A couple of years ago, I had IPL (Elos) done on my brown spots and Seborrheic Keratosis. There was no improvement. The marks really annoy me and affect my confidence. I have tried various creams (Nimue, Simplicite) to no avail. I am seeing a dermotologist in a month's time. Do you have any suggestions on what products I can use and anything I should ask the dermotologist? What are your feelings on Hydroquinone and is it a steroid? (The photo submitted is serborheic kerotosis. I couldn't load the rest of the brown spots.)
How Do I Get Rid of Sun Spots and Seborrheic Keratosis?
Doctor Answers 7
Seborrheic Keratoses should be removed
It is in your best interest to have your dermatologist treat this and make sure it is not a lesion that requires a biopsy prior to treatment.
The best method to definitively eliminate seborrheic Keratoses is to remove them. This can be accomplished by several different methods but in any event it will likely result in a wound which requires time to heal (usually 3-5 days). Hydroquinone does not treat these because the piogment is not melanin but heaped up layers of dead skin protein (keratin). Various treatments ranging from least invasive to most include medications (retin-a longterm), chemical peels, topical liquid nitrogen, IPL, laser resurfacing, and shave excision or dermabrasion.
Once treated it is important to remain on a medical regimen of retin-A or exfoliative medications as well as sunblock/screen to prevent recurrence. Occasionally, steroids are utilized to minimize or treat post-inflammatory hyperpigmentation.
Age spots come off nicely with freezing, lasering or burning by your doc.
Please see a board-certified dermatologist
The size of the seborrheic keratosis suggests to me that a biopsy should be done to confirm the benign nature of this lesion prior to any further cosmetic treatments. Please see a board-certified dermatologist. This is not meant to alarm you but is the most prudent course to follow. If it is confirmed to be benign, then freezing with liquid nitrogen can be done but they may induce permanent lightening in that area. Microdermabrasion or dermabrasion (sanding) can be done, or several chemical peels might improve the appearance. Hydroquinone usually does not improve the brown color of a seborrheic keratosis.
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Getting rid of sun spots and seborrheic keratoses
I would encourage you to see your dermatologist to make sure if a biopsy is required prior to any treatment.
Treatment of Brown Spots
First off, see a board-certified dermatologist to evaluate all of these brown spots and make sure that there is nothing else going on ... like a type of skin cancer. The likelihood is low, but still better to evaluate and make sure that none of these are the begining of skin cancer (e.g. lentigo maligna).
Second, use a good broad-specturm sunscreen with an SPF of 30 or greater and get in the habit of doing things to decrease your ultraviolet exposure. This will decrease new ones from forming (not the seborrheic keratoses).
Third, treatment options... Some brown spots (e.g. flat discoloration) may respond to topical prescription-strength hydroquinones and retinoids. Also, a series of superficial chemical peels or a single medium-depth chemical peel by an experienced dermatologist could help. Or another alternative might be laser treatment (e.g. Fraxel) or light-based therapy (IPL). Some of the seborrheic keratoses may be most easily treated by light cryotherapy in experienced hands.
How to treat sun spots and seborrheic keratoses
One of the most effective ways to reverse sunspots due to the effects of chronic sun damage to your skin is by using a combination of two prescription strength medications: 4% hydroquinone and tretinoin cream. Prescription strength 4% hydroquinone is not a steroid cream is better than any OTC product for lightening dark spots in the skin. These dark spots are typically due to chronic sun damage so daily use of sunscreens is essential in your treatment. Combining prescription-only tretinoin cream with hydroquinone will make it even more effective. I 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.