DEAR DR. GOTT: Some time ago, I began noticing dark discolorations on my face. The condition was diagnosed as hyperpigmentation. Three dermatologists offered varying suggestions. One said to use facial products containing hydroquinone. One suggested chemical peels. The third indicated nothing will diminish the pigment.
I’ve tried many facial products with no improvement. And, at age 70, I do not wish to try invasive treatments such as chemical peels. I have not found makeup or a concealer that provides good cover.
Is there a product you would recommend, or should I just learn to live with these discolorations? Any suggestions would be greatly appreciated.
DEAR READER: As we age, it is common to see darkened spots on the face, backs of our hands and in other areas of the body exposed to sunlight. They are known as age spots or liver spots. The spots vary in size and are brown or black in appearance. They can range in size from that of a freckle to the size of a dime. As a general rule, they are harmless and do not require any medical care.
Ultraviolet light increases the production of melanin, the pigment that gives skin its normal color. The production of additional melanin causes the darker color to appear. This generally develops over time — whether exposed to the sun’s rays or not.
It is my guess that you have benign lesions that can be disregarded unless their appearance bothers you. There are creams available by prescription to bleach the spots; cryotherapy, which applies a freezing agent to the spot to destroy the pigment; dermabrasion, which sands down the area with a rotating brush; laser therapy, which destroys melanocytes that created the darker pigmented area; or chemical peel that involves the application of an acid that burns off the outer layer of the skin.
Over-the-counter remedies include topical creams or lotions containing hydroquinone, glycolic or kojic acid, or deoxyarbutin. If you choose this route, speak with your pharmacist if you have any questions about which product is best. Keep in mind that prolonged use can result in skin irritation.
Readers who wish to avoid liver spots should take precautions when going out in sunlight by wearing protective clothing and appropriate sunblock. For example, a broad-brimmed hat should prevent direct exposure to the face.
If there is any question of new lesions that appear on the skin or if any spot darkens, enlarges or changes, be sure to make an appointment with a general practitioner or dermatologist for clarification.
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