Blog with Dr. Irwin

Tag >> Brown Spots

Hi, Which treatment is best to treat sundamaged skin on the hands and upper chest area? IPL, or LED rejuventation?

Okay - so this is a complicated question because I don't know your age or exactly what's bothering you.  Sun damage has a lot of different problems it can cause.  It can make the skin... more


What does small brown spot in legs indicate?
Everyone -  just a reminder.  A brown spot can be anything from a deadly melanoma skin cancer to a harmless freckle (lentigo).   This is not the place for a web or self diagnosis. ... more

-------------------------------------------------------------- Hi Dr. Irwin- I am a woman in my early thirties that experienced melasma from my pregnancies. I am no longer on any birth control and I VERY careful about sunscreen and sun exposure. I have Asian skin and have tried tri-luma. I recently read an article stating that a new product called Elure Advanced Skin Lightening actually "dissolves hyper pigmentation using melanozyme to destroy melanin accumulation on the surface of skin." Have you heard of this line or tried this product. Thank you.

So far, I think this is another triumph of marketing over substance/science - but time will tell.  Elure's patented 'Melanozyme' is the enzyme lignin peroxidase which is an enzyme... more


Can you please recommend some over the counter hydroquinone cream brands? I have hyper-pigmentation and would like to try and over the counter bleach cream. Thank you.

All of the over the counter "bleaching" products that contain hydroquinone are limited to a 2.0% concentration in the United States. Prescription creams are usually 4% and dermatologists... more


Hi Dr. Iwin, My derm's assistance took a polarized picture of me. The picture showed that I did not have any sun damage. How it that possible when I have brown spots on my face? What's the best topicals to get rid of the brown spots? I know for sure I got these brown spots from staying out in the sun and not melasma.
You bring up a good point which is that lab tests, cameras, computer imaging, etc can all be in error sometimes or just not functioning well that day.  Since almost everyone has at least... more

hello Dr. Irwin first of all i love your suggestions it helped me a lot. so my problem is like this- i am from India. naturally i have fair coloured skin. i am 14 years old . but from 2 or 3 years . my skin is getting dull. when i clean my skin it gets glowing but after few hours it again gets dull. is it because my diet? and i have dark circles also. i sleep enough ? how can i get rid of them.
Thank you for writing.  Can you write again and give me  a little more information.  Is your skin dry, oily, acne prone?  Are you putting anything on your skin after you wash?  Are you... more

Hello DR. does tri-luma help with brown sccaring from picking? I.. like to try it ty
Most of the time, the brown spots you see after picking aren't really scars.  Meaning they aren't truly depressed below the level of the skin or a different texture.  Most of the time... more

I am considering a laser treatment for my face to just rejuvenate and even out the skin tone. I would also like to fix some broken blood vessels. I have no idea what type of laser procedure to look for and how to make sure the doctor is qualified to perform it. Is it a dermatologist or a plastic surgeon that I need to find? Any advice would be appreciated. Thank you.

Okay - to start, read my articles on lasers to learn what type of results each laser can provide. Also, look at my directory of excellent cosmetic dermatologists in the U.S. to help you... more


Hi Dr. Irwin, I had a two IPL treatments for brown spots/previous sun damage. I was very please with my resuls. I went to Costa Rica a month after my ipl treatment and my spots are back!!! I wore Neutragena SPF 100, a hat and wasn't basking out in the sun. I was very good with reapplying the sunscreen. I am perplexed! What do you recommend? I would get another IPL treatment, but is it really worth the cost? I was so disappointed that after two days in the sun, with heavy sunscreen on, they came back. Is there a better sunscreen then Neutragena 100? Any over the counter creams do you recommend or should I try another IPL? Thanks so much!

