White spots and sun damage on the arms

Hi Dr Irwin, I have white spots on my arms that my skin specialist has described as reverse freckles, and says nothing can be done about them. Is there anyway of restoring the pigment to these ‘reverse freckles’. My age is 58. I have an olive completion. I appreciate your wonderful website so much, thank you for your expertise and compassion. Donna

You’re so welcome.  I love the questions you all ask, and just when I think I’ve heard them all…..someone comes up with another really great one. 🙂

Well……we know what these white spots are due to – sun damage!!   And it was probably done a long time ago, so the first step in improving these is the high zinc sunscreen that we talk about all the time here at Madison Skin & Laser Center.

The first step: Better sunscreening.

3 facts you don’t know about effective sunscreening:

  1. The SPF (as long as it’s over 30) doesn’t matter.  Ignore it for daily use!  If you’re swimming all day, go for higher and reapply.
  2. Zinc is the ONLY sunscreen ingredient on the market that effectively blocks most UVA.  Titanium does not.  Plus zinc is safer for you and the environment.  Look for sunscreen between 10-20% if your arms are exposed.  Less is ok for daily wear, especially in winter.
  3. Sunscreen companies don’t want you to look at the ingredients.  They will say “Zinc” on the front but when you turn the bottle/tube over – you’ll often see that they put in very little.  Look at the back!

5 Tips for evening up white spots, uneven skin tone and blotchiness on the arms:

  1. If the blotches are darker and big, not “freckley,” start with a prescription bleaching cream with hydroquinone per your doctors instructions OR a prescription plant based lightening cream twice a day for 3 months first.
  2. Sunscreen or covered every day a per above.   These two things start to ramp down the cells (melanocytes) that are creating the uneven pigment.
  3. IPLs, also called photorejuvenation, also called broadband…. do NOT work well for this ….and often leave patients striped on the arms due to the way the filters are shaped.
  4. Fraxels DO work well for this problem because one wavelength (the 1927 nm) helps even up the brown/white pattern and the second wavelength (1550 nm) helps to retexture and facilitate pigment cell migration (melanocytes) back into the white areas.  This is assuming you’re going to a great center where they have the skills/knowledge.  And that  you are working to keep light off the area you’re trying to improve. 🙂  You could also try a series of baby Fraxels (also called Clear & Brilliant) you’d just need more treatments.
  5. Fractionated CO2 is NOT as good for this because there is no setting that is great for pigment problems.   It’s more for tightening and retexturing wrinkles and scars.
Hope this helps,
Dr. BI
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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