Written by Dr. Ringpfeil
Aside from wrinkles, brown spots are one of the most obvious signs of sun-damaged and aging skin. Over the years, they accumulate and mottle the skin on our faces, chests, and hands. Let us help you regain the youthful, flawless skin clarity you once had with our diverse array of leading edge procedures and products.
“Brown spots” is a broad term used for any brown lesion on the skin. In fact, there are several different types of benign brown lesions that can occur on sun-exposed skin, such as solar lentigines, ephelides, and seborrheic keratoses. Solar lentigines, commonly referred to as “sun spots,” and ephelides, better known as “freckles,” are similar in appearance and both affected by UVA light exposure. It is believed that solar lentigines are caused by UVA light, while ephelides are caused by genetics and only darkened by UVA light. Seborrheic keratoses are brown growths that affect the uppermost layer of the skin and are often seen in conjunction with sun damage. Their etiology is not well understood.
Although these lesions are benign, removal for cosmetic reasons is possible. It is also important to note that, because all of these brown spots are affected by the sun, proper sun protection is paramount in preventing their development and prolonging treatment results.
Our practice offers a variety of treatments for brown spots to provide you with options that match your scheduling and financial needs. Treatment is determined by the type and number of brown spots present. We utilize topical products, chemical peels, light treatments, laser treatments, and surgical procedures to help you attain your desired results. Treatments are indicated only with commitment to tan prevention and UVA ray protection.
Topicals agents such as hydroquinone, arbutase, kojic acid, azelaic acid, and vitamin C can help to fade brown spots and even skin tone. We carry many products with these ingredients in our office and often create customized compounds for our patients that attack the specific characteristics of their brown spots. Prices available in office.
The Melanage Skin Lightening System is the most effective chemical peel for reduction of unwanted skin pigment. This system, consisting of a superficial peel and an at-home skin care kit, is a great option when a large amount of brown spots are present. In addition to improving skin pigment, the system promotes skin turnover, which provides the added benefit of reduction of fine lines. For more information about the Melanage Skin Lightening System, please see our Chemical Peels page.
A series of glycolic acid peels can reduce the appearance of brown spots by exfoliating the superficial layer of the skin. They involve little downtime or discomfort. Glycolic acid peels are most effective when used in combination with microdermabrasion treatments, which also exfoliate the skin. For more information about glycolic acid peels, please see our Chemical Peels page.
$100 per peel or $500 for 6 peels/ $120 per microdermabrasion or $500 for package of 6
Intense pulsed light treatment, commonly referred to as “IPL,” delivers high intensity light into the skin to destroy both vascular and pigmented lesions. It is a great option when immediate improvement in overall skin clarity is desired. IPL is performed as a field treatment rather than focally to individual brown spots. Therefore, it is not the most effective treatment option for brown spot reduction. Still, decent improvement in overall skin pigmentation and clarity can be noted after a series of IPL treatments. The procedure involves minimal discomfort and causes the skin to be pink for a few days after the treatment.
$295 full face/$195 hands/$325 forearms.
Photodynamic therapy is an in-office procedure that can reduce the appearance of brown spots and improve overall skin clarity and texture. After a photosensitizing agent is applied to the skin and allowed to incubate for 30-60 minutes, the area is exposed to visible red and blue light for 10-15 minutes. This light exposure stimulates the photosensitizing agent to destroy the sun-damaged cells. Some discomfort may be experienced during this part of the procedure. Afterwards, redness, peeling, and sometimes swelling are prominent for 24 hours, then gradually diminish over several days. The skin cannot be exposed to sun or fluorescent light for the first 48 hours after the procedure. About 2-3 treatments performed 4-6 weeks apart is needed for desired results. Photodynamic therapy provides better brown spot reduction than CO2 or Pixel laser treatments.
$500 full face/$300 per additional location on same day.
The Candela Gentlelase Alexandrite laser is the most effective treatment option for individual brown spots. Just 1-3 treatments performed 4-6 weeks apart will provide desired results. The laser is attracted to dark pigmentation and therefore, targets each brown spot directly. The treatment causes the brown spot to flake off, which can take up to 2 weeks. The treated areas will appear darker until the brown spot completely falls off. Coverage with makeup is only difficult when flaking is present on the day of the procedure and the eighth day after the procedure.
$105 for first spot and $20 each additional spot/$400 full face/$600 full chest/$300 hands.
Picosure laser treatments are a great option when a large number of brown spots are present and no downtime can be afforded. The laser shatters pigment with extremely short pressure waves. The small pigment particles are then cleaned up by our immune system. The treatment causes pinkness on the skin that resolves after several hours. A short series of treatments performed every 4-6 weeks is necessary for desired results.
$500 full face/$300 hands or neck.
CO2 laser and Pixel laser can improve the appearance of brown spots, but are typically reserved for full skin resurfacing and skin tightening. Both procedures involve downtime.
Pixel $500 per area/CO2 $500-3000.
Surgical intervention is the best treatment option to remove seborrheic keratoses. Curettage, a shave removal technique performed under local or topical anesthesia, provides the best cosmetic results. The growth is gently scraped away, which creates a wound on the skin that must be cared for with daily application of Vaseline or Aquaphor for one week after the procedure. Cryosurgery, or treatment with liquid nitrogen, is another option to remove seborrheic keratoses. It is topically applied or sprayed onto the growth. The growth then becomes flaky and falls off within days after the procedure. Surgery is not used to treat solar lentigines or ephelides.
$130 first spot and #65 each additional spot.
Use of a broad spectrum (UVA/UVB) sunscreen with SPF 50 or higher on a daily basis is the most effective way to prevent sun spot formation and the best way to prolong your treatment results. We recommended Anthelios Mineral Sunscreen SPF 50, available in our office.