Sun Spots, Brown Spots, Age Spots

What is hyperpigmentation?

Hyperpigmentation (dark spots) is a common skin problem where patches of skin become darker than the surrounding skin, due to an excess deposit of melanin. Melanin is the substance that gives our skin its color.  Hyperpigmentation affects people of all skin colors.  Dark spots include brown spots, birthmarks, age spots, liver spots, freckles, sunspots, and melasma.  Melasma is hyperpigmentation due to hormonal changes.  Post-inflammatory hyperpigmentation results from an inflammatory skin condition such as acne or a bug bite.

Hyperpigmentation can affect any area, but is commonly found on the face, ears, back of the hands, arms, neck, chest, shoulders and back.  Hyperpigmentation is not dangerous to one’s health but is cosmetically unappealing.

What causes hyperpigmentation?

Hyperpigmentation can result from sun damage, acne scarring, heredity, some medications, and hormonal imbalances.

Melasma

Melasma is a common problem that affects mostly women, caused by hormone changes.  Intense UV radiation exposure and a genetic predisposition play a role in the development of melasma.  In pregnancy it is called the “mask of pregnancy”. Melasma can also be caused by birth control pills and hormone replacement therapy. About 10% of melasma cases are in men.  Melasma affects Caucasians as well as people of color.

Melasma appears as brownish-gray patches on the face, bridge of the nose, forehead, chin and upper lip.  Sun exposure can trigger the return of melasma after it has faded. Melasma is difficult to treat and may require maintenance therapy after it clears. Common treatments include Hydroquinone, Retin-A, and Azelaic acid.  However, Dr. Jenna Queller is an expert who trained in Los Angeles where there were numerous cases of melasma.  She works with a local pharmacy that creates a topical compounded product with several ingredients.  In addition, she is one of few in the country who knows how to prescribe a new cutting-edge oral treatment with great success.

Sun Spots (Solar Lentigines)

Sun spots, also called age spots and liver spots, are flat pigmented spots on sun exposed skin.  Sun spots are caused by sun damage that occurred in the past.  90% of light-skinned people over the age of 60 have age spots.  Age spots typically appear on the face, hands, forearms, chest, back and lower legs.

Common treatments include:

• Chemical peels
• Photofacial (IPL, BBL)
• Laser skin resurfacing
• Topical creams 

Combination treatment has been found to be the best approach, in addition to the daily use of a sunscreen.

Post-inflammatory hyperpigmentation (PIH)

PIH is hyperpigmentation is caused by an inflammatory skin condition that is triggered by numerous inflammatory disorders — to name a few — acne, infections from bacteria, viruses, and fungi; skin eruptions due to certain medications; eczema and psoriasis, and many others.

Acne breakouts often result in PIH.  PIH is the discoloration left after acne or other inflammation heals.  PIH can be pink, red, purple, brown or black flat discolored areas. Acne scars may also be discolored.  Overexposure to the sun, and drugs that cause hypersensitivity to the sun, such as some antibiotics, can cause PIH.

PIH discolorations may fade with time but take a long time to fade.  It can take several months or longer for superficial spots to fade, and longer to treat deeper discolorations that may not fade on their own.  People with medium to dark complexions are more prone to PIH especially in areas with intense sun exposure such as Florida.

To control your risk for PIH from acne, the first step is to get your acne under control and to use sunscreen daily.

If you already have PIH there are effective treatments.

Common treatments may include:

• Alpha hydroxy acids like glycolic acid which speed exfoliation and can improve PIH.
• Hydroquinone
• Retin A
• Azelaic acid
• Chemical peels
• Microdermabrasion
• Laser skin resurfacing

Dr. Jenna Queller is a board-certified dermatologist who is highly trained in skin of color.  Her training and experience with top skin of color experts in the country provide her with the expertise to diagnose and treat hyperpigmentation and melasma in any skin type including people of color.  Dr. Queller specializes in the diagnosis and treatment of common and rare skin disorders in patients of all ages.

When you are distressed by dark spots, sunspots, melasma or acne discolorations professional treatments can help.  Dr. Jenna Queller is a board-certified dermatologist and expert in cosmetic and surgical dermatology in Boca Raton, Florida.  Contact Dr. Queller to schedule a consultation to receive an accurate diagnosis and a personalized skin care regiment including laser therapy, chemical peels and topical medications.