If you have not already tried fading creams then I would try them first. It's hard to tell without seeing a photo how severe your pigmentation is, but hydroquinone, kojic acid and arbutin are all brightening ingredients that can help to fade brown spots. Retinol oil can also be effective. At 111SKIN, we offer 1% Retinol oil which is prescriptive strength and highly effective. Make sure you are using SPF (at least 30) on a daily basis to help prevent developing more. Failing that, I find the TCA peel most effective for fading pigmentation and I use Fraxel laser for more aggressive cases.
You can do both. I would recommend Melarase AM and Melarase PM, Melapads, and light chemical peels to help reduce the pigmentation.
Without a picture its impossible to give good advice. We can start with fading creams for melasma and mild sun pigmentation, but adding an AHA can give better results. TCA peels (performed in theatre) can give excellent results, and still remain as one of my favourite procedures. Glycolic peels can work well, certainly if one moves to higher concentrations. Lasers probably work the best, depending on your pigmentation. See a Board Certified dermatologist for all these treatment options, all the bestDr Davin LimLaser and aesthetic dermatologistBrisbane, Australia.
Brown spots or age spots can be a sign of aging or to much sun. I advise all my patients to apply a special moisturizer sunscreen every morning before they go out . I like the revision product which has an SPF of 50 or a special super moisturizer product. We have 3 different skin care modalities that can be applied to reduce brown spots. Glycolic based, hydroquinone based and teaming based products are helpful. We start with the cheapest product first and then try the others as necessary. There is always our 532nm Medlite LASER. Good luck...
Age spots are a common problem and there are several different ways to effectively treat them. In my practice, we often start with the Obagi Nu Derm skin system because it has minimal down time (although in the early stages patients have some redness and peeling) and it is effective. This system has a combination of prescription strength chemicals including Retin-A and acids as well as a fade cream. I have been less impressed the results from using a fade cream alone and it is the combination of the different active ingredients in the Nu Derm system which improves the results over hydroquinone or other lightening agents by themnselves. Superficial glycolic peels can be effective as well although the depth of the peel will determine how fast the areas lighten. The deeper the peel, the longer it takes for the skin to recovery. More aggressive treatment would include deeper peels, and laser resurfacing. The depth once again will relate to the results you will see and how long it will take. A general rule of thumb would be that for treatments like peels and laser, deeper treatments will get rid of the spots faster, take a smaller number of treatments, but will take longer to recover from. I hope this helps. Good luck with your spots!
In my practice, patients with age spots that want minimal downtime treating them have the best results with Obagi Nu Derm skin transformation system.
Obagi Nu Derm is a medical grade skin treatment that is only available at doctor'f offices (plastic surgeons, etc) because it contains components that are prescriptions). Some of the components include a brightening cream ( aka "fade cream"), very mild chemical peel (glycol acid) as well as tretinoin, etc that ultimately rejuvenate the skin thus removing the age spots similar to a very strong TCA chemical peel.