Okay -  this is good - because there are some important points here.  Remember that for brown spots the SPF doesn't matter much as long as it's at least an SPF 30.  You want an SPF 30... more


Hello DR. does tri-luma help with brown sccaring from picking? I.. like to try it ty

The short answer is yes............ but only if you stop picking!    So here's my question to you.  I'd like you to think about why you're picking.  If you have acne, please see a... more


Dr I, What do you think about Epiquin micro. I try Tri_luma was thinking aobut switching. I use Renova at night, but does it help what brown spots that well?...I also like to try Vaniqa cream for unwanted facial hair, Your thought. ty

The Triluma is very hard to find right now.   We are having the equivalent specially compounded for our patients when we need it.  The Epiquin micro is excellent.  It doesn't have the mild... more


Hi Dr Irwin, I learn a lot from your blog and it gives me hope! Just wanted to share an observation on brown spots. I am 42, type 2 skin, dry but with monthly cyctic acne on jawline, and increasingly large lentigoes on cheeks/eye area. I tried Comet laser treatments (spots came back next summer), 4% hydroquinone (made the area redder not lighter) but whats surprizingly helped the last few months is using ROC vit A+C+E moisturizer. Why would this cream reduce the brown spots so drastically? It only seems to work on the lentigoes not red acne scars. I am resigned to them coming back this summer though, given i break out with most sunscreen including all the paula's choice ones :( And the ones you recommend are not avail. in the Netherlands. Any Euroepan suncreens you'd recommend? Thanks!

Thanks for sharing this.  I'm not too surprised though that the Roc Vit A,C,E product helped because the vitamins C & E are antioxidants and the Vitamin A (probably Retinol since it's... more


About 2 years ago I started getting red spots on my forehead that eventualy turned to brown spots. This is happening more lately, last Sunday I woke up and the whole section above my left eyebrown was freckled red. What is this stuff? I am 52 years old, no hormone replacement.
There are about 10 (at least!) different skin diseases or problems that can cause red spots on the face that then turn brown.  Please, please see a good Dermatologist and get an accurate... more

Is it ok to use the dual fraxel laser for melasma and brown spots

Okay - so this is a much more complicated question than you think which is why  you need a good dermatologist to work with you.  Here are the things I would want to know.

  1. What is your
... more

Please help me! I am a 50 year old Asian female. I have a benign, slightly raised, seborrheic keratoses on my cheek, the result of staying out in the sun too long and getting sunburned. I have seen a couple of dermatologist already but I don't know what to do. The first dermatologist wants to shave it off. Another wants to spray liquid nitrogen on it. One says I can try laser and the other says I can't do laser because the spot is raised and I am Asian. Since the raised brown spot is on my cheek, I don't want a scar. What should I do? Since I'm Asian, can I do laser? Would laser remove and flatten the brown spot? Or should I just let the doctor spray the liquid nitrogen on my face? Also will liquid nitrogen flatten the raised spot? Please help me!!! I am so tormented every time I see my face. Thank you!

I'm guessing you are getting more than a little frustrated with all these different answers!  Here's my "2 cents" and I've have removed thousands of these on my asian patients over the... more


What do you think of Obagi cosmetics?

I think I'll just tell you the pros and cons in my mind because it's a little complicated.  Obagi was one of the first doctors who tried to base skin care more on science, and for that I... more


What do you think of Obagi cosmetics?

I think I'll just tell you the pros and cons in my mind because it's a little complicated.  Obagi was one of the first doctors who tried to base skin care more on science, and for that I... more


Dr Irwin, Thanks for sharing your expertise! My qs is about hair removal and lentigoes. Which specific laser do you recommend for facial hair removal for type 2/type 3 skin? (light olive with dark hair)? What is your opinion on LightSheer v/s Alexandrite v/s ELOS (by Syneron)? I have had 7 treatments of ELOS but the hair still comes back (though not any more within the 6 week interval, more like 12 weeks). Is it true a traditional laser will get faster results than ELOS? The clinic also used ELOS on another setting on my lentigoes but after 2 x crusting and improvement, it didnt reduce the pigment any further. Of course i use sunblock daily (la roche posay meroxyl sx 50+ and clinique spf 15 powder on top of that - based on your recommendation for layering- thank you!), but despite this, this summer the spots all came back, with vengeance- there is now more general melasma under the eye area on both cheeks which looks like it will become one giant patch. I'm 42, and don't take any medication or hormones.

