Over the last 1-2 years, I have developed two brown patches under my eyes, one large patch on my forehead and one on the top of my nose. After being told this may be caused by starting oral contraceptives 2 years ago, I stopped taking them about 6 months ago but not have seen the brown patches fade. I'm 29 and don't get much sun except an annual cruise and I always wear a hat and sunscreen on those trips. I wear an SPF15 sunscreen moisturizer every day. What are these, and is there anything I can do to get rid of them?
Treatment for Facial Brown Spots?
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Doctor Answers 10
Help is available for facial brown spots
This is likely due to the increase in estrogen along with the sun exposure. This is melasma and is difficult to treat, but not impossible.
The least invasive way to treat brown spots is with skin bleachers like hydroquinone. A relatively new modality is Trilumina, which contains additional agents and is more effective.
Finally, skin peels like the Vi peel, often in conjunction with microdermabrasion, may be effective. You may need to try several different modalities and several treatments.
Keep out of the sun, use the strongest sun blocks you can get, and wear big brim hats (look for clothing that is rated for sun blocking).
You likely have melasma...
...but since there are numerous conditions that can mimick melasma, I suggest you be evaluated by your local dermatologist.
Melasma, a genetic and hormone-related condition is worsened by sun exposure. I would advise a daily moisturizer with SPF 30 or greater. Another great alternative containing a tinted cover-up make-up and zinc oxide is a product called Colore Science Sunforgettables, available online.
Besides strict sun protection, other interventions that can help:
1. hydroquinone ("bleaching" creams)
2. light chemical peels such as Jessners, sal acid and 10% TCA
3. Intense Pulsed Light ("photofacial")
4. Fraxel re:fine or re:store lasers.
The caveat is that if your melasma is successfully treated with any or a combination of these treatments, it tends to come right back if you do not protect yourself from the sun.
Likely benign hyperpigmentation areas or benign growths
Have a dermatologist or plastic surgeon take a look. First be sure that the areas are not abnormal growths that require biopsy and treatment to prevent spread or turning into something worse.
Likely there is no medical concern. If not, the hyperpigmentation spots can be from inflammation, hormones, sun exposure, age or heredity. Treatment methods include various chemical peels, liquid nitrogen, bleaching creams and various intense pulsed light/laser systems from miminally invasive to ablative.
Most important is that with any treatment, prevention of recurrence is essential, through the use of sunblock (SPF 30+ is better) and various bleaching creams on an ongoing basis to prevent post-inflammatory (after any treatment that involves controlled "wounding" of the skin) hyperpigmentation.
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I find that chemical peels in combination with bleaching creams like Triluma work well for your condition (melasma), however the recurrence rate is high. I recommend SPF 30 every day on the face. Lasers also help, however I find peels and bleaching creams to be as effective (in most cases) and much more cost effective.
Melarase AM and PM for Sun spots, melasma, hyperpigmentation and skin darkening
Treatment includes topical creams, IPL, avoidance of the sun, and discontinuation of exogenous estrogen.
I would recommend the Melarase AM and Melarase PM creams as a starter.
Based on your description is sounds like you may have melasma. Melasma is very common especially in women and is usually triggered by hormonal contraception or pregnancy. However, once it develops it probably won't remit even if you stop your contraception. We don't understand a lot about it in terms of why it happens and how it happens. It's a condition that will improve with treatment but does flare with sun exposure and maybe even heat. Topical lightening agents, tretinoin and chemical peels are the typical ways we treat it. Laser can be helpful but should be used with caution since it can flare melasma.
CLEAR & BRILLIANT and the PERMEA is a revolutionary, gentle laser skin care treatment, clinically proven to fight the effects of aging skin. The laser is a safe, non-surgical option with little-to-no downtime after treatments. Skin tone and texture is noticeably improved after each treatment and best of all, it is safe for all skin types and the treatment of melasma.
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Treatment for Facial Brown Spots
1) A good sunscreen is a must - we prefer a broad spectrum at least 50 SPF for South Florida
2) Core Obagi which includes clear, blender, and Retin A
3) You may also benefit from a combination laser resurfacing treatment/intense pulse light (such as Halo Laser and BBL/ipl).
Consult with 3 experienced and expert board certified physicians to understand your options.
Treating Facial Brown Spots
One of the most effective ways to reverse the effects of chronic sun damage to your skin is by using a combination of two prescription strength medications: tretinoin cream and 4% hydroquinone. Unlike the unsubstantiated claims made by over-the-counter skin care products, the results of using these creams are backed by real medical science. We recommend the Obagi Nu-Derm System which uses both tretinoin cream and hydroquinone to visibly lighten age spots as well as the fine lines and wrinkles that are due to chronic sun exposure.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.