Age spots, liver spots, sun spots – whatever you choose to call them – are areas of hyperpigmentation and can affect all of us, irrespective of our skin colour.
Sun exposure is the main cause, and when it comes to Melasma – a condition that mostly affects pregnant women or women on the contraceptive pill – hormones are often involved.
Melasma and sun spots are different in the way they present. According to the American Academy of Dermatology melasma “causes brown to gray-brown patches, usually on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip.”
It’s usually diffuse and spread out rather than being a single spot.
The British Skin Foundation says while the exact cause isn’t known, pregnancy or birth control pills can trigger changes that cause melasma. After the pregnancy, when the hormones return to normal, it may resolve on its own. If the contraceptive pill is your problem, speak to your doctor about changing it. Some cosmetics, perfumes and stress may also trigger it or make it worse, according to the Foundation.
Sun spots, or solar lentigo or lentigines, are different. They are usually self-contained areas of darker skin – often on the face, back of the hands or chest – or any areas of high sun exposure. They tend to develop as we age.
Other causes of hyperpigmentation care acne or other types of damage to the skin that can cause what’s known as post-inflammatory hyperpigmentation.
What all of these have in common is that sun exposure – including sun beds or tanning beds, can make the pigmentation spots worse. According to the British Association of Dermatologists (BAD) pigmentation spots, including melasma, usually become more noticeable in the summer and improve during the winter.
As such, it’s not surprising that Harley Street Consultant Dermatologist, Dr Adam Freidmann says the key to avoiding pigmentation issues is staying out of the sun, and if you already have them, it’s doubly important.
“Wear a high SPF sunscreen, wear a broad rimmed hat, long sleeves. Sun exposure can make it worse,” he says.
He recommends a broad spectrum SPF that includes both UVA and UVB coverage – so look for 5 stars and an SPF of 50 in Summer.
He also recommends staying out of the sun during the hottest hours of the day – usually between 10.00 am and 4.00 pm
There are a number of creams on the market that, depending on the severity of the marks may help. If not there are prescription creams and cosmetic treatments.
When it comes to creams, dermatology nurse and clinical director of Clinica Medica in Glasgow, Shirley Nicol, says “treatment involves trying to make the skin tone even, clearing imperfections and leaving the skin flawless.”
Shirley says two ingredients are particularly important when it comes to reducing hyperpigmentation– Vitamin A and a tyrosinase inhibitor which reduces the amount of melanin or pigmented cells that are produced by melanocytes.
Evidence Skincare (ESK) has a range of skin care products designed for pigmentation including its Enlighten. It contains one of the most up-to-date formulations including a tyrosinase inhibitor called 4-n-b resorcinol. It helps reduce the amount of melanin produced by melanocytes so the spots eventually fade away. With all pigmentation treatments patience is required. It make 3 months or so to see a result.
Vitamin C is also an important ingredient to look for as it evens skin tone, and helps prevent sun damage and repair sun damaged skin.
It is especially good for sun damaged skin when it’s combined with Ferulic Acid and Vitamin E.
Before and after treatment with ESK Skincare products.
Dr Penelope Tympanidis is a firm believer in vitamin C and its power to help reverse the signs of sun damage and skin aging. From do it yourself masks with an egg and lemon juice to serums with vitamin C, these can over time help even skin tone.
ESK Skincare have products that are high in Vitamin C and have been shown to be effective when it comes to evening skin tone and reducing pigment spots including its C Forte which has 16% L ascorbic acid and Vitamin E and ferulic acid to boost its sun damaging reversing effects.
It will take time to show results – at least a few months of use – so be patient.
Dr Tympanidis says chemical peels are another treatment that can make a difference as they are able to target deeper layers of the skin where the damage lies.
“Chemical Peeling is the safest and most sophisticated way to actually keep your skin looking healthy. It also addresses most of the skin conditions including acne and melasma,” she says.
Laser treatment is another cosmetic treatment that can be quite effective when it comes to reducing pigmented skin. It is always important to ensure that whoever does these treatments is qualified as lasers can burn and may do more harm than good in the wrong hands.
Prescription treatments that can help include creams that contain hydroquinone. This is only available through a doctor in the UK as, while it is effective in reducing pigmentation and lightening the skin, it has a number of side effects including turning the skin bluish if used incorrectly, and high doses have been associated with cancer in rodent experiments.
Dr Friedmann suggests Tranexamic Acid as also effective, especially for people with melasma. It is a drug in tablet form that was traditionally used for period pain, but it was found that is also had a beneficial effect on hyperpigmentation.
On a positive note, BAD says melasma is not:
If you are concerned about pigment issues, see your doctor because they can help.