One need not look far back to find examples of how our beauty ideals (and regimens) have changed throughout the ages. During the Elizabethan era, popular practice saw women pluck their hairlines to achieve the higher forehead associated with aristocracy. Unibrows were all the rage in ancient Greece, with women painting in the area between their eyes to achieve a fuller look. Closer to home, survivors of the 80s and 90s sought everything from Christie Brinkley’s bronzed tan, to Brooke Shields’ famous brows. And yet, despite this flux across time and culture, there has been one consistent pursuit—an even, clear complexion.
If you’re one of the many women (or men) who suffer from dark spots or pigmentation problems, you understand all too well what we’re talking about. With a number of unappealing pseudonyms (including age spots, sun spots, and granny warts) the two main types of brown spots are known medically as solar lentigines, and seborrheic keratosis[c]. Flat in appearance, these spots are typically darker in colour (black, brown or tan) and are found mostly on the face, chest, hands and shoulders; but sometimes also appear on the back and neck. These brown spots can affect women of all ages and walks of life, but are more common after the age of fifty, and in paler complexions.
If you’re on a mission to successfully treat your brown spots, you would be well served to understand a little bit about how exactly your skin works. The largest organ in the body, our skin has three main layers: the epidermis, the dermis, and the hypodermis. To put it in easy to understand terms, think of your skin’s layers like a segment of peach. [d]The rosy blushed ‘skin’ is the epidermis, or outermost layer, while the dermis is the thick middle section of fruit, and the hypodermis or basal layer is the pit. In the epidermis we can find the two main types of cells responsible for producing brown spots—keratinocytes and melanocytes. Accounting for up to 95% of cells in this layer, if keratinocytes sound familiar, it may be because they produce keratin, a structural protein commonly found in hair-care products. Among other functions, keratinocytes are our first line of defense against UV radiation.
Melanocytes on the other hand, are melanin-producing cells found (among other places) in the deepest part of our epidermis. After exposure to UV radiation, such as when we sunbathe, these melanocytes produce melanin in a process called melanogenesis[e]—which is what leads our skin to become tanned. Widely known as the primary determinant of skin colour (as well as hair and eye colour), melanin plays a significant role in the formation of brown spots and skin discolouration. One example is that localized concentration of melanin in the skin leads to the formation of freckles and moles.
We often forget there are parts of our body typically exposed to a significantly higher amount of UV rays on a regular basis—our face (we will include the neck and décolleté by extension), and our hands. Think about that for a moment, and what it might mean if you were to tally up your accumulated lifetime total of sun exposure (this includes tanning beds). A proportional increase in melanogenesis follows an increase in our exposure to UV-B radiation—leading to brown spots, skin discolouration and other effects of photoaging. Interestingly, the purpose of melanogenesis is to protect the hypodermis from damaging UV-B light—the very thing we purposely expose ourselves to when we tan.
“Skin Integrity Is Compromised By Air Pollution.” This was the shocking title of a study recently published in the Journal of Investigative Dermatology[f]. One of the first large-scale studies to look at the effects of air pollution on skin, it demonstrated a solid link between chronic exposure to traffic-related air pollution with the formation of dark spots on the skin. Although the most pronounced changes were observed on the cheeks of Asian women over the age of 50, the overall effects were nothing short of astonishing. Over the long term, pollution can also lead to secondary skin conditions such as eczema (dermatitis) that often exacerbate the look of brown spots, and further complicate treatment.
Excessive picking at blemishes, an improper cleansing routine, not using an SPF when you’re outdoors, and not extending your skin care to your neck, chest and hands can all make their own contribution to dark spots on the skin. Acne scars in particular can cause disruptions in the skin’s pigmentation, leading to darker spots further down the road.
Hormonal shifts experienced largely during pregnancy and menopause, as well as while taking birth control pills, can present a significant shift in the body’s production of melanin. During pregnancy, for example, levels of estrogen rise; which stimulates melanin production—often causing hyperpigmentation[g]. Also known as melasma, these dark patches appear mostly on the forehead, upper lip, cheeks and chin. Sun exposure can trigger (or worsen) melasma, and genetics are also a factor, but the exact cause is not known. More common among darker skin types, melasma occurs in around 40% of Southeast Asian women[h]. Although different from brown spots, melanin plays a pivotal role in both and treatment is usually the same.