In my opinion, the Elos Syneron system is not the best for hair removal. Best choices for you with light olive skin would be the LightSheer or any of the Nd:Yag based systems.   If the hair... more


I was told by my family physician to use "Mother of Pearl" cream to help with a brown spot I have on the side of my eye since it is getting larger. After reading your tips on brown spots, I am making an appointment with a dermatologist to make sure it is nothing serious.
Thank you for writing this.  You did exactly the right thing!!  There are brown spots that can be melanomas or lentigo maligna or "pre melanomas"  - also called dysplastic nevi.  I... more

Hello Dr Irwin, I have very lage dark brown spots on each cheek which appeared in 1999. They have been diagnosed as chloasma. I consulted three dermatologists between 2000 and 2005, two of whom advised me that laser or peeling techniques were not recommended for Asian skin types , I have Indo-European origins. Therefore I have only used depigmenting creams which had no effect and in fact the spots have increased in size in recent years. My question is: have laser techniques advanced since 2005 and are there any now which would provide a good result on my skin type? Thank you

So first, I'm assuming you've had these spots looked at in the past year by a dermatologist to make sure they are not skin cancer!

Then, this is a tough question and not all dermatologists... more


Dr. Irwin, I was diagnosed by a dermatologist a few years ago with melasma. I have also had slight acne and with my pregnancy 2 years ago my melasma was really dark. I am 35 years old and the melasma and acne started in my late late 20's. I have had numerous laser treatments (ip-Fraxel) and they helped some and broke up some spots but I still have really dark spots all over my face. It is uneven all over and very oily. I'm searching for a good glycolic peel but have not decided on anything. Do you have any recommendations on what to try now or what type of peel to use. I used the Obagi for months and still use some of the products but the hydroquinone didn't seem to make a difference. Help DWebb

I still think that melasma is the toughest problem to treat because there is no cure for it - just good control. You will absolutely need the help of a dermatologist who's interested in... more


Dear Dr I, I took your advise and went back to the doctor who did my IPL and left me with brown/black marks on my face for 10 days!!!! I still have dark spots on my face a month later and he says it's just a matter of time and he will do a peel once a week to speed up the process. I didn't like that answer and went for a second opinion. The 2nd doc said to wait about a month and do a lime light treatment. I got a 3rd opinion who recommended to do another IPL treatment with a lower setting to break up the pigmentation he says is stuck right below the surface. Needless to say, I still value your opinion over a computer than these other people. I know it's hard without seeing me but any suggestions you have I will use to help make a better decision. I'm hispanic, 37 yrs old and had good skin with the exception of some sun spots that led me to the horrible IPL treatment. I still have the sun spots plus alot more brown blotches:( Thanks for your time.

I'm impressed because this is a really tough situation and you're doing such a great job being proactive about it.  Kudos to you!

I'm guessing, hoping that they all went over the basics... more


Hi Dr. Irwin: I have medium color skin (latin), with some melasma spots on forehead. A Dermatologist and a Cosmetic surgeon had recommended to stay away from deep laser. I used many products, hydroquinone, BHA, AHA. Renova, and plenty of sun block with 17% zinc oxide. I don't see any changes. What else can I do? Thanks for your help. Myrna

If I could have one dermatology wish granted by a good fairy, I would wish for a true cure for melasma!!!   It is such a painful problem for many women (and some men)!  And, in some... more


Dr. Irwin: Your website has been extremely helpful - thank you! I have been thinking about Photorejuvenation for brown spots on my face. I have them on my upper lip & a few on my cheeks. Just as you said in the video - "many people are scared of lasers" well I am one of those people. I have read a great deal online & have discussed the treatment with a local doctor, but still have concerns. First, I have read about the "striping" that can occur after - how common is this; what % of people would you say this happens to; how long does this effect last; what's done to correct it? Is there typically any crusting of the brown spots after a treatment, if so what % of people experience this? Finally, what % of people actually see results from the treatment, if done properly? I guess, my fear is making the "problem" worse because of the "striping" & is the cost worth it? I looked at your recommendations for local doctors - do you know of anyone in the Cleveland, Ohio area? Thanks so much....

These are all good questions.  My concern is that when you saw your local doctor these questions weren't answered.  I would recommend getting a second opinion from another office and... more


Hi I just had a treatment for brown spots using IPL laser and had very severe swelling any tips to reduce the swelling, thanks.

