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Facial Color and Texture Issues

Brown spots on face from age and sun damage

Brown spots on the face are essentially sun damage. You may have had them as freckles when you were younger, but they get larger and often darker as you get older.
The first thing to do about brown spots and age spots on the face or hands is to prevent more of them by applying sunscreen daily. Make sure you use a sunscreen that protects you from UVA radiation by having at least 5-10% zinc or titanium. And, wear a hat! You can also try over-the-counter bleaching creams if your age spots are recent and not too dark. The bleaching creams are 2% hydroquinone. There have been some questions raised about the safety of hydroquinones in Europe and the European Union has banned them. Drugstore “bleaching” creams will cost under $50 and take effect in about 30 days. Prescription bleaching creams are usually 4% hydroquinone and will cost under $150, with some insurance plans covering them. Hydroquinones should be used for no more than 3 months unless under the care of a dermatologist.

Bear in mind that continued sun exposure will stimulate the growth of brown spots, so that the bleaching creams will not protect you against the regrowth of brown spots or the development of new ones. There are also plant-based bleaching creams for treatment of brown spots and age spots. These ingredients are ones like arbutin, thymol, and kojic acid, and are less effective than prescription products.

Microdermabrasion and peels are also options for brown spots. A good aesthetician can perform microdermabrasion or a low-strength peel, and these can often give good results as long as the problem is minimal to moderate. Usually a series is needed.

Many patients ask how to get rid of brown spots on the face.  The most effective treatment option for brown spots is a series of laser treatments. This is also, unfortunately, the most expensive. An IPL or a Q-switched YAG laser, for example, can give excellent results. Fractional lasers are a good option for removing brown spots on the face if your problem is more severe or you have wrinkles or acne scars that would also benefit from a fractional laser. A series of five IPL/Photorejuvenation or laser treatments for brown spots is needed, but often an IPL will also reduce any redness, stimulate some mild collagen growth, and add to your skin’s glow. You will need maintenance treatments when brown spots reappear, or once or twice a year.

Brown spots or splotches due to melasma

If your brown spots tend to be larger splotches that appear on the cheeks, jaw line, upper lip, or forehead, they may be due to melasma from pregnancy, oral contraceptives or other hormones. If you think you might have melasma, you should see a dermatologist before trying any treatment of melasma. This can be a tough problem to treat and the sooner you start the better.

Red or broken blood vessels on face

Having redness or broken blood vessels on your face or nose does not necessarily mean that you are an alcoholic, contrary to popular myth. Often people with Celt genes develop redness or even broken blood vessels on the nose and face, but it can happen to anyone. These changes can be caused by rosacea, sun damage, allergies (lots of nose blowing), or even some systemic diseases, like lupus.

You will need a doctor to help you figure out the cause of your redness. If redness is due to rosacea, the first step may be to look at lifestyle changes, like decreasing coffee or red wine consumption.  But there are many effective treatments for rosacea, so see your dermatologist.

If the redness is due to sun damage, or you have rosacea, you may want to consider laser treatments to reduce the enlarged blood vessels or redness. This procedure requires about four to six treatments depending on how much redness you have and how large the area is that needs to be treated. Full face treatments will cost more than just treating your nose. The results are usually excellent.  A series takes 3-6 months to complete, and you will need maintenance treatments once or twice a year.

Redness

Redness is often due to rosacea. If you think you have rosacea or are looking for treatment for rosacea, see our other rosacea treatment options.

The culprit can often be sun damage also. If your red and blotchy skin is due to sun damage, your best option is the IPL or pulsed dye lasers, needing about four to six treatments. The results are usually excellent. It takes about 6 months for the effects to be noticeable, and you will need maintenance treatments once a year.

Remember that if your redness is from rosacea, you’ll need to see a doctor in order to get the redness under control. Also with rosacea, there are no creams that can take away bad redness for anything longer than a few hours. Some people have tried hydrocortisone, and that may have a very temporary effect. But, you do not want to use hydrocortisone for more than a few days.