usually seen in women and often referred to as the brown “mask of pregnancy” commonly involves the forehead, temples, cheeks and upper lip and may occur during pregnancy or with the use of hormonal contraceptives (eg, estrogen-containing birth control pills, NuvaRing) and estrogen replacement therapy (HRT).

Once a well-trained dermatologist has examined your skin and determined that the brown spots you have are indeed benign and only cosmetic in nature, there are several effective options available to treat and remove them.

Prescription-strength topical skin care products. Many over-the-counter skin care products aimed at removing unwanted brown spots and other signs of skin damage just don’t contain the concentration levels in their active ingredients to provide the most effective results. For example, most skin-lightening products available at the dermatologist’s office are far stronger in concentration while also formulated to be gentler to the skin than the products you find at high-end department stores. By allowing a dermatologist to create an individualized skin care regimen for you, you will have an expert selecting the most effective products for your skin. Your dermatologist will be able to target your specific skin concerns while taking into consideration your skin type and skin sensitivities, as well as your lifestyle.

Chemical Peels and Lasers

Procedures such as chemical peeling, laser treatments (Fraxel, Clear and Brilliant, PicoWay laser, Intense Pulsed Light), and even liquid nitrogen (freezing) are all effective in improving brown spots, but only when performed under the direction of an experienced dermatologist who has extensive knowledge of patients’ skin types and risks for post-inflammatory hyperpigmentation (see above) which may occasionally occur due to the potential for irritation from these procedures. In most cases, pretreatment of patients with the use of prescription-strength topical fading products both before and after the chemical peel or laser treatment, is strongly recommended to ensure the best, longest-lasting results. Remember, the cause of brown spots is sun exposure, and the sun is not going away anytime soon!

It is critical to always remember that meticulous sun protection of your skin is as important as any treatment choice when considering removal of brown spots.

Have a wonderful summer and protect your skin from the sun!

Written By: Lillian Soohoo, MD
Board-Certified Dermatologist – Golden State Dermatology, Mountain View

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