Here are some things to try for swelling after an IPL treatmemt:

 

  • Ice, ice and more ice right after the treatment.  They should give you several ice/cold packs so you can sit for 20-30
... more

Dr. I, Your site is Fabulous!!!! You are so helpful...thank you. I am outside (work) during the day. I have sun spots that I am trying to manage. I use the sunscreens (zinclear and colorscience)to protect and I do IPLs in hope of lightening and minimizing the spots. I have been using the obagi blender and retina A once a week. I use it on my last day of work because then I have the tree days out of the sun. Is this enough to make a difference or should I just not use it till the winter. I want to do away with these spots all together!!!! They bother me. I have olive skin and I am 39. Thank you for your help!!

Thank you!  I'm having so much fun doing this.  You're doing a good basic job I can tell.  Here are some thoughts for fine tuning more.  Do you have a hat with a good brim??  Hats are... more


Hi Dr. Irwin I just had an IPL treatment for my brown spots at a new clinic. This was my 4th treatment over the span of 2 years. I didn't feel the "zapping" that I did in my previous treatments and my brown spots have not gotten darker like past times- immediately after the treatments. I was expecting the pinkness on my cheeks,the slight scabbing for a few days and then the spots disappear or are much lighter. This experience was very different. Do you think it can have the same results if I didn't experience any of my expected/usual things? I know the settings must have been different and probably the machine. I hope I didn't waste money trying to find a new place closer to home. I know time will tell ...I was just wondering if there is somewhat of standard experience for the IPLs? Thank You

Excellent question!   There are many different companies making IPLs now and they are not all created equally.  The ones sold to salons and medispas tend to be less powerful and therefore... more


Dear Dr. Irwin, I am 54 years old and in menopause. The past 4 years I have brown spots on both legs below the knee. I get more and more usually starting as red botches and then turning brown, in all sizes. What can I do? Grateful for your help. Regards Ruth Sternberg Gothenburg, Sweden

Dear Ruth:

Do you have a dermatologist nearby?  I think it would be good for you to see one.  What you're describing sounds like something called Schamberg's disease but it's absolutely... more


Hi Dr. I!I have a question regarding skin care products. I am such a fan that I have aquired the products you use and recommend to see what works for me. I guess at this point I have become a little neurotic/obsessed with my skin as I see the changes that I know are inevitable. So, how much is too much??? This is what I am doing right now. Night time: Obagi Nu-derm (hydroquionone 4%) for the brown spots, TNS Recovery Complex, Eye cream, Revaleskin Night Cream, and a moisturizing lotion (dry skin).Day Time is much harder for me to figure out. Obagi Nu-derm (hydroquionone 4%) for the brown spots, TNS Recovery Complex, Eye cream,SkinMedica Vitamin C & E, Moisturizer (Dry skin), Zincclear Sunscreen and I am trying to figure out if I can add a firming/wrinkle filler for the slight wrinkles that are NEW ON my cheeks and then Makeup (foundation, blush, lipstick)!!!!I\'m almost 40 and my skin has become dry, a few brown spots and NEW (very noticeable to me) wrinkles under the eyes and cheeks. Do the products work as well piled on??? I was told I should use a \"treatment\" type product such as \"Perricone Md\" face firming activator and/or \"Substiane\" (La Roche-Posay). There is just so much. I know a lot of it is trial and error and I know everyone is different. I apoligize for this \"book\" I have written in trying to ask you for your advise and what is too much product and if am I going over board if I throw in an extra wrinkle filler or two in my daily regimen??? Thank you for your time and for this website.

Whoa!!   This is way too much so let's simplify and get back to basics a bit.  Here's what I'd recommend:

AM   cleanse, Vit C & E (your antioxidant), eye cream, spot treat your brown spots... more


Dr Irwin; Thanks for your informative internet chat with Paula Begoun. How do you feel about cryosurgery for facial brown spot removal? I have had 5 laser treatments which have worked to some degree; but I have 2 stubborn spots which were only lightened. I have had cryosurgery before, but the brown spots returned in the same location. I am 54, and am vigilant about daily sunscreen protection. I don't have any wrinkle issues; I'm lucky in that regard. But the brown spots are driving me crazy ! I have tried everything, including 4% hydroquinone. Cryosurgery seems to work more quickly than laser treatment; would you disagree? Thanks for your honest manner; I so appreciate that! Gail

