Color and Texture Issues
Here are the top issues! A more complete discussion can be found my book, The Surgery-Free Makeover: All You Need to Know for Great Skin and Younger Face.
Brown spots on face from age and sun damage
Brown spots on the face are essentially sun damage. You may have had them as freckles when you were younger, but they get larger and often darker as you get older. Be sure they are checked by a dermatologist first to make sure they are not skin cancer.
The first thing to do about brown spots and age spots on the face or hands is to prevent more of them by applying sunscreen daily. Make sure you use a sunscreen that protects you from UVA radiation by having at least 5-10% zinc or titanium. And, wear a hat!
You can also try over-the-counter bleaching creams if your age spots are recent and not too dark. The bleaching creams are 2% hydroquinone. There have been some questions raised about the safety of hydroquinones in Europe and the European Union has banned them. Drugstore "bleaching" creams will cost under $50 and take effect in about 30 days. Prescription bleaching creams are usually 4% hydroquinone and will cost under $150, with some insurance plans covering them. Hydroquinones should be used for no more than 3 months unless under the care of a dermatologist.
Bear in mind that continued sun exposure will stimulate the growth of brown spots, so that the bleaching creams will not protect you against the regrowth of brown spots or the development of new ones.
There are also plant-based bleaching creams for treatment of brown spots and age spots. These ingredients are ones like arbutin, thymol, and kojic acid. You are welcome to try them but they are less effective than prescription products.
Microdermabrasion and peels are also options for brown spots. A good aesthetician can perform microdermabrasion or a low-strength peel, and these can often give good results as long as the problem is minimal to moderate at a cost under $250. Usually a series is needed.
Many of my patients ask me how to get rid of brown spots on the face. The most effective treatment option for brown spots is a series of laser treatments. This is also, unfortunately, the most expensive. An IPL or a Q-switched YAG laser, for example, can give excellent results.
Fractional lasers are a good option for removing brown spots on the face if your problem is more severe or you have wrinkles or acne scars that would also benefit from a fractional laser.
A series of five IPL/Photorejuvenation or laser treatments for brown spots will cost you anywhere from $1,000 to $2,500, but often an IPL will also reduce any redness, stimulate some mild collagen growth, and add to your skin’s glow. You will need maintenance treatments when brown spots reappear, or once or twice a year. Fractional lasers are more expensive.
Laser Treatments for Brown Spots
Brown spots or splotches due to melasma
If your brown spots tend to be larger splotches that appear on the cheeks, jaw line, upper lip, or forehead, they may be due to melasma from pregnancy, oral contraceptives or other hormones. If you think you might have melasma, you should see a dermatologist before trying any treatment of melasma. This can be a tough problem to treat and the sooner you start the better.
Brown Spots vs Melasma
You should also see a dermatologist before receiving any laser treatment for melasma. Some lasers can make melasma worse.
One promising development in this area is the fractional lasers, which have shown some good results on the treatment of melasma. These links will give you more information on melasma and its treatment.
Red or broken blood vessels on face
Having redness or broken blood vessels on your face or nose does not necessarily mean that you are an alcoholic, contrary to popular myth. Often people with Celt genes develop redness or even broken blood vessels on the nose and face, but it can happen to anyone. These changes can be caused by rosacea, sun damage, allergies (lots of nose blowing), or even some systemic diseases, like lupus.
You will need a doctor to help you figure out the cause of your redness. If redness is due to rosacea, the first step may be to look at lifestyle changes, like decreasing coffee or red wine consumption. But there are many effective treatments for rosacea, so see your dermatologist.
If the redness is due to sun damage, or you have rosacea, you may want to consider laser treatments to reduce the enlarged blood vessels or redness. These treatments cost $1,000 to $2,500 for a series of four to six treatments depending on how much redness you have and how large the area is that needs to be treated. Full face treatments will cost more than just treating your nose.
The results are usually excellent. A series takes 3-6 months to complete, and you will need maintenance treatments once or twice a year.
See Dr. Irwin's Guide to IPL/Photorejuvenation Laser
Redness is often due to rosacea. If you think you have rosacea or are looking for treatment for rosacea, see your dermatologist.
The culprit can often be sun damage also. If your red and blotchy skin is due to sun damage, your best option is the IPL or pulsed dye lasers. These will cost $1,000 to $2,500 for a series of four to six treatments. The results are usually excellent. It takes about 6 months for the effects to be noticeable, and you will need maintenance treatments once a year.
Remember that if your redness is from rosacea, you’ll need to see a doctor in order to get the redness under control.
Remember also that there are no creams for rosacea at this writing that can take away bad redness for anything longer than a few hours. Some people have tried hydrocortisone, and that may have a very temporary effect. But, you do not want to use hydrocortisone for more than a few days.
Lumps, bumps, and moles
You should see a dermatologist if you have any moles, lumps or bumps that you want treated. Some growths are precancerous or cancerous, so make sure that a dermatologist checks anything that you think has changed or is suspicious. The various lumps, bumps, and moles we have are all treated in different ways depending on what they are. It is best to see your doctor to decide on the right course for you.
See Dr. Irwin's Tip of the Week on Who Needs Mole Checks.
Next, learn about Neck and Chest Issues
See Dr. Irwin's expert answers to other reader's questions on Color and Texture Issues:
Is sunscreen really needed if I'm at home? Problems with pigment increase after peels. Can Thermage, Exilis and Ultherapy be used for prevention? Are Dysport/Botox and Sculptra compatible? A problem! Which retinol is best for use on the delicate eye area? How does radiofrequency (Thermage & Exilis) compare with Ultherapy? All these different forms of Retin A (Renova, Atralin, tretinoin) -- arghhhh!
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