Darkened areas on the cheeks, dark circles under the eyes, age spots, and hyperpigmentation are all basically the same problem– excess melanin production in the skin. It can happen at any age, but as we grow older it becomes more of a problem. While we often focus on lines and wrinkles as signs of aging, clearing brown spots and splotches can erase years from your skin.
While there seems to be a boatload of options, there are basically two different approaches:
1. Products that inhibit the skin cells from producting melanin.
2. Procedures that actually remove darkened skin.
One of the most powerful tools against hyperpigmentation has been hydroquinone, but many doctors use it cautiously. There were reports of increased pigmentation and allergic reactions with hydroquinone and but according to Dr Wendy Roberts these problems were often due to contamination of hydroquinone products. Doctors found that it was the addtion of mercury to the hydroquinone in unregulated products from Asia and Mexico that was causing the problems. Mercury is banned in the United States and is never part of skin lightening products made in the US.
If you still feel uncomfortable about hydroquinone, there is a buffet of new ingredients including azaleic acid, licorice and vitamin C that have been demonstarted some ability to remove pigmentation, but not as effectively as hydroquinone. However when the two or even three are combined they can work better than when used separately and with lower risk of side effects.
Lasers of different sorts have been used to treat hyperpigmentation and one of the best new is intermitment pulsed light or IPL. This type of light literally explodes freckles and without affecting normal skin color. Dr Marmur treated my BFF Judith with IPL and the before and after pix are impressive.
Often the best treatment plan is a combination of therapies. A camera shy friend, used IPL to remove post pregnancy dark patches near her hairline and made sure they stayed away with a vitamin C serum at night to discourage melanin production. I used a YAG lser for my bigger lumpy sun spots, nightly treatment with Retin A to gradually fade small freckles and IPL to even off skin color. You can seem my results in the photo album on my facebook pages. Just click the Facebook button.
Curent wisdom seems to be that there is no one single silver bullet for unwanted pigmentation. Best results usually occur when different products and tools are used in combintion. And remember, whatever you do, you must be diligent using sunscreen every day. Even a single sunny day can provoke their return. I know this the hard way.