Sun spots summarized

Sun spots are very common in adults over 40, but they can appear on younger skin, too. Not surprisingly, they typically result from long-term sun exposure. Even if you rarely lounge around poolside or spend time at the beach, sun spots can still appear on your body. For instance, spots can form on your hands from driving in the sun.

So, how do sun spots develop? To defend itself against sun exposure, the skin reacts by generating more melanocytes, which produce melanin. When too much melanin is produced, sun spots emerge — commonly appearing on the face, chest, back, shoulders and hands.

The skin-lightening staple: Hydroquinone

Hydroquinone is the most effective, well-researched skin lightening ingredient on the market. It works by inhibiting the enzyme, tyrosinase, which synthesizes melanin. Over-the-counter products are made with 0.5 to 2 percent hydroquinone; higher concentrations require a prescription.

Compared with alternatives like lasers and chemical peels, which must be administered in a doctor’s office, hydroquinone is a much more affordable option. Side effects are minor and can include itching and reddened skin.

Product picks and tips: For a lightener with hydroquinone, choose a product like DDF Fade Gel 4, which fades sun spots and evens out the complexion. While using any product with hydroquinone, avoid using other medicated topical treatments, particularly those that contain peroxide. Apply the lightener to the skin several minutes before putting on makeup, moisturizer or sunscreen.

Hydroquinone can be a relatively unstable ingredient, oxidizing (or darkening) with exposure to the air or sunlight. Make sure the package isn’t transparent and keep the product away from sunlight.

Importantly, avoid excessive sun exposure and wear sunscreen every day. Apply SkinCeuticals Physical UV Defense SPF 30 daily.

Recent concerns: On August 29, 2006, the FDA recommended a ban on over-the-counter hydroquinone products, citing safety concerns. Specifically, "some evidence" suggests that hydroquinone poses a carcinogenic risk in animals, according to the National Toxicology Program (NTP), though there’s no evidence of a potential risk in humans. The FDA also cited a link between hydroquinone and ochronosis, a condition that causes the skin to darken and thicken.

Many dermatologists strongly disagree with the FDA’s proposal, pointing to hydroquinone's well-established safety and efficacy as a lightening agent. For instance, its link to ochronosis appears weak. Pearl S. Grimes, M.D., a clinical professor of dermatology at the University of California, tells Allure that in 50 years, just 30 cases of ochronosis have been reported in the U.S. If you have any concerns about using hydroquinone products, consult with your dermatologist.

Alternative treatments

If you would like to avoid using hydroquinone, you can choose from many plant-based skin lighteners, including kojic acid, bilberry extract, mulberry extract and licorice. Of these, one of the most popular is kojic acid, which is derived from the fungus Aspergillus oryzae.

Like hydroquinone, kojic acid also inhibits the production of melanin in the skin, causing dark spots to fade. Even though kojic acid is an effective lightener, it’s unstable in skincare formulas. So, some companies use the more stable kojic dipalmitate, but its effectiveness is less clear.

Product picks and tips: For a lightener with kojic acid and alpha hydroxy acids, try NeoStrata Skin Brightening Gel and then protect your skin daily with La Roche Posay Anthelios SX Daily Moisturizer with SPF 15.

If you want to avoid topical treatments overall, try one of the newest forms of skin rejuvenation: LED light, which helps to improve the texture, tone and overall clarity of the complexion. For an easy, at-home treatment, try Evis MD Platinum Red.

Applying the product

Once you choose the appropriate lightener, follow these tips for proper application.

• Only apply skin lightening products to dark spots, being careful to avoid the surrounding skin.
• Use a Q-tip to apply a small amount to the dark spot, allowing it to dry completely before putting on moisturizer or foundation.
• Follow directions carefully on how often to apply the product; usually twice a day is adequate.
• For larger spots, such as on hands and legs, gently massage the product into the skin to ensure even delivery.
• Once you’ve achieved the desired level of fading, stop using the lightening product or reduce your use to once a day.

General tips

• Don’t stop using sunscreen; if you do, the hyperpigmentation is likely to return.
• Keep in mind that lightening takes time; it could take weeks or even months depending on your skin type and the intensity of the spots.
• With proper use, skin lighteners will deliver noticeable results. Select your lightening product carefully and be diligent about applying sunscreen.

See also:

SPF: What You Need to Know

Preventing and Treating Age Spots

Topical Hydroquinone