Liquid nitrogen (cryosurgery) is used for a lot of different purposes in dermatology including, sometimes, removing brown spots. It does work!  There are problems with it though when used... more


Hi Dr. I I had a consultation today regarding the brown spots/sun damage on my face and I wanted to ask for your opinion. I am a 37 years old, on birth control pills,hispanic(olive skin) and work outdoors (10 hour days).I have done the IPL 3 times and see results but not completly satisfied. I started the IPL after I had a baby. I was told that a peel would be better than a laser treatment and that I should use certain products(cosmelan). I am using the sunscreen you recommended Zinclear but this doctor told me that I don't need Zinc in my sunscreen at my age???????? What do you suggest? I do plan to get a different opinion but I was wondering what you thought of this and what direction/questions may be more helpful in my next consultation.

I know for sure that that advice about your sunscreen was not good!!!  You are YOUNG - only 37 - and if you have brown spots, are hispanic, on birth control and work outside, you need a... more


I'm 52 with fair skin and I have brown spots on my face from too much sun exposure years ago.I was told that all I needed was two IPL treatments to get rid of the brown spots. I purchased a package of 2 IPL's and 2 Peels along with microderm treatments. I had two IPL's for the brown spots. I had the two peels and microderm treatments. The first IPL treatment brought up the coffee-grounds type discoloration. Then the coffee-ground appearance became lighter and eventually came off leaving my brown spots a little lighter. The second treatment did nothing at all. I went back a third time and they retreated the main spots and again nothing changed. Does this mean that they will never get any lighter? I also use a 4% hydroquinone product and tretinoin gel 0.05%. I use an SPF 50 sunscreen and avoid the sun as much as possible. Am I missing something? Should I have more IPL treatments?

I hear this question/problem A LOT!  IPL systems are numerous and not all created equally.  Some IPL systems are almost worthless in my opinion because they are underpowered and not easy to... more


I'm 54 and getting lots of freckles on my shoulders. Sun damage, I guess. Which laser would be best to lessen those freckels? Is it expensive to get the whole shoulder area treated?

Too many sunburns in the past and all those fun racerback tops might be catching up with you!  The most cost effective way to treat these is with an IPL or an older laser called a... more


I'm 54 and getting lots of freckles on my shoulders. Sun damage, I guess. Which laser would be best to lessen those freckels? Is it expensive to get the whole shoulder area treated?

The most cost effective, efficient laser for this would be the laser cousin - an Intense Pulsed Light system.    Doing a light peel on the area about 1-2 weeks before the laser, would help... more


my face don't have much melasma but after I try fraxel lazer my face show more melasma. I want to ask if fraxel lazer do make melasma worse thank you
This is a good question!  Despite prior small studies indicating that the Fraxel laser might improve melasma, that has not always been true.  Unfortunately, the Fraxel laser like all other... more

-------------------------------------------------------------- Dear Dr. Irwin, I am 20 years old and my skin in general is in a good state. Though I have noticed a big, light brown spot in my bikini zone. It's about two thumbnail sized, flat and with a slightly dry skin on it. I am not sure how long has it been there, since it is an awkward place and it doesn't hurt. What do you think could it be? it's not a spot that has been exposed to a lot of sun.
I think you should have this looked at by your primary doctor or a dermatologist. It's not worth the risk to wait because of the small possibility it could be an early melanoma.  Melanoma,... more

What is the best treatment for facial brown spots and age spots, aside from Laser treatments?

There really aren't any fabulous treatments for this problem, if you eliminate the laser option.  I think that's why there are so many of us frustrated with this issue.  Despite all the... more


Hi i have been using 6%hydroquinone to try to resolve my post inflammatory hyperpigmentation post laser i have been using it for six months and it does not seem to be working any suggestions?

You will definately need a good dermatologist to help you with this!!  Assuming you are already seeing one, it might be time to consider whether you may be one of those people who gets... more


What is your take on IPL vs. Yag lasers for removing PIH brown spots on cheeks of face? Thanks for any suggestions.

