Buh-Bye, Dark Spots

Follow docs' top advice for dealing with brown patches, sun spots, and more.

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It almost seems like it happens overnight. As you stare in the mirror one morning, you notice a patch of skin on your face that looks a little…darker. Is it a freckle? Is it an age spot? Is it your bathroom lighting? Dark spots happen when skin cells called melanocytes produce excess pigment, usually because of too much sun exposure. After enough damage, those cells keep churning out pigment, even when you're no longer in the sun. Up pops a spot.

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Wear sunscreen and problem solved, right? It's not so simple. Recent research suggests that other factors — the polluted air around us, the lighting in our homes and offices — can also make melanocytes go haywire. 

"This means our skin is more vulnerable to spots than we thought, and it's not enough just to protect yourself from the sun," says Patricia Farris, MD, a clinical associate professor of dermatology at Tulane University Medical Center in New Orleans. So what can you do? First step: Learn what causes discoloration. Then follow our pro-approved plan to get even and stay that way.

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Why You're Seeing Spots

Identify the culprits so you can stop new ones from cropping up.

You're surrounded by lots of light.

The sun's UV rays are the number one offender, but experts now say that other kinds of light, including infra red rays (what we experience as heat from the sun) and visible light (from indoor fluorescent lights, computers, smartphones, and TV screens) can also rev pigment production. 

"Infrared light penetrates deeply into skin, prompting cell damage," says Dr. Farris. Your skin responds by cranking out more pigment, especially if you have a darker complexion, new research shows. (You can protect yourself against both wavelengths — more on that later.)

You live in an urban jungle.

Head's up, city-dwellers! Women who were exposed to a lot of traffic-related pollution had 20 percent more dark spots on their forehead and cheeks than those who weren't, says a study in the Journal of Investigative Dermatology. It's concerning news, since more than 80 percent of us in this country now live in larger cities. 

"Researchers think that the exhaust from cars and industry releases nanoparticles tiny enough to penetrate the skin," says Zoe Draelos, MD, a consulting professor of dermatology at Duke University in Durham, NC. Those particles may damage pigment-making cells, leading to spotting. 

Your hormones are acting up.

Any boost in estrogen or progesterone that you get from birth control pills, hormonal IUDs, hormone replacement therapy, or during pregnancy can result in patchy, grayish-brown discoloration across your face or above your upper lip when you go out in the sun. It's a condition known as melasma

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"Some women will even get dark patches when they're menstruating," says Dr. Draelos. Pigment cells usually calm down once you stop using the Pill or after you've given birth. If switching your birth control method isn't an option, sun protection is especially crucial, she says.

You've been roughing up your skin.

Have you ever popped a monster pimple or plucked a brow hair only to be left with a dark spot that lingers for months? It happens when skin cells produce extra melanin because of inflammation, a reaction that's more common in darker skin tones, says Farris. Anything that irritates skin — acne, aggressive exfoliation, plucking hairs, insect bites, and skin services such as laser treatments — can leave brown marks. Some of them may fade, but it can take months. Read on for solutions that will speed up the process.

Your Plan for Even Skin

These simple steps will send your spots packing (you'll fight wrinkles and brighten skin, too).

Take a Topical Approach

Brightening treatments work either by breaking down existing pigment or throwing a wrench into some part of the pigmentation process so new spots never hit the surface. The most effective ingredient, say our derms: hydroquinone. Smooth it on in the morning to block the main enzyme that amps up pigment, says Dana Sachs, MD, professor of dermatology at the University of Michigan. Try:

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1. Ambi Fade Cream ($6, drugstore.com). At night, use a cream with anti-agers such as retinol and peptides. "Retinol speeds up cell turnover to fade spots on the surface, and peptides shut down the pigment-making process," says Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York. We like

2. StriVectin Advanced Retinol Intensive Night Moisturizer ($112, Macy's), which combines retinol with copper tripeptides, found in your body naturally. (Once spots fade, stop using hydroquinone, but continue using that retinol to keep 'em gone.) A one-and-done option: prescription Tri-Luma, which combines a retinoid, hydro quinone, and a mild topical steroid. With all topical treatments, it can take up to four months to see a change.

Step Up Sunscreen

For spots, some screens trump others. Our experts recommend a zinc oxide-based product (with at least SPF 30) like:

 3. SkinMedica Total Defense + Repair Broad Spectrum Sunscreen SPF 34 ($65, skin medica.com)

4. EltaMD Skin Care UV Daily Broad-Spectrum SPF 40 ($20, dermstore.com)

5. Mineral Fusion SPF 30 Brush-On Sun Defense ($20, mineralfusion.com

Why is zinc better than chemical sunscreens when it comes to spot prevention? "It protects against the full light spectrum, including UVA and UVB rays, as well as infra red and visible light," says Farris. Plus, says Draelos, zinc reflects the sun's rays while chemical sunscreens absorb them and convert them to heat within the skin, which can lead to more spots. So make zinc part of your daily skin-care routine — because you might be super diligent with the treatment products, but just one day outside without SPF could bring you back to square one.

Wear your antioxidants.

Even the best sunscreen can't shield your skin from pollution — that's where antioxidants come in, says Farris. These products stop free radicals (unstable molecules that can damage skin cells) before they can cause problems, whether they're brought on by light or pollution, she says.

Dermatologists like tried-and-true skin defenders such as vitamins C and E, resveratrol, ferulic acid, and niacinamide. If you can get a few of them in one bottle, even better: Studies have shown that antioxidants are more potent when cocktailed together. Two good options: 

6. SkinCeuticals C E Ferulic Combination Antioxidant Treatment ($162, skinceuticals.com

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7. Ole Henriksen Truth Serum Collagen Booster ($48, Sephora)

Exfoliate — but gently.

Can you possibly scrub off spots? To some extent, yes, says Draelos: "When you exfoliate, you scrape off the dead surface cells that contain pigment, so those spots will appear lighter." Before you go at your face with a Brillo pad, remember that rough scrubbing can lead to skin inflammation and more dark patches. Use a soft touch: Slough once weekly with an alpha hydroxy acid such as glycolic or fruit acid (not scratchy fruit pits or granules). Try:

8. Paula's Choice Skin Perfecting 8% AHA Gel ($28, paulaschoice.com)

If your skin is too sensitive for acids, use your basic cleanser with disposable textured cotton rounds or a washcloth, says Draelos. "That way, you can control how hard you rub."

Go pro.

Stubborn spots? It's time to turn the treatment up a notch. Your dermatologist can do an in-office chemical peel to give skin a deep exfoliation and slough off spots. "In my practice, we do a series of three to seven peels spaced out every two to four weeks," says Dr. Sachs. The cost is typically around $200 per treatment. "If you want even faster results, that's where lasers can be effective," she adds. "They destroy pigment." 

The PicoWay recently received FDA approval for pigmented spots on all skin types (newsy because some lasers can actually cause more spots in darker skin tones). The brown spot will darken and then, after a couple of days, flake off. The price of each session ranges between $450 and $750 and should treat your entire face. Most women require one or two, spaced three to four weeks apart. And that, ladies, is how you get out those damned spots.

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