With the number of causative factors in brown spots, it should come as little surprise that the most effective treatment requires a multi-pronged approach. So if you’re serious about seriously improving your skin, check out these tips from the experts.
The very first step in banishing your brown spots for good is to look into reverse aging treatments. High-quality skin care products may produce results, but you will not eradicate brown spots with these alone. Therefore, laser and light skin treatments are an absolute must.
Essentially a laser skin resurfacing treatment, BBL™ Photofacial is an intense pulse light treatment for brown and red spots—whether from rosacea, acne scars or brown spots—and requires no downtime. A series of 3 to 5 treatments over the course of a couple of months is most common, although patients benefit tremendously from the treatment being highly customizable to their own unique needs.
For those who can tolerate a little bit more downtime, Halo™ Hybrid Fractionated Laser is an excellent option. Essentially, Halo™ works as two lasers (fractionated and ablative) in one hand piece. The ablative erbium laser acts to resurface the top layer of skin, while a non-ablative laser works to create minuscule channels deep in the skin that causes the stimulation of collagen.
Fioré Skin Clinic’s medical aesthetician, Suzanne Power, points out that, “I can completely customize the treatment for each patient and decide how deep I want to go on both the ablative and non-ablative lasers. And with Halo™, not only are the sun-damaged brown spots being lifted from the skin, it’s getting resurfaced but plumped as well.”
Particularly with current trends moving towards ever more natural, minimalist makeup and flawless complexions, high quality medical-grade skin care products are a must for anyone who wants to get serious about their skin care. By doing your research and investing wisely in products that are developed specifically for brown spots (like hydroquinone and retinols) you will gain far better results.
Highly developed skin care lines like ZO® Skin Health multitask with a number of powerful ingredients, offering clinically observable results. Retinols feature prominently in this line, particularly among their products designed to combat brown spots and photo-damaged skin. For patients who prefer a gentler approach to hydroquinones, ZO features highly capable alternatives such as their Brightenex™ skin lightening cream. This product has a glucosamine melanin inhibitor which works to prevent the formation of new brown spots.
High quality skin care products are not limited to face creams. Quality sunscreens that block out UVA/UVB and HEV are your first lline of defense against. HEV (also known as high-energy visible light) are light rays that penetrate the skin on its deepest level and come not only from pollution, but includes industrial indoor lights.
ZO™ skin specialist, Ashely Hall, explains how sexy corn–an ingredient found in ZO™ sunscreen products–protects our skin specifically from the HEV rays that penetrate 380-495 nanometres into the skin (a nanometre is 1 thousandth of a millimetre). Specifically the rays that come from iPhones, tablets and smartlights.
Cosmetic dermatologist Dr. Rachael Eckel notes that although UVA is widely accepted as being less carcinogenic, it is 20 times more abundant in sunlight and penetrates the dermal matrix more deeply[i] than UVB. One need not look further than a fascinating case study published in 2012 by The New England Journal of Medicine[j] to see the dramatic effects of photoaging.
In it, a 69 year-old man who had driven a delivery truck for 28 years (thus exposing only the left side of his face to UVA rays through the glass) exhibited two completely different complexions (literally) side-by-side. While the right half of his face was still quite smooth, the left had suffered severe photoaging.
Particularly if you’re looking to advance your skin care routine with medical grade products such as hydroquinones, it is important to do so under the supervision of a specialist. A medical skin care specialist, such as a medical aesthetician, will benefit you in many ways: they can diligently monitor your skin’s improvement, are well-informed and experienced on all laser platforms, and can be on the lookout for any potential adverse effects. No matter how safely you think you’re being; a specialist has an arsenal of tools at their disposal to monitor your skin.
Unfortunately, there is no magic cure for brown spots. Like most things worth having in life, the road to spot-free skin takes time, dedication and patience. By working with a medical skin care specialist and following the steps outlined above, you will give yourself the best fighting chance to regain your former radiance.
At Fioré Skin Clinic, it is our mission to help you love your skin. If you’re interested in speaking with one of our own skin care experts about a possible treatment plan, you can click here for a consultation free of charge.