There are different YAG  lasers so it really depends on which it is.  Most of the YAG lasers in use now are designed for hair removal and not particularly good for brown spots (lentigines)... more


Brown Spot on the Cheek

Posted in Brown Spots on Jul 04, 2009 | Permalink

I have a big brown freckle on my cheek. I tried epi???? but it did not work. What can I do next?

I'm going to assume that you've had your doctor look at this to make sure it isn't a skin cancer!  Did your doctor try freezing it very lightly (1-2 seconds) with liquid nitrogen? Sometimes... more


Brown spots on the legs

Posted in Brown Spots on Jun 25, 2009 | Permalink

I have had my sun spots laser off my legs, with great result. But I still have some brown spots where the gentle laser does not help. They look like a sun/age spot but with dry patch of skin on top. What are these spots and can I get rid of them. Thank you, Kathy

Hi Kathy -  Without seeing these, I can only give you some general guidelines.  Usually if small brown spots are completely flat (not raised and no texture) they are a freckle (lentigo)... more


Brown spots on the face and melasma I'm Hispanic and have hormonal brown spots it looks like I have a mask on my face. Will laser treaments work for me?

I'm so glad you asked about this now since this is the worst time of year for everyone for these hormonal brown blotches (melasma).    A Fraxel laser (the original one, not the carbon... more


Lasers and Pigment

Posted in LasersBrown Spots on May 29, 2009 | Permalink

1. I work with lasers and I release that when a laser is targeting brown spots the langerhan cells in the immune system will asborb them since the laser has destroyed them. The immune system will absorb the cells just like white bllod cells do in the body. My question is will the immune systen in the skin also absorb a cell that is dead from damage from free radicals or will it go throught the whole kertinization phase. I would think that the immune system would take care of the dead cells before kertinization since langerhan cells absorb the brown cells filed with melanin that have been damaged by the laser . 2. How effective are the home-use photo-rejuvenation devices (like Omnilux New-U, DPL System, and LightStim) for wrinkles and hyperpigmentation? Worth the money?

1.   I think it's great that you're thinking about how lasers work!  It shows you're really thinking about what you do and trying to understand as much as you can.  Remember though that... more


Acne Spots and Sunscreens

Posted in Brown SpotsAcne on May 07, 2009 | Permalink

Hello. Thank you for this site. I've had acne and pitted acne scar/pigmentation issues my whole life. Currently, Ive finally gone back to a dermatologist to see if I can try something new. I'm on what is triluna essentially (6% hydrocortisone/.5% retin a/kojic acid/cortisone temporarily and so far I feel like Im seeing more spots. I feel this has to do with my sunscreen application. Even though I use a physical blocker and reapply every 2 hours, I made the mistake initially of using a sunscreen that get deactivated when also used with mineral makeup. (no one ever told me.) I refer to your site quite a bit and I think I'll buy the color science powder and the 48 sunscreen and layer every day but, wouldnt this mean that i'd have to wash my face every 2 hours in order to reapply the new layer of sunscreen and powder sunscreen?

Okay -  these are good questions.  First of all, no one and I repeat no one should have to reapply sunscreen every two hours unless you're a professional surfer and you are spending all... more


I have a a large brown spot on my upper arm, that resulted from a sun burn, or perhaps someone was using a mirror near by as I felt the burn locally. I have tried IPL treatments several times, as well as a "hot" laser treatment once, with little or no effect. A few days ago I noticed a bluish tinge to it. Touching it very lightly resulted in the bursting of a blood vessel burst leaving a larger hematoma with a bump. I applied ice and the area flattened. I hope the bruise will go away in a few weeks. I have been applying Arnica which has helped in the past for bruising. Did the IPL treatments weaken the veins and thus indirectly cause this to happen. Should I avoid additional laser treatments? People are often staring at the spot or ask me what happened. Is there another treatment to try? I also have many sun spots on the tops of my thighs from living in a tropical country in my early 20s. I am afraid to try IPL on those. Would a chemical peel help? Many thanks in advance for your advice. Robbie

Robbie - thank you for writing because you bring up some good points.  You may have done this already so forgive me if you have but..........    For everyone out there, every single unusal... more


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