How Do I Get Rid of Sun Spots and Seborrheic Keratosis?

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.)

Doctor Answers 7

Seborrheic Keratoses should be removed

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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.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Age spots come off nicely with freezing, lasering or burning by your doc.

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Most age spots don't change with OTC creams. They need more aggressive treatment such as freezing, lasering or peeling or burning them off. They will come back later with a lot of sun exposure. Sincerely, David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Please see a board-certified dermatologist

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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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Getting rid of sun spots and seborrheic keratoses

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First, make sure you visit a dermatologist to not only diagnoses all your skin lesions (I can't tell you how many skin cancers I've picked up in people looking to simply "fade brown spots"), but to also treat your lesions in the best way possible, with the least pain, and the least potential for side effects. Medical-grade lasers and other photo rejuvenating devices , as well as deep chemical peels, occasionally electrodesiccation, and medical-grade creams can also be beneficial depending on your skin type, how old the lesions are, whether they are raised etc. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon


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I would encourage you to see your dermatologist to make sure if a biopsy is required prior to any treatment.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Treatment of Brown Spots

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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.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

How to treat sun spots and seborrheic keratoses

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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.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

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.