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When a patient comes in that has sun spots, I have several different tiers of approaches in that case. I like to protect the patient's pocketbook, so we try to go with the cheaper options first. Usually, we try to use a lightening cream. I've pulled away from calling it a bleaching cream, because people think that bleaching cream means that it's going to take the normal pigment out of your skin giving you a Michael Jackson-type of appearance. But that's not the case. We're just lightening the dark spots. So the extra pigment that's there, we're working on that. So that's probably the least expensive approach. I usually do a trial of two months of that first to see how much improvement we can get.
Aside from that, then you can look into lasers as well, as options. IPL, if they have sunspots. If they have melasma, that's a little bit of a different beast. You have to be very careful with that. You definitely don't want to use IPL which is Intense Pulse Light in those types of cases, because that can actually make things worse.
There are some other topical agents that I would use across the board like an anti-oxident serum which can also help with sun spots and pigmentation. There's a lot of new products now such Elure, Lytera, that use agents which are "natural" to remove pigment from the skin of plant sources and other sources that can add some additional benefits.
That's not going to happen. We're just taking the dark spots that you have -- this is your normal skin -- trying to bring them to a more even playing field. We're not going to take your own skin and kind of bring it down. That's not